Carbonyl Iron Less Toxic and Better Tolerated than Ferrous Iron
Slower to Absorb
With ferrous iron, generally all iron is available for absorption. However, with carbonyl iron, only a small percentage is available for absorption.1,2 The rate at which your body absorbs carbonyl iron depends on the production of gastric acid (which is required to make carbonyl iron soluble), and the balance between the iron being dissolved and absorbed by your intestines. This means that carbonyl iron enters your system much more gradually than other types of iron that can dissolve rapidly.2
Less Toxic than Ferrous Iron
Researchers believe that this slow rate of solubilization minimizes the toxicity of carbonyl iron.1 In fact, studies have shown that carbonyl iron is far less toxic than other forms of iron, even at high doses. Patients taking carbonyl iron can tolerate 10 to 150 times the standard dose of ferrous sulfate iron, while still having nearly the same side effects.1,3
Lower Incidence of Overdose
Lower toxicity can also help prevent iron overdose, a serious concern in households with children. Statistics from the American Association of Poison Control Centers show that when compared with ferrous iron, carbonyl iron is associated with a much lower incidence of accidental overdose or poisoning.4,5 In fact, one study found that between 1985 and 2002, 19 deaths were reported for children who ingested ferrous sulfate, while none were reported for carbonyl iron.5
Important Safety Information
WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. KEEP THIS PRODUCT OUT OF THE REACH OF CHILDREN. In case of accidental overdose, call a doctor or poison control center immediately.
Warning
Folic acid alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient.
Precautions
Administration of Drug- General: Take 2 hours after meals. Do not exceed recommended dose. Discontinue use if symptoms of intolerance appear. The type of anemia and underlying cause or causes should be determined before starting therapy with Ferralet® 90 tablets. Ensure Hgb, Hct, reticulocyte count are determined before starting therapy and periodically thereafter during prolonged treatment. Periodically review therapy to determine if it needs to be continued without change or if a dose change is indicated. This product contains FD&C Yellow No. 5 (tartrazine) which may cause allergic type reactions (including bronchial asthma) in certain susceptible persons. Although the overall incidence of FD&C Yellow No. 5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity.
- Folic Acid: Folic acid in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurological manifestations remain progressive. Pernicious anemia should be excluded before using these products since folic acid may mask the symptoms of pernicious anemia.
- Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
- Geriatric Use: Dosing for elderly patients should be cautious. Due to the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy, dosing should start at the lower end of the dosing range.
This material is intended to provide basic information. Patients should discuss all medical advice, diagnosis, and treatment with their healthcare provider.
Please see full Prescribing Information
- Gordeuk VR, Brittenham GM, McLaren CE, Hughes MA, Keating LJ. Carbonyl iron therapy for iron deficiency anemia. Blood 1986 Mar;67(3):745-752.
- Brittenham GM, Klein HG, Kushner JP, Ajioka RS. Preserving the national blood supply. Hematology Am Soc Hematol Educ Program. 2001:422-32.
- Gordeuk VR, Brittenham GM, Hughes M, Keating LJ, Opplt JJ. High-dose carbonyl iron for iron deficiency anemia: a randomized double-blind trial. Am J Clin Nutr. 1987 Dec;46(6):1029-34.
- Ferronyl iron [Internet]. ISP Corp; 2005 Oct [accessed 2008 Apr 8]. Available at: http://www.ispcorp.com/products/pharma/content/brochure/ferronyl/.
- Manoguerra AS, Erdman AR, Booze LL, Christianson G, Wax PM, Scharman EJ, Woolf AD, Chyka PA, Keyes DC, Olson KR, Caravati EM, Troutman WG. Iron ingestion: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2005;43(6):553-70.
Iron Absorption
