ferrous fumarate (Rx, OTC)

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

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

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

tablet extended release

  • 150mg (50mg Fe)

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

Dosage Forms & Strengths

tablet

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

tablet extended release

  • 150mg (50mg Fe)

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 aged >10 years: 12 mg/day Fe PO

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

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

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Interactions

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              Serious - Use Alternative (13)

              • baloxavir marboxil

                ferrous fumarate 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

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

              • doxycycline

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

              • eltrombopag

                ferrous fumarate 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

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

              • gemifloxacin

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

              • levofloxacin

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

              • minocycline

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

              • moxifloxacin

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

              • mycophenolate

                ferrous fumarate 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

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

              • oxytetracycline

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

              • tetracycline

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

              Monitor Closely (38)

              • aluminum hydroxide

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

              • bictegravir

                ferrous fumarate 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 ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cimetidine

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

              • ciprofloxacin

                ferrous fumarate decreases levels 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.

              • deferasirox

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

              • deferiprone

                ferrous fumarate 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 ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferoxamine chelates iron.

              • delafloxacin

                ferrous fumarate 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 ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • dolutegravir

                ferrous fumarate 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.

              • esomeprazole

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

              • famotidine

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

              • green tea

                green tea, ferrous fumarate. 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

                ferrous fumarate 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 ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • lansoprazole

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

              • levodopa

                ferrous fumarate 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

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

              • liothyronine

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

              • methyldopa

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

              • mifepristone

                mifepristone decreases effects of ferrous fumarate by pharmacodynamic antagonism. Use Caution/Monitor. Backup contraceptive method recommended.

              • nizatidine

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

              • omadacycline

                ferrous fumarate 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 ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • pancrelipase

                pancrelipase decreases levels of ferrous fumarate by enhancing 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 ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • penicillamine

                ferrous fumarate 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 ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sarecycline

                ferrous fumarate 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 ferrous fumarate 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 ferrous fumarate 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 ferrous fumarate 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 ferrous fumarate 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 ferrous fumarate 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 ferrous fumarate 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.

              • thyroid desiccated

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

              • trientine

                trientine, ferrous fumarate. 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 (11)

              • acetohydroxamic acid

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

              • calcium acetate

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

                ferrous fumarate 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 ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                ferrous fumarate 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 ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                ferrous fumarate 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 ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                ferrous fumarate 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 ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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

              • carbidopa

                ferrous fumarate 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 ferrous fumarate 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 ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • manganese

                ferrous fumarate 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 ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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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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              Administration

              Oral Administration

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

              Vitamin C may enhance absorption

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              ferrous fumarate oral
              -
              324 mg (106 mg iron) tablet
              Ferrocite oral
              -
              324 mg (106 mg iron) tablet
              Ferretts oral
              -
              325 mg (106 mg iron) tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              ferrous fumarate oral

              IRON SUPPLEMENTS - ORAL

              WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children younger than 6 years. Keep this product out of reach of children. If overdose does occur, seek immediate medical attention or call a poison control center.

              USES: This medication is an iron supplement used to treat or prevent low blood levels of iron (such as those caused by anemia or pregnancy). Iron is an important mineral that the body needs to produce red blood cells and keep you in good health.

              HOW TO USE: Follow all directions on the product package, or take as directed by your doctor. Do not take more than the recommended dosage. If you have any questions, ask your doctor or pharmacist.Iron is best absorbed on an empty stomach (usually if taken 1 hour before or 2 hours after meals). If stomach upset occurs, you may take this medication with food. See the instructions below for the liquid drops for infants/children. Avoid taking antacids, dairy products, tea, or coffee within 2 hours before or after this medication because they will decrease its effectiveness.Take tablets or capsules with a full glass of water (8 ounces or 240 milliliters) unless otherwise directed by your doctor. Do not lie down for at least 10 minutes after taking your tablet or capsule dose.Swallow extended-release capsules whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.If you are taking chewable tablets, chew the medication thoroughly, then swallow.If you are taking a liquid suspension form of this medication, shake the bottle well before each dose.If you are taking the liquid form for adults, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Mix the dose in a glass of water or juice, and drink the mixture through a straw to prevent staining the teeth.If you are giving the liquid drops to an infant or child, use the dropper provided to carefully measure the dose. The dose may be placed directly into the mouth (towards the back of the tongue) or it may be mixed in formula (not milk), fruit juice, cereal, or other food as directed to increase your child's acceptance. It is best to give this medication right after a meal. Follow the directions on the product package for the brand that you use.Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day.

              SIDE EFFECTS: Constipation, diarrhea, stomach cramps, or upset stomach may occur. These effects are usually temporary and may disappear as your body adjusts to this medication. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.Iron may cause your stools to turn black, an effect that is not harmful.If your doctor has prescribed this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before taking this medication, tell your doctor or pharmacist your medical history, especially of: iron overload disorder (e.g., hemochromatosis, hemosiderosis), use/abuse of alcohol, liver problems, stomach/intestinal problems (e.g., ulcer, colitis).If your brand of iron supplement also contains folic acid, be sure to tell your doctor or pharmacist if you have vitamin B12 deficiency (pernicious anemia) before taking it. Folic acid may falsely improve certain laboratory tests for vitamin B12 deficiency without actually treating this anemia. Untreated vitamin B12 deficiency may result in serious nerve problems (for example, peripheral neuropathy symptoms such as numbness/pain/tingling sensations). Consult your doctor or pharmacist for details.Chewable tablets of this medicine may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to restrict your intake of aspartame (or phenylalanine), consult your doctor or pharmacist about using this drug safely.Liquid preparations of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.This product can decrease the absorption of other drugs such as bisphosphonates (for example, alendronate), levodopa, penicillamine, quinolone antibiotics (for example, ciprofloxacin, levofloxacin), thyroid medications (for example, levothyroxine), and tetracycline antibiotics (for example, doxycycline, minocycline). Separate your doses of these medications as far as possible from your doses of this product. Ask your doctor or pharmacist about how long you should wait between doses and for help finding a dosing schedule that will work with all your medications.Avoid taking this medication at the same time as antacids. Wait at least 2 hours between taking this medication and an antacid.If your brand of iron also contains folic acid, be sure to tell your doctor or pharmacist if you take certain anti-seizure drugs (for example, hydantoins such as phenytoin).This medication may interfere with certain laboratory tests (e.g., fecal occult blood tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: stomach pain, nausea, vomiting, diarrhea.

              NOTES: If your doctor has prescribed this medication, do not share it with others.Laboratory and/or medical tests (e.g., complete blood count) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.This medication is not a substitute for a proper diet. It is important to maintain a well-balanced diet. Foods rich in iron include red meats (especially liver), fish, beans, dried fruit, and iron-fortified/enriched cereals and bread.

              MISSED DOSE: If you are taking this product on a prescribed schedule and miss a dose, take it as soon as you remember. If it is near the time for the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not freeze liquid forms of this medication. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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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.
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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.