ferric maltol (Rx)

Brand and Other Names:Accrufer
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 30mg

Iron Deficiency

An iron replacement product indicated for iron deficiency

30 mg PO BID

Continue as long as necessary until ferritin levels are within the normal range

Treatment duration depends on severity of iron deficiency but generally at least 12 weeks of treatment is required

Safety and efficacy not established

Next:

Interactions

Interaction Checker

and ferric maltol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (15)

              • baloxavir marboxil

                ferric maltol will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Human studies not conducted.

              • demeclocycline

                ferric maltol decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • dimercaprol

                dimercaprol increases toxicity of ferric maltol by nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

              • doxycycline

                ferric maltol decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • eltrombopag

                ferric maltol decreases levels of eltrombopag by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Separate by at least 4 hours.

              • fleroxacin

                ferric maltol decreases levels of fleroxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • gemifloxacin

                ferric maltol decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • levofloxacin

                ferric maltol decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • lymecycline

                ferric maltol decreases levels of lymecycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • minocycline

                ferric maltol decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • moxifloxacin

                ferric maltol decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • mycophenolate

                ferric maltol decreases levels of mycophenolate by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Interaction only with oral iron administration.

              • ofloxacin

                ferric maltol decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • oxytetracycline

                ferric maltol decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • tetracycline

                ferric maltol decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              Monitor Closely (71)

              • aluminum hydroxide

                aluminum hydroxide will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • bictegravir

                ferric maltol will decrease the level or effect of bictegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Bictegravir and supplements containing iron can be taken together with food. Routine administration of bictegravir (under fasting conditions) simultaneously with, or 2 hr after, supplements containing iron is not recommended.

              • calcium carbonate

                calcium carbonate will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • carbamazepine

                ferric maltol, carbamazepine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • cimetidine

                cimetidine will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ciprofloxacin

                ferric maltol decreases effects of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Coadministration of ciprofloxacin with multivalent cation-containing products may reduce the bioavailability of ciprofloxacin by 90%. Administer ciprofloxacin at least 2 hours before or 6 hours after using these products. Use alternatives if available.

              • clonidine

                ferric maltol, clonidine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • colchicine

                ferric maltol, colchicine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • cyclosporine

                ferric maltol, cyclosporine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • deferasirox

                deferasirox decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferasirox chelates iron.

              • deferiprone

                ferric maltol decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.

                deferiprone decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferiprone chelates iron.

              • deferoxamine

                deferoxamine decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferoxamine chelates iron.

              • delafloxacin

                ferric maltol will decrease the level or effect of delafloxacin by cation binding in GI tract. Modify Therapy/Monitor Closely. Oral delafloxacin form chelates with alkaline earth and transition metal cations. Administer oral delafloxacin at least 2 hr before or 6 hr after these agents.

              • dexlansoprazole

                dexlansoprazole will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • digoxin

                ferric maltol, digoxin. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • dihydroergotamine

                ferric maltol, dihydroergotamine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • disopyramide

                ferric maltol, disopyramide. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • divalproex sodium

                ferric maltol, divalproex sodium. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • dolutegravir

                ferric maltol will decrease the level or effect of dolutegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer dolutegravir 2 hr (dolutegravir or abacavir/dolutegravir/lamivudine) or 4 hr (dolutegravir/rilpivirine) before or 6 hr after taking medications containing polyvalent cations.

              • enalapril

                enalapril, ferric maltol. Mechanism: unknown. Use Caution/Monitor. Risk of GI symptoms, hypotension.

              • ergotamine

                ferric maltol, ergotamine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • esomeprazole

                esomeprazole will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ethosuximide

                ferric maltol, ethosuximide. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • everolimus

                ferric maltol, everolimus. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • famotidine

                famotidine will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • fentanyl

                ferric maltol, fentanyl. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • fosphenytoin

                ferric maltol, fosphenytoin. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • green tea

                green tea, ferric maltol. Other (see comment). Use Caution/Monitor. Comment: When possible, do not consume green tea or green tea extract within 1 hour before or 2 hours after giving iron salts.

              • ibandronate

                ferric maltol decreases levels of ibandronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • ibuprofen/famotidine

                ibuprofen/famotidine will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • lansoprazole

                lansoprazole will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • levodopa

                ferric maltol decreases levels of levodopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Oral administration of iron salts should be separated from levodopa by at least 2 hours.

              • levothyroxine

                ferric maltol decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                ferric maltol, levothyroxine. Either increases effects of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • liothyronine

                ferric maltol decreases levels of liothyronine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • lithium

                ferric maltol, lithium. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • methotrexate

                ferric maltol, methotrexate. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • methyldopa

                ferric maltol decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • minoxidil

                ferric maltol, minoxidil. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • nizatidine

                nizatidine will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • omadacycline

                ferric maltol will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

              • omeprazole

                omeprazole will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • pancrelipase

                pancrelipase decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Levels of iron salts may decrease with concomitant administration of digestive enzymes.

              • pantoprazole

                pantoprazole will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • penicillamine

                ferric maltol decreases levels of penicillamine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Interaction only with oral iron administration.

              • phenobarbital

                ferric maltol, phenobarbital. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • phenytoin

                ferric maltol, phenytoin. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • pimozide

                ferric maltol, pimozide. Either increases effects of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • prazosin

                ferric maltol, prazosin. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • primidone

                ferric maltol, primidone. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • procainamide

                ferric maltol, procainamide. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • quinidine

                ferric maltol, quinidine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • quinine

                ferric maltol, quinine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • rabeprazole

                rabeprazole will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sarecycline

                ferric maltol will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

              • sirolimus

                ferric maltol, sirolimus. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • sodium bicarbonate

                sodium bicarbonate will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sodium citrate/citric acid

                sodium citrate/citric acid will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                sodium picosulfate/magnesium oxide/anhydrous citric acid decreases levels of ferric maltol by cation binding in GI tract. Use Caution/Monitor. Take at least 2 hours before and not less than 6 hours after administration of sodium picosulfate, magnesium oxide and anhydrous citric acid to avoid magnesium chelation .

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • sodium zirconium cyclosilicate

                sodium zirconium cyclosilicate will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.

              • tacrolimus

                ferric maltol, tacrolimus. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • theophylline

                ferric maltol, theophylline. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • thioridazine

                ferric maltol, thioridazine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • thyroid desiccated

                ferric maltol decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • topotecan

                ferric maltol, topotecan. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • triazolam

                ferric maltol, triazolam. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • trientine

                trientine, ferric maltol. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hr.

              • valproic acid

                ferric maltol, valproic acid. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              • vitamin E

                vitamin E decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • warfarin

                ferric maltol, warfarin. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).

              Minor (10)

              • acetohydroxamic acid

                acetohydroxamic acid decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium acetate

                ferric maltol increases levels of calcium acetate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                calcium acetate decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium carbonate

                ferric maltol increases levels of calcium carbonate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                calcium carbonate decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium chloride

                ferric maltol increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                calcium chloride decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium citrate

                ferric maltol increases levels of calcium citrate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                calcium citrate decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium gluconate

                ferric maltol increases levels of calcium gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                calcium gluconate decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • carbidopa

                ferric maltol decreases levels of carbidopa by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • didanosine

                didanosine will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration

              • gymnema

                gymnema decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • manganese

                ferric maltol decreases levels of manganese by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              Previous
              Next:

              Adverse Effects

              1-10%

              Flatulence (4.6%)

              Diarrhea (4%)

              Constipation (4%)

              Discolored feces (4%)

              Abdominal pain (2.9%)

              Nausea (1.7%)

              Vomiting (1.7%)

              Abdominal pain (1.7%)

              Abdominal discomfort (1.1%)

              Abdominal distension (1.1%)

              Previous
              Next:

              Warnings

              Contraindications

              Hypersensitivity to active substance or to any of the excipients

              Hemochromatosis and other iron overload syndromes

              Patients receiving repeated blood transfusions

              Cautions

              Avoid use in patients with an active inflammatory bowel disease flare, as there is potential risk of increased inflammation in the gastrointestinal tract

              Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children ages ≤6 years; keep this product out of reach of children

              Iron overload

              • Excessive therapy with iron products can lead to excess storage of iron with the possibility of iatrogenic hemosiderosis; do not administer to patients with evidence of iron overload or patients receiving IV iron
              • Assess iron parameters before initiating treatment and monitor during therapy

              Drug interaction overview

              • Oral medications
                • There are no empirical data on avoiding drug interactions between ferric maltol and concomitant oral medication
                • Concomitant use of some oral drugs may reduce bioavailability of iron after ferric maltol administration
                • Separate the administration of ferric maltol from these drugs; duration of separation may depend on the absorption characteristics of the medication concomitantly administered, such as time to peak concentration or whether the drug is an immediate- or extended-release product; monitor clinical response to ferric maltol
                • Coadministration of ferric maltol with some oral medications may also decrease the bioavailability of some drugs
                • For oral drugs for which reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate ferric maltol administration by at least 4 hr; monitor clinical responses to concomitant drugs as appropriate
              • Dimercaprol
                • Coadministration of iron products with dimercaprol may increase the risk of nephrotoxicity
                • Avoid use with dimercaprol
              Previous
              Next:

              Pregnancy & Lactation

              Pregnancy

              Not absorbed systemically as an intact complex following oral administration

              Maternal use is not expected to result in fetal exposure to the drug

              Animal data

              • In animal reproduction studies, oral administration of ferric or ferrous compounds to gravid CD1-mice and Wistar rats during organogenesis at doses 13-32 times the recommended human dose resulted in no adverse developmental outcomes
              • Overdose of iron in pregnant women may carry a risk for spontaneous abortion, gestational diabetes, and fetal malformation

              Clinical considerations

              • Untreated iron deficiency anemia (IDA) in pregnancy is associated with adverse maternal outcomes such as postpartum anemia
              • Adverse pregnancy outcomes associated with IDA include increased risk for preterm delivery and low birth weight

              Lactation

              There are no data on the presence of ferric maltol in human milk, the effects on the breastfed child, or the effects on milk production

              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.

              Previous
              Next:

              Pharmacology

              Mechanism of Action

              Nonsalt, oral formulation of ferric iron

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

              Delivers iron for uptake across the intestinal wall and transfer to transferrin and ferritin

              Absorption

              Dissociates upon uptake from gastrointestinal tract, allowing iron and maltol to be absorbed separately

              Peak plasma time: 1.5-3 hr

              Effect of food

              • Food shown to decrease bioavailability of iron after administration of ferric maltol

              Metabolism

              Maltol is metabolized through glucuronidation (UGT1A6) and sulphation in vitro

              Elimination

              Excretion (maltol): Urine (39.8-60%; as maltol glucuronide)

              Previous
              Next:

              Administration

              Oral Administration

              Take 1 hr before or 2 hr after a meal

              Do not open, break, or chew capsules

              Storage

              Store at 20-25ºC (68-77ºF); excursions permitted to 15-30ºC (59-86ºF)

              Previous
              Next:

              Images

              No images available for this drug.
              Previous
              Next:

              Patient Handout

              A Patient Handout is not currently available for this monograph.
              Previous
              Next:

              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              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.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
              Email to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Email Forms to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Previous
              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.