Iron comes in two forms: heme iron (from meat and animal products) and non-heme iron (from other sources like vegetables and iron supplements). Non-heme iron used in iron supplements can appear in 3 forms:
- Ferric iron (Fe3+) — This type of iron is less soluble than ferrous iron in an environment when pH is greater than 3. It has to be converted to ferrous iron (Fe2+) so that it can be dissolved and absorbed in the small intestine.
- Ferrous iron (Fe2+) — Ferrous iron is more soluble and easier to absorb than ferric iron. It is frequently used in iron supplements as ferrous sulfate, ferrous gluconate, and ferrous fumarate.
- Carbonyl iron (Fe0) — Carbonyl iron is a pure form of iron that is widely used as a food additive and has been studied for the treatment of iron deficiency anemia.1,2 When ingested, it requires gastric acid from the stomach to become soluble. Gastric acid converts the carbonyl iron to ferrous iron (Fe2+), and once this happens, it is absorbed in the same manner as ferrous iron.1 Because carbonyl iron is dependent upon gastric acid for absorption, it is less toxic and better tolerated than other forms of iron.1,2
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, 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.
- Gordeuk VR, Brittenham GM, McLaren CE, Hughes MA, Keating LJ. Carbonyl iron therapy for iron deficiency anemia. Blood 1986 Mar;67(3):745-752.
Iron Absorption
