Hemolytic Anemia Medication

  • Author: Paul Schick, MD; Chief Editor: Emmanuel C Besa, MD   more...
 
Updated: Aug 8, 2011
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications in patients with hemolytic anemia. Treatment is specific to the type of hemolytic anemia. For example, corticosteroids are usually the first line of treatment in autoimmune hemolytic anemia but are seldom effective in pediatric cold agglutinin disease.

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Vitamins

Class Summary

Vitamins are essential for normal DNA synthesis and the formation of a number of coenzymes in many metabolic systems.

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Folic acid (Folacin-800)

 

Folic acid is a cofactor for enzymes involved in production of red blood cells. Administered folic acid replenishes depleted folate stores consumed during chronic hemolysis.

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Corticosteroids

Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. These agents modify the immune response of the body to diverse stimuli.

Glucocorticoids, such as prednisone, are usually the first line of treatment in autoimmune hemolytic anemia (AIHA). Consult a hematologist to individualize therapy and determine whether other forms of therapy are indicated in the treatment of AIHA. Taper glucocorticoids very gradually to avoid a relapse of hemolysis.

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Prednisone

 

Prednisone inhibits phagocytosis of antibody-covered red blood cells. This agent is indicated in some hemolytic disorders such as AIHA.

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Iron Salts

Class Summary

Iron therapy is contraindicated in most hemolytic anemias. However, iron therapy is indicated for patients with severe intravascular hemolysis in which persistent hemoglobinuria has caused substantial iron loss.

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Ferrous sulfate (Feosol, Fer-In-Sol, MyKidz iron 10)

 

Ferrous sulfate is the most common and inexpensive form of iron used. Tablets contain 50-60 mg of iron salt. Other ferrous salts are used and may cause less intestinal discomfort because they contain a smaller dose of iron (25-50 mg). Oral solutions of ferrous iron salts are available for use in pediatric populations.

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Contributor Information and Disclosures
Author

Paul Schick, MD  Emeritus Professor, Department of Internal Medicine, Jefferson Medical College of Thomas Jefferson University; Research Professor, Department of Internal Medicine, Drexel University College of Medicine; Adjunct Professor of Medicine, Lankenau Hospital

Paul Schick, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Society of Hematology, International Society on Thrombosis and Haemostasis, and New York Academy of Sciences

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Ronald A Sacher, MB, BCh, MD, FRCPC  Professor, Internal Medicine and Pathology, Director, Hoxworth Blood Center, University of Cincinnati Academic Health Center

Ronald A Sacher, MB, BCh, MD, FRCPC is a member of the following medical societies: American Association for the Advancement of Science, American Association of Blood Banks, American Clinical and Climatological Association, American Society for Clinical Pathology, American Society of Hematology, College of American Pathologists, International Society of Blood Transfusion, International Society on Thrombosis and Haemostasis, and Royal College of Physicians and Surgeons of Canada

Disclosure: Glaxo Smith Kline Honoraria Speaking and teaching; Talecris Honoraria Board membership

Chief Editor

Emmanuel C Besa, MD  Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Clinical Oncology, American Society of Hematology, and New York Academy of Sciences

Disclosure: Nothing to disclose.

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Polychromasia.
Spherocytes. One arrow points to a spherocyte; the other, to a normal RBC with central pallor.
Schistocytes (thrombotic thrombocytopenic purpura).
Peripheral blood smear with sickled cells at 1000X magnification. Image courtesy of Ulrich Woermann, MD.
Supra vital stain in hemoglobin H disease that reveals Heinz bodies (golf ball appearance).
 
 
 
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