Sideroblastic anemia medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nazia Fuad M.D.


The medical therapy for sideroblastic anemia include pyridoxine, thiamine and follic acid. For iron overload iron chelators are used.

Medical Therapy

Non pharmacologic and general measures

The following measures are used to treat sideoblastic anemia.[1][2]

  • Avoid alcohol
  • Avoid zinc supplements
  • Remove toxic agents
  • Blood transfusion
    • Blood transfusion can treat anemia but carries the risk of iron overload.
  • Phlebotomy

Pharmacologic measures


  • Folic acid
    • Preferred regimen: Adults 0.4mg PO once daily
    • Preferred regimen: Pediatric: 1 mg/day IV/PO/IM/SC initially, then 0.1-0.4 mg/day
  • Pyridoxine
    • Preferred regimen: Adults: Aminoxin 2.5-10 mg, PO,once daily
    • Preferred regimen: Pediatric: Aminoxin 0.1-1.2 mg I/M once daily
  • Thiamine
    • Preferred regimen: Adults: 50mg PO once daily
    • Preferred regimen(1): Pediatric: 10-25 mg IV/IM qDay
    • Preferred regimen(2): Pediatric: 10-50 mg PO qDay for 2 weeks, then 5-10 mg/day PO for 1 month

Iron chelators

  • Used in patietns having iron overload to remove toxic iron from tissues.
    • Preferred regimen(1): Adults: Desferal 0.5-1g I/M daily
    • Preferred regimen(2): Adults: Desferal 20-40mg/kg/day SC over 8-24 hours with portable pump providing continuous mini-infusion
    • Preferred regimen(1): Pediatric: Desferal SC 1-2g (20-40mg/kg/day) SC over 8-24 hours by small portable pump
    • Preferred regimen(2): Pediatric: Desferal IV, 40-50mg/kg/day over 8-12 hours for 5-7 days/ week,maximum, < 60mg/kg/day and an IV infusion rate of <15mg/kg/hr)


  1. Fujiwara T, Harigae H (December 2013). "Pathophysiology and genetic mutations in congenital sideroblastic anemia". Pediatr Int. 55 (6): 675–9. doi:10.1111/ped.12217. PMID 24003969.
  2. 2.0 2.1 Mason DY, Emerson PM (February 1973). "Primary acquired sideroblastic anaemia: response to treatment with pyridoxal-5-phosphate". Br Med J. 1 (5850): 389–90. PMC 1588335. PMID 4691061.