Intravenous Iron Use in Older Adults

Purpose: Iron deficiency (ID) is common in older adults and is associated with adverse clinical outcomes. Oral iron is often limited by poor absorption and gastrointestinal intolerance. The current article reviews considerations for intravenous (IV) iron therapy in older adults with ID. Method: To review IV iron efficacy, safety, and practical use in older adults. Results: IV iron effectively restores iron stores; improves hemoglobin, functional status, and quality of life; and reduces transfusion requirements. Comorbidities, such as chronic kidney disease, heart failure, and gastrointestinal disorders, frequently necessitate IV iron therapy. Risks include allergic reactions, infusion reactions, hypophosphatemia, and transient hypotension, although serious adverse events are rare. Therapy should be individualized based on comorbidities and practical considerations. Conclusion: IV iron is a safe and effective option for older adults, offering reliable and rapid repletion when oral iron is ineffective or contraindicated. Clinicians must weigh benefits and risks to optimize outcomes.