Published: 2016-12-27

Comparative study of safety and efficacy of intravenous iron sucrose and ferric carboxymaltose in the treatment of postpartum iron deficiency anaemia

Alpana Singh, Ramadevi Yerragudi


Background: Anaemia is the most commonly encountered and reversible medical problem during pregnancy and postpartum period. It adversely affects the health of both mother and foetus. Oral iron therapy has many disadvantages-poor compliance and gastrointestinal side effects lead the list. Intravenous iron is an effective alternative in correcting anaemia and restoring iron stores. The objective of this study was to evaluate the safety and efficacy of intravenous iron sucrose and ferric carboxymaltose in treatment of post partum anaemia and compare the rise in Hb% and serum ferritin stores after treatment with IV iron sucrose and ferric carboxymaltose.

Methods: This was a prospective analytical study conducted on 100 postpartum patients in a medical college and research centre in South India. Patients for study were selected from the postnatal ward, having haemoglobin concentration of <10gm/dl and iron deficiency anaemia as the aetiology. All the selected patients were randomly categorized into two groups to receive intravenous iron sucrose and ferric carboxymaltose. The tolerability and side effects of both the injections were noted. Hb% and serum ferritin were repeated 2 weeks and 6 weeks after treatment and results analyzed. 

Results: The increment in Hb% in IV iron sucrose group after 2 and 6 weeks was 9.69±0.49 gm/dl and 11.28±0.53 gm/dl respectively. Ferric carboxymaltose showed 9.8±0.43 gm/dl and 12.22±0.43 gm/dl rise in Hb% at the same time interval. Serum ferritin showed a significant increase in IV ferric carboxymaltose group as compared to IV iron sucrose at 2 and 6 weeks (p=0.049; p=0.023).

Conclusions: Ferric carboxymaltose has a greater safety profile (p) and offers faster elevation of haemoglobin and iron stores with lesser hospital stay as compared to iron sucrose.


Iron sucrose, Ferric carboxymaltose, Postpartum anaemia, Haemoglobin, Ferritin

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Centre for disease control. Criteria for anaemia in children and childbearing aged women. MMWR. 1989;38:400-4.

Pavord S, Myers B, Robinson S, Allard S, Strong J, Oppenheimer C, et al. UK guidelines on the management of iron deficiency in pregnancy. Br J Haematol. 2012;156:588-600.

Kouser S, Kouser S, Malik M, Malik A. Safety and efficacy of intravenous iron therapy in postnatal patients with iron deficiency anemia. J South Asian Fed Obstet Gynaecol. 2011;3(1):25-7.

Perez EM, Hendricks MK, Beard JL, Murray-Kolb LE, Berg A, Tomlinson M, et al. Mother-infant interactions and infant development are altered by maternal iron deficiency anemia. J Nutr. 2005;135:850-5.

Seid MH, Derman RJ, Baker JB, Banach W, Goldberg C, Rogers R. Ferric carboxymaltose injection in the treatment of postpartum iron deficiency anemia: A randomized controlled clinical trial. Am J Obstet Gynecol. 2008;199:435.e1-7.

Breymann C, Gliga F, Bejenariu C, Strizhova N. Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia. Int J Gynaecol Obstet. 2008; 101:67–73.

Breymann C. The Use of Iron Sucrose complex for Anemia in Pregnancy and postpartum period. Semin Hematol. 2006;43(Suppl 6):S28-31.

Patel J, Patel K, Sharma A, Date SK. Comparison of intravenous Iron sucrose and intravenous Ferric carboxymaltose therapy in iron deficiency anemia during pregnancy and postpartum period. J of Pharmaceutical science and Bioscientific research. 2015;5(3):239-43.

Rathod S, Samal SK, Mahapatra PC, Samal S. Ferric carboxymaltose: A revolution in the treatment of postpartum anemia in Indian women. Int J Appl Basic Med Res. 2015;5(1):25-30.

Pfenniger A, Schuller C, Christoph P, Surbek D. Safety and efficacy of high- dose intravenous iron carboxymaltose vs. Iron sucrose for treatment of postpartum anemia. J Perinat Med. 2012;40(4):397 -402.