ferrous fumarate (Rx, OTC)

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Brand and Other Names:Feostat, Ferro-Sequels, more...Hemocyte, Nephro Fer, Palafer

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablets

  • 63mg (20mg Fe)
  • 324mg (106mg Fe)
  • 325mg (106mg Fe)

tablet extended release

  • 150mg (50mg Fe)
more...

Iron Deficiency, Chronic Hemodialysis with Erythropoietin Treatment

150-200 mg Fe (elemental iron)/day PO; may administer 60-100 mg elemental iron q12hr or up to 60 mg elemental iron q6hr

Prophylaxis of Iron Deficiency

60-100 mg Fe (elemental iron)/day PO

Administration

For maximum absorption take on empty stomach, but may take with or after meals to minimize GI irritation

Vitamin C may enhance absorption

Dosage Forms & Strengths

tablets

  • 63mg (20mg Fe)
  • 200mg (66mg Fe)
  • 324mg (106mg Fe)
  • 325mg (107mg Fe)

tablet extended release

  • 150mg (50mg Fe)
more...

Iron-deficiency Anemia, Treatment

3-6 mg Fe/kg/day qDay or divided q8hr PO 

Iron-deficiency Anemia, Prophylaxis

1-2 mg Fe/kg/day qDay or divided q8hr PO ≤15 mg/day 

Recommended Daily Allowance

Males >10 years old: 12 mg/day Fe PO

Females >10 years old: 15 mg/day Fe PO

Administration

For maximum absorption take on empty stomach, but may take with or after meals to minimize GI irritation

Vitamin C may enhance absorption

Lower doses of 15-50 mg elemental iron/day recommended may cause fewer GI adverse ements

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Interactions

Interaction Checker

and ferrous fumarate

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            Adverse Effects

            Frequency Not Defined

            Dizziness

            Headache

            Nausea

            Constipation

            Urine discoloration

            Stomach cramping

            Dark stools

            Heartburn

            Diarrhea

            Esophagitis

            Gastrointestinal discomfort

            Gastrointestinal hemorrhage, perforation (rare)

            Dental staining

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            Warnings

            Black Box Warnings

            Severe iron toxicity may occur in overdose, especially when ingested by children.

            Nonintentional iron overdose is the leading cause of fatal poisoning in children younger than 6 years. Keep out of reach of children

            Contraindications

            Hemochromatosis, hemosiderosis, hemolytic anemia (unless iron-deficient state is also present)

            Hypersensitivity

            Cautions

            Do not administer oral iron with parenteral iron

            Absorption may be hindered by antacids containing Al or Mg

            <6 years: Overdose is highly toxic

            Prophylactic Palafer CF during pregnancy should be discontinued at term & switched to Palafer (or other iron supplements) post-parturition

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            Pregnancy & Lactation

            Pregnancy Category: not available

            Lactation: enters breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Replacement of iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin

            Pharmacokinetics

            Onset: 3-10 days (reticulocytosis); 2-4 weeks (hemoglobin values increase)

            Protein bound: Serum transferrin

            Excretion: Sweat, urine, menses, sloughing of intestinal mucosa

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
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            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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