Dosing & Uses
Dosage Forms & Strengths
tablet (Ferate, generic)
- 240mg (27mg elemental iron)
- 324mg (38mg elemental iron)
Iron Deficiency Anemia
Treatment: 60 mg elemental Fe PO q6-12hr
Prophylaxis: 60 mg elemental Fe PO qDay
Recommended Daily Intake
Men: 8 mg elemental Fe PO qDay
Women: 18 mg elemental Fe PO qDay
Pregnant women: 27 mg elemental Fe PO qDay
Lactating women: 9 mg elemental Fe PO qDay
Dosage Forms & Strengths
tablet (Ferate, generic)
- 240mg (27mg elemental iron)
- 324mg (38mg elemental iron)
Iron Deficiency Anemia
Treatment: 3-6 mg elemental Fe/kg/day PO
Prophylaxis: 1-2 mg elemental Fe/kg/day PO; not to exceed 15 mg/day
Recommended Daily Intake
0-6 months: 0.27 mg elemental Fe PO qDay
7-12 months: 11 mg elemental Fe PO qDay
1-3 yr: 7 mg elemental Fe PO qDay
4-8 yr: 10 mg elemental Fe PO qDay
9-13 yr: 8 mg elemental Fe PO qDay
14-18 Years
- Males: 11 mg elemental Fe PO qDay
- Females: 15 mg elemental Fe PO qDay
- Pregnant females: 27 mg elemental Fe PO qDay
- Lactating females: 10 mg elemental Fe PO qDay
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 (13)
- baloxavir marboxil
ferrous gluconate 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 gluconate decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- doxycycline
ferrous gluconate decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- eltrombopag
ferrous gluconate 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 gluconate decreases levels of fleroxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- gemifloxacin
ferrous gluconate decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- levofloxacin
ferrous gluconate decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- minocycline
ferrous gluconate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- moxifloxacin
ferrous gluconate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- mycophenolate
ferrous gluconate 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 gluconate decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- oxytetracycline
ferrous gluconate decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- tetracycline
ferrous gluconate 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 gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- benazepril
benazepril increases toxicity of ferrous gluconate by Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Benazepril may enhance adverse/toxic effects of ferrous gluconate.
- bictegravir
ferrous gluconate 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 gluconate 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 gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ciprofloxacin
ferrous gluconate 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 gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferasirox chelates iron.
- deferiprone
ferrous gluconate 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 gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferoxamine chelates iron.
- delafloxacin
ferrous gluconate 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 gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- dolutegravir
ferrous gluconate 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, ferrous gluconate. Mechanism: unknown. Use Caution/Monitor. Risk of GI symptoms, hypotension.
- esomeprazole
esomeprazole will decrease the level or effect of ferrous gluconate 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 gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ibandronate
ferrous gluconate 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 gluconate 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 gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- levodopa
ferrous gluconate decreases levels of levodopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- levothyroxine
ferrous gluconate decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- liothyronine
ferrous gluconate decreases levels of liothyronine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- methyldopa
ferrous gluconate 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 ferrous gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- omadacycline
ferrous gluconate 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 gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- pancrelipase
pancrelipase decreases levels of ferrous gluconate 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 ferrous gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- penicillamine
ferrous gluconate 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 gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sarecycline
ferrous gluconate 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 gluconate 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 gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferrous gluconate 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 gluconate 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 gluconate 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 gluconate decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- trientine
trientine, ferrous gluconate. 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 ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
Minor (11)
- acetohydroxamic acid
acetohydroxamic acid decreases levels of ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- calcium acetate
ferrous gluconate 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 ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - calcium carbonate
ferrous gluconate 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 ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - calcium chloride
ferrous gluconate 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 ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - calcium citrate
ferrous gluconate 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 ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - calcium gluconate
ferrous gluconate 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 ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - carbidopa
ferrous gluconate 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 gluconate 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 gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- manganese
ferrous gluconate 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 gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
GI irritation
Nausea
Stomach cramping
Staining of teeth
Heartburn
Vomiting
Constipation
Diarrhea
Discoloration of urine
Dark color stools
Warnings
Black Box Warnings
Severe iron toxicity may occur in overdose, particularly when ingested by children; iron is a leading cause of fatal poisoning in children younger than 6 yr; store out of children’s reach and in children-resistant containers
Contraindications
Hypersensitivity
Hemochromatosis
Hemosiderosis
Hemolytic anemia
Anemia other than iron-deficiency anemia
Cautions
Oral absorption variable and incomplete
Avoid with peptic ulcer, enteritis, or ulcerative colitis
Avoid with frequent blood transfusions
Iron stores in elderly are usually normal; anemia of chronic disease often seen in elderly is caused by inability of reticuloendothelial system to use available iron stores
Premature infants with vitamin E deficiency: administration of Fe may cause red cell hemolysis and hemolytic anemia
Pregnancy & Lactation
Pregnancy Category: A; pregnant women typically require increased iron ingestion to meet dietary requirements (see dosing sections)
Lactation: Distributed in breast milk, considered safe for breast feeding; breast milk generally provides enough iron to meet infant nutritional requirement; amount of iron in breast milk typically not influenced by maternal iron status
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
Essential nutrient, component of heme and nonheme iron proteins; ferrous gluconate contains 12% elemental Fe
Pharmacokinetics
Absorption: 10-35% (normal Fe stores); 80-95% (depleted iron stores); food decreases absorption by up to 60%
Onset: 1 week
Excretion: Urine (trace), feces (trace), sweat, sloughing intestinal mucosal cells, menses (women)
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
May administer in divided daily doses q8-12hr
Antacids may interfere with absorption; administer 2 hr before or 4 hr after antacids
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Fergon oral - | 240 mg (27 mg iron) tablet |  | |
| ferrous gluconate oral - | 324 mg (37.5 mg iron) tablet |  | |
| ferrous gluconate oral - | 236 mg (27 mg iron) tablet |  | |
| ferrous gluconate oral - | 324 mg (38 mg iron) tablet |  | |
| ferrous gluconate oral - | 240 mg (27 mg iron) tablet |  | |
| ferrous gluconate oral - | 240 mg (27 mg iron) tablet |  | |
| ferrous gluconate oral - | 324 mg (37.5 mg iron) tablet | | |
| Ferate oral - | 240 mg (27 mg iron) tablet |  |
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