Dosing & Uses
Dosage Forms & Strengths
tablet
- 45mg (Feosol)
- 66mg (Ircon)
oral suspension
- 15mg/1.25mL (Icar Pediatric)
tablet, chewable
- 15mg (Icar Pediatric, Wee Care)
tablet with vitamin C
- 100mg iron/250mg vitamin C (Icar C)
Dietary Iron Supplement
Doses expressed as elemental iron unless otherwise noted
19-50 years old:
Male: 8 mg PO qDay
Female: 18 mg PO qDay
Pregnant female: 27 mg PO qDay
Lactating female 9 mg PO qDay
>50 years old: 8 mg PO qDay
Iron Deficiency Anemia
300 mg PO q12hr; may increase to 300 mg q6hr or 250 mg ER PO q12hr
Note: Dose expressed as ferrous sulfate
Prophylaxis of Iron Deficiency
300 mg PO qDay
Note: Dose expressed as ferrous sulfate
Dosage Forms & Strengths
tablet
- 45mg (Feosol)
- 66mg (Ircon)
oral suspension
- 15mg/1.25mL (Icar Pediatric)
tablet, chewable
- 15mg (Icar Pediatric)
tablet with vitamin C
- 100mg iron/250mg vitamin C (Icar C)
Dietary Iron Supplement
Doses expressed elemental iron unless otherwise noted
0-6 months old: 0.27 mg PO qDay (adequate intake)
7-12 months old: 11 mg PO qDay
1-3 years old: 7 mg PO qDay
3-8 years old: 10 mg PO qDay
8-12 years old: 8 mg PO qDay
>12 years old: Same as adult
Severe Iron Deficiency Anemia
Mild to Moderate Iron Deficiency Anemia
3 mg/kg PO qDay or divided q12hr
Prophylaxis
Lower doses of 10-50 mg elemental iron/day recommended may cause fewer GI adverse ements
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (14)
- baloxavir marboxil
carbonyl iron 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.
- ciprofloxacin
carbonyl iron decreases levels of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- demeclocycline
carbonyl iron decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- doxycycline
carbonyl iron decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- eltrombopag
carbonyl iron 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
carbonyl iron decreases levels of fleroxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- gemifloxacin
carbonyl iron decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- levofloxacin
carbonyl iron decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- minocycline
carbonyl iron decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- moxifloxacin
carbonyl iron decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- mycophenolate
carbonyl iron 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
carbonyl iron decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- oxytetracycline
carbonyl iron decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- tetracycline
carbonyl iron decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
Monitor Closely (33)
- aluminum hydroxide
aluminum hydroxide will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- calcium carbonate
calcium carbonate will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- cimetidine
cimetidine will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- deferasirox
deferasirox decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferasirox chelates iron.
- deferiprone
carbonyl iron 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.
- deferoxamine
deferoxamine decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferoxamine chelates iron.
- delafloxacin
carbonyl iron 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 carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- didanosine
didanosine will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. 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
- esomeprazole
esomeprazole will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- famotidine
famotidine will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ibandronate
carbonyl iron 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 carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- lansoprazole
lansoprazole will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- levodopa
carbonyl iron 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
carbonyl iron decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate administration by 4 hours.
- liothyronine
carbonyl iron decreases levels of liothyronine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- methyldopa
carbonyl iron decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- nizatidine
nizatidine will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- omadacycline
carbonyl iron 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 carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- pantoprazole
pantoprazole will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- penicillamine
carbonyl iron 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.
- rabeprazole
rabeprazole will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sarecycline
carbonyl iron 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.
- sodium bicarbonate
sodium bicarbonate will decrease the level or effect of carbonyl iron 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 carbonyl iron 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 carbonyl iron 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 carbonyl iron 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 carbonyl iron 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. .
- thyroid desiccated
carbonyl iron decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- trientine
trientine, carbonyl iron. 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.
- vonoprazan
vonoprazan will decrease the level or effect of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
Minor (8)
- calcium acetate
calcium acetate decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
carbonyl iron increases levels of calcium acetate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - calcium carbonate
calcium carbonate decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
carbonyl iron increases levels of calcium carbonate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - calcium chloride
calcium chloride decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
carbonyl iron increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - calcium citrate
calcium citrate decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
carbonyl iron increases levels of calcium citrate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - calcium gluconate
calcium gluconate decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
carbonyl iron increases levels of calcium gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - gymnema
gymnema decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- manganese
carbonyl iron decreases levels of manganese by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- vitamin E
vitamin E decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
Adverse Effects
>10%
Constipation
Diarrhea
Nausea
Epigastric pain
Dark stools
Vomiting
Dark stools
Frequency Not Defined
Hemosiderosis (during long-term administration of large amounts)
Urine discoloration
Dental stain by some formulations
Heartburn
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
Hypersensitivity
Hemochromatosis, hemolytic anemia or anemia not associated with iron deficiency
Peptic ulcer, regional enteritis, ulcerative colitis
Cautions
Do not take within 2 hr of oral tetracycline antibiotics
Not for use in patients receiving frequent blood transfusions
Avoid in premature infants until their deficient vitamin E stores at birth are replenished
Avoid administering iron for >6 months except in patients with continuous bleeding or menorrhagia
May cause increased red cell hemolysis & hemolytic anemia in infants with low serum vitamin E concentrations
Pregnancy & Lactation
Pregnancy Category: Not available
Lactation: Excreted in 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.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)
Absorption: 5-13% (20-30% during deficiency)
Excretion: Sweat, urine, menses, sloughing of intestinal mucosa
Administration
Oral Administration
For maximum absorption take on empty stomach, but may take with or after meals to minimize GI irritation
Some formulations contain vitamin C; vitamin C may enhance absorption
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