PEBC: What You Need to Know: Oral and Intravenous Iron Supplements

Indication: Treatment of Anemia


Oral Examples: Ferrous Gluconate, Ferrous Sulfate, Ferrous Fumarate, Polysaccharide Iron, Heme Iron

Intravenous Examples: Iron Sucrose, Iron Dextran


Each agent has different amounts of elemental iron.

Gluconate: 35 mg

Sulfate: 60 mg

Fumarate: 100 mg

Polysaccharide: 150 mg

Heme: 11 mg


Oral Dosing:

-Can vary greatly, once to three times daily

-Dividing doses can help with less adverse effects

-Empty stomach has the best absorption, but may be taken with food to reduce GI upset

-vitamin C helps with absorption too

Oral Adverse Effects:

-GI upset including nausea, constipation (drink more water)

-black stools (normal)


IV Adverse Effects:

-Iron overload

-Anaphylaxis (more likely with iron dextran) --> recommend to do a test dose


Oral Drug Interactions: Space Apart Administration

-Antacids: calcium, aluminum --> decreased iron absorption

-Chelators: levothyroxine, fluoroquinolones, cholestyramine, tetracyclines --> decreased iron absorption

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