Hemolytic Anemia Medication

Updated: Dec 19, 2017
  • Author: Paul Schick, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Medication

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 (AIHA) but are seldom effective in pediatric cold agglutinin disease. Rituximab has been used and can be effective in steroid-resistant AIHA. [33, 46]

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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.

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.

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.

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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