Oral iron supplements

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Hi friends,
I feel glad to share this information with you. This blog will help us to reach out to people and also reminds us of our duty in the society. Hope each of you will make best of this information. This information is taken from USP DI, Volume II, Advice to the patient [1]

Information for the pharmacist:
1. Iron supplements are chelated by acetohydroxauric acid; this may result in reduced intestinal absorption of iron.
2. Concurrent use of alcohol with ferric iron for a prolonged period may result in toxicity since absorption and hepatic storage of iron is increased, especially if alcohol usage is high.
3. Concurrent use of any of the following with iron will decrease iron absorption because of the formation of less soluble or insoluble complexes. Antacid containing carbonates or magnesium tricilicate or coffee or eggs or foods or medication containing bicarbonates, carbonates , oxalates or phosphates or milk or milk products or tea (containing tannic acid) or whole grain breads and cereals (containing phytic acid) and dietary fiber. Iron supplements should not be used within 1 hour before or 2 hours after ingestion of any of the above.
4. Concurrent use of iron supplements with pancreatic or pancrelipase may decrease iron absorption with, pencillamine may decrease the effects of pencillamine, with tetracyclines oral may decrease absorption of tetracycline. Vitamin E impair the hematologic response in patients with iron deficiency anemia.

Information to the patient:
1. Iron is used by your body to make red blood cells.
2. The best way to take oral iron is to take it on an empty stomach, 1 hour before or 2 hours after meals. But if you suffer from stomach upset it may be taken with the food.
3. Take iron with water or fruit juice, a full glass (240ml) for adults, half glass (120 ml) for children, to prevent staining of teeth and to mask taste.
4. Keep iron medications out of reach of children. Overdose is especially dangerous in young children.
5. Oral iron supplements may make your stools a very dark or black colour. This is not usually of any concern.
6. Oral iron supplements may sometimes cause diarrhea or constipation. If this is persistent or troublesome, tell your doctor.

Advice for the patient: Drug information in lay language; USP DI; 1995 15th Edition page nos: 988-989.

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kranthi kumar's picture
Author: kranthi kumar


Niklesh Rao V's picture

Nice info Kranthi. We can also tell about the nutritional sources of iron like liver, yams and many others. Do try to include those too.

Regards, Niklesh Rao V

kranthi kumar's picture

Dear Nik, Thank you for adding up to my blog. I will definately add it to my upcoming blogs.
P.V.ABHIGNA's picture

Kranthi, That was a simple but a very informative blog which was clear in its matter.Thanks for sharing.I'll definitely make people aware of these things. Regards,


kranthi kumar's picture

Dear Abhigna, I am glad to see your comment, especially that your commitment to make people aware of these things. Hope every pharmacist will take this kind of commitment.
Uma Pratyusha's picture

Dear Kranthi, A very nice one but can you say me how the chelation of iron supplements can be avoided?


Uma Prathyusha

kranthi kumar's picture

Dear Uma pratyusha, Good question, here is the answer for that, Chelating of iron is simply iron that has undergone a chemical process that firmly binds the iron molecule to another substance, usually an amino acid or any other specifically some minerals. This can be avoided by following some simple steps like the one Me and Madam has mentioned. Hope you got the answer.
Santosh kumar. JH's picture

Nice Kranthi, Worthy informative page for all those who take Oral Iron supplements...
kranthi kumar's picture

Dear Santosh, Thanks for the comment, hopefully everyone will make the best of this blogs.
Prof. J. Vijaya Ratna's picture

Dear Kranthi We recently participated as pharmacists in a medical camp. We found that the most prescribed medicine is oral iron either as tonic or as cpasules. So I used to ask the students to clearly tell the patients in the following manner: if it given as a once a day dose: 1. Iron is given to you because you are anemic. 2. You must take it regularly as prescribed by your doctor. 3. Take it at night, two hours after your dinner. So take dinner at eight pm and take this tonic at 10 pm. We are asking you to take it two hours after dinner because, if you take it after food , iron will not be absorbed. We are asking you to take it at night because any small discomfort in the stomach will not be noticed by you in your sleep. 4. Do not combine iron with any food or milk or coffee or curd or buttermilk. All these interfere with iron's absorption. 5. Iron may cause some side effects sometimes like headache, or diarrhea. But do not stop the medicine. Tolerate the side effect or take some aspirin for it. But you do need that iron for coming out of anemia, that is why doctor prescribed for you. 6. Before this course is over meet the doctor again. 7. Store this bottle away from children. 8. Do not combine this with any other medicine. take this separately. --------------------------------------- If it is given as twice daily,the different point is; 1. Take this two hours after breakfast and two hours after dinner.
kranthi kumar's picture

Dear Mam, This is really interesting and useful stuff, thank you for adding upto my blog.
Madhuri's picture

hi kranthi, very good and simple presentation. very informative definitely i will tell to the people who are unware of these.


Prof. J. Vijaya Ratna's picture

Dear Kranthi Whenever you get the opportunity, read two journals, American pharmacy and the Pharmaceutical Journal. They contain very good articles on clinical pharmacy related issues. vijaya Ratna

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