Mechanism of effect
Replaces iron found in hemoglobin, myoglobin, and enzymes; allows the transportation of oxygen via hemoglobin.
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)
Drug indications
Iron-deficiency anemia
Dosage
Iron-deficiency anemia, prevention in areas where anemia prevalence is ≥40% (off-label use): Oral: Menstruating women (nonpregnant females of reproductive potential): 30 to 60 mg elemental iron/day for 3 consecutive months in a year
Iron-deficiency anemia, treatment: Oral: 65 to 200 mg elemental iron/day .may administer in up to 3 divided doses
Pediatric, ron deficiency, prevention in areas where anemia prevalence is >40%: Oral:
Infants ≥6 months and Children <2 years: 10 to 12.5 mg daily for 3 consecutive months in a year
Children 2 years to <5 years: 30 mg daily for 3 consecutive months in a year
Children ≥5 to 12 years: 30 to 60 mg daily for 3 consecutive months in a year
Adolescent menstruating females (non-pregnant females of reproductive potential): 30 to 60 mg daily for 3 consecutive months in a year
Drug contraindications
Hypersensitivity
Hemochromatosis
Hemosiderosis
Hemolytic anemia
Anemia other than iron-deficiency anemia
Side effects
Constipation, darkening of stools, nausea, stomach cramps, vomiting,Dental discoloration, diarrhea, heartburn,Urine discoloration,Contact dermatitis
Interactions
Iron sucrose , Vitamin E , Fosinopril , Ramipril , Demeclocycline , Dimercaprol , Dolutegravir , Eltrombopag , Dexlansoprazole , Deferiprone , Penicillamine , Levothyroxine , Methyldopa , Levodopa , Trientine , Cefdinir , raltegravir , entacapone , baloxavir marboxil , Bictegravir , Sarecycline , Acetohydroxamic acidAlerts
- Avoid in patients with peptic ulcer, enteritis, or ulcerative colitis
-Avoid in patients receiving frequent blood transfusions
-Avoid use in premature infants until the vitamin E stores, deficient at birth, are replenished
-Administration of iron for >6 months should be avoided except in patients with continuous bleeding or menorrhagia.
-Severe iron toxicity may occur in overdose, particularly when ingested by children
-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
Points of recommendation
-Should be administered with water or juice on an empty stomach
- Immediate release oral iron products are preferred for treatment of iron deficiency anemia; enteric coated and slow/sustained release preparations are not desired due to poor absorption
-Oral absorption variable and incomplete
Pregnancy level
Pregnancy Category: A; pregnant women typically require increased iron ingestion to meet dietary requirements
Breast feeding warning
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
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