Oral iron is frequently prescribed in these patients to correct the iron deficiency. The usual practice has been to give oral iron as once-daily dose or in daily divided doses. In what could be described as “practice changing”, a recent trial published in Lancet Haematol. 2017;4(11):e524-e533 has shown that administering iron supplements on alternate days rather than every day and in single doses rather than in divided doses results in greater absorption of iron along with fewer gastrointestinal side effects. Iron absorption is better with alternate day dosing in comparison to daily dose and compliance is also increased. Daily iron supplementation in divided doses increases serum levels of hepcidin and reduces absorption of iron with successive doses. Alternate day dosing is therefore suggested as a preferred mode of iron supplementation.

Patients treated with oral iron for iron deficiency should now be advised to take iron supplements on alternate days rather than daily.