ferrous gluconate (OTC)

Brand and Other Names:Ferate
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Dosing & Uses

AdultPediatricGeriatric

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

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Interactions

Interaction Checker

and ferrous gluconate

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            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.

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              Adverse Effects

              Frequency Not Defined

              GI irritation

              Nausea

              Stomach cramping

              Staining of teeth

              Heartburn

              Vomiting

              Constipation

              Diarrhea

              Discoloration of urine

              Dark color stools

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              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

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              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.

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              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)

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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

              May administer in divided daily doses q8-12hr

              Antacids may interfere with absorption; administer 2 hr before or 4 hr after antacids

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              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

              Copyright © 2010 First DataBank, Inc.

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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.