Iron Supplements

Ferrous Fumarate, Ferrous Gluconate, Ferrous Sulfate

WHY is this medicine prescribed?

Iron (ferrous fumarate, ferrous gluconate, ferrous sulfate) is used to treat or prevent anemia (a lower than normal number of red blood cells) when the amount of iron taken in from the diet is not enough. Iron is a mineral that is available as a dietary supplement. It works by helping the body to produce red blood cells.

HOW should this medicine be used?

Iron supplements (ferrous fumarate, ferrous gluconate, ferrous sulfate) come as regular, film-coated, and extended-release (long acting) tablets; capsules, and an oral liquid (drops and elixir) to take by mouth. Iron is usually taken with food or immediately after a meal once daily or as directed by your doctor. Take iron at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take iron exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Iron supplements are available alone and in fixed-combination with vitamins and certain medications. If your doctor has prescribed a medication that contains iron, you should be careful not to take any other supplements or medications that also contain iron.

Swallow the tablets, film-coated tablets, and extended release tablets whole; do not split, chew, or crush them.

Mix the elixir with water or fruit juice to avoid possible teeth staining; do not mix with milk or a wine-based solutions.

Iron drops come with a special dropper for measuring the dose. Ask your pharmacist or doctor to show you how to use it. The drops may be placed directly in the mouth or mixed with water, breastmilk, cereal, formula, or fruit juice. Dispense gently into mouth towards inner cheek; a small amount will remain in the tip. If you are giving iron drops to a child, read the package label carefully to be sure that it is the right product for a child of that age. Do not give iron products that are made for adults to children.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking an iron supplement,

• tell your doctor and pharmacist if you have previously had trouble tolerating iron products, including ferrous fumarate, ferrous gluconate, ferrous sulfate, any other medications, or any of the ingredients in iron preparations. Ask your doctor or pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• if you are taking certain antibiotics such as doxycycline, minocycline (Dynacin, Minolira, Solodyn, Ximino), and tetracycline, take them 2 hours before or 2 hours after iron supplements.
• tell your doctor if you have a certain type of blood disease such as hemolytic anemia (a condition with an abnormally low number of red blood cells). Your doctor may probably tell you not to take an iron supplement.
• tell your doctor if you have or have ever had ulcers or gastrointestinal bleeding.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking an iron supplement, call your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Iron supplements may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• constipation
• stomach pain
• diarrhea
• nausea
• teeth staining

Iron supplements may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat, and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• stomach pain
• vomiting
• diarrhea

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to iron.

Ask your pharmacist any questions you have about iron supplements.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: February 15, 2022.