carbonyl iron (Rx, OTC)

Brand and Other Names:Feosol (Carbonyl Fe), Icar C, more...Icar Pediatric, Ircon
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Dosing & Uses

AdultPediatricGeriatric

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

4-6 mg/kg PO divided q8hr  

Mild to Moderate Iron Deficiency Anemia

3 mg/kg PO qDay or divided q12hr  

Prophylaxis

1-2 mg/kg PO; 15 mg PO maximum  

Lower doses of 10-50 mg elemental iron/day recommended may cause fewer GI adverse ements

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Interactions

Interaction Checker

and carbonyl iron

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      Serious - Use Alternative

        Significant - Monitor Closely

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            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 (32)

              • 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.

              • 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.

              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.

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              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

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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

              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

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              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.

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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)

              Absorption: 5-13% (20-30% during deficiency)

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

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              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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              Formulary

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