Required for biosynthesis of heme and heme-containing proteins including hemoglobin

Oral therapy: nausea, cramps, constipation, diarrhea

Parenteral therapy: arthralgias, vomiting, back pain, urticaria, bronchospasm, anaphylaxis

Rx: Iron deficiency which manifests as microcytic anemia

Acute Toxicity: (e.g. children who ingest iron tablets) necrotizing gastroenteritis, vomiting, abdominal pain, bloody diarrhea, shock, lethargy, dyspnea

Chronic Toxicity: hemochromatosis, with damage to heart, liver, pancreas, etc.; organ failure and death can ensue

Iron-chelating compound that can bind iron that has already been absorbed and promote its excretion in urine and feces

May cause hypotension

Long term use: acute respiratory distress (infusions), neurotoxicity and ↑ susceptibility to infections

Acute iron poisoning and for inherited or acquired hemochromatosis that is not adequately treated by phlebotomy

Cofactor required for essential enzymatic reactions that form tetrahydrofolate, convert homocysteine to methionine, and metabolize L-methylmalonyl-CoA

Required for amino acid and FA metabolism and DNA synthesis

No toxicity associated with excess vitamin B₁₂

Vitamin B₁₂ deficiency, which manifests as megaloblastic anemia and is the basis of pernicious anemia

Precursor of an essential donor of methyl groups used for synthesis of amino acids, purines, and DNA

Not toxic in overdose

Partially compensates for vitamin B₁₂ deficiency and puts people with unrecognized deficiency at risk for neurologic consequences

Folic acid deficiency which manifests as megaloblastic anemia

Prevention of congenital neural tube defects

Binds to receptors on red cell progenitors; stimulates erythroid proliferation and differentiation and induces the release of reticulocytes from  bone marrow

Darbepoetin = long-acting glycosylated form

Hypertension, thrombotic complications, and very rarely pure red cell aplasia

Anemia, especially anemia associated with chronic renal failure, HIV infection, cancer, and prematurity

Prevention of need for transfusion in patients undergoing certain types of elective surgery

Granulocyte-macrophage colony-stimulating factor (G-CSF)

Stimulates G-CSF receptors on neutrophils and their progenitors: ↑ proliferation and differentiation of neutrophil progenitors, activates phagocytic activity of mature neutrophils and extends their survival, mobilizes hematopoietic stem cells

Bone pain

Splenic rupture (rare)

Neutropenia associated with congenital neutropenia, cyclic neutropenia, myelodysplasia, aplastic anemia

Secondary prevention of neutropenia in patients undergoing cytotoxic chemotherapy

Mobilization of peripheral blood cells for stem cell transplantation

Myeloid growth factor that acts through a distinct GM-CSF receptor to stimulate proliferation and differentiation of early and late granulocytic, erythroid, and megakaryocyte progenitors

More likely than G-CSF to cause fever, arthralgia, myalgia, and capillary leak syndrome (characterized by peripheral edema and pleural/pericardial effusions)

Similar to G-CSF (Filgrastim)

Recombinant Interleukin-11:

activates IL-11 receptors and stimulates growth of multiple lymphoid and myeloid cells including megakaryocyte progenitors; ↑ # of circulating platelets and neutrophils

Fatigue, headache, dizziness, anemia, fluid accumulation in the lungs, transient atrial arrhythmias

Secondary prevention of thrombocytopenia in patients undergoing cytotoxic chemotherapy for nonmyeloid cancers

Genetically engineered protein in which the F_c component of a human antibody is fused to two copies of a peptide that stimulates thromboietin receptors

Idiopathic thrombocytopenic purpura