Iron deficiency: When and why oral iron may not be enough

Use of intravenous iron in children has been limited due to concerns regarding adverse effects. However, newer preparations of intravenous iron have been shown to be effective and associated with fewer side effects in adults as well as in preliminary studies involving children. Indications for intravenous iron might include iron deficiency secondary to dietary causes, blood loss unresponsive to oral iron and situations where oral iron is ineffective, contraindicated or when functional iron deficiency exists. This review will discuss the various preparations of iron available for parenteral administration and the potential indications for their use in children.