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Apo-Ferrous Gluconate

Brand Name: Apo-Ferrous Gluconate
Common Name: oral iron (ferrous gluconate, ferrous fumarate, ferrous sulfate)

How does this medication work? What will it do for me?

Ferrous gluconate, ferrous fumarate, and ferrous sulfate belong to a group of medications known as oral iron supplements. Iron is important for the production of red blood cells. It helps red blood cells to carry oxygen to the various parts of the body. When the body does not get enough oxygen due to lack of iron, symptoms such as tiredness, shortness of breath, and learning problems may occur. This is a type of anemia called iron deficiency anemia.

Iron supplements are used to prevent and treat iron deficiency anemia.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed or recommended it.

How should I use this medication?

There are different types of iron preparations that contain different amounts of elemental (pure) iron. For example, 300 mg of ferrous fumarate contains 100 mg of elemental iron (33%), 300 mg of ferrous gluconate contains 35 mg of elemental iron (11.6%), while 300 mg of ferrous sulfate contains 60 mg of elemental iron (20%).

Ask your doctor or pharmacist for help when choosing the recommended amount of iron for your circumstances. To prevent deficiency, dietary intake is preferred over taking iron supplements. Good food sources of iron include red meat, poultry, organ meats, spinach, dried fruits, whole grains, nuts, beans, and clams.

To prevent deficiency the recommended daily intake of iron (including dietary and supplement sources) for adults is 8 mg to 13 mg daily. An additional 5 mg daily is recommended in the second trimester of pregnancy, and an additional 10 mg per day is recommended in the third trimester. For adults who are deficient in iron, 50 mg to 100 mg elemental iron 3 times daily is the recommended intake.

Premature infants who are not receiving iron-fortified formula should receive 2 mg to 4 mg of elemental iron per kilogram of body weight given as a single daily dose or in 2 divided doses. Iron supplementation should begin at the age of 8 weeks and continue until the age of 1 year. The maximum dose is 15 mg daily.

For infants and children with severe iron-deficiency anemia, 4 mg to 6 mg of elemental iron per kilogram of body weight per day is given in 3 divided doses. Infants and children with mild to moderate iron-deficiency anemia should receive 3 mg of elemental iron per kilogram of body weight daily given as a single daily dose or in 2 divided doses. Infants and children who require iron-deficiency anemia prevention should receive 0.5 mg to 2 mg of elemental iron per kilogram of body weight daily. The maximum dose is 15 mg daily.

Iron is best absorbed when taken on an empty stomach with water or fruit juice (adults: full glass or 8 ounces; children: half glass or 4 ounces), about one hour before or 2 hours after meals. However, if stomach upset occurs, lower doses may be given to start with, and the iron can be taken after food.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without talking to your doctor.

It is important to take this medication exactly as prescribed or recommended by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of reach of children, as severe reactions including death have resulted from childhood ingestions.

This medication is available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under "What form(s) does this medication come in?"

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?

Apo-Ferrous Gluconate is no longer being manufactured for sale in Canada. For brands that may still be available, search under oral iron (ferrous gluconate, ferrous fumarate, ferrous sulfate). This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to iron or any ingredients of the medication
  • are receiving iron injections
  • have an anemia other than iron deficiency anemia
  • have conditions known as hemosiderosis or hemochromatosis (iron overload)

Do not give this medication to premature infants with vitamin E deficiency.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • constipation
  • dark stools
  • diarrhea
  • heartburn
  • nausea and vomiting
  • stained teeth (especially with liquids)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abdominal or stomach pain
  • black, tarry stools with signs of blood
  • chest or throat pain when swallowing

Overdose: Taking too much iron can cause the signs and symptoms listed below. If you are concerned that you or your child have taken too much iron, seek immediate medical attention and contact your regional Poison Control Centre. Do not wait for these symptoms to appear.

    Early symptoms of iron overdose

  • diarrhea (may contain blood)
  • nausea
  • severe vomiting (may contain blood)
  • stomach pain or cramping (sharp)

    Late symptoms of iron overdose

  • bluish-coloured lips, fingernails, and palms of the hands
  • convulsions (seizures)
  • drowsiness
  • fast heartbeat
  • pale, clammy skin
  • shallow and rapid breathing
  • unusual tiredness or weakness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Bowel movements: Stools often become dark green or black when iron supplements are taken by mouth. This is harmless. However, in the rare instance that stools have a sticky consistency or red streaks (signs of blood) along with cramping, soreness, and sharp pains in the stomach, contact your doctor immediately.

Stomach and intestines: If you have stomach ulcers, ulcerative colitis, or regional enteritis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Teeth staining: Liquid iron products may stain the teeth. To help prevent staining, mix the dose with water or fruit juice, drink it through a straw and follow each dose with a drink of plain water or juice. Brushing the teeth with sodium bicarbonate (baking soda) or hydrogen peroxide 3% will usually remove existing stains.

Pregnancy: Taking normal daily requirements of iron is safe and needed during pregnancy. To prevent deficiency, the recommended daily intake of iron from dietary and supplement sources is 8 mg to 13 mg daily. An additional 5 mg daily is recommended in the second trimester of pregnancy, and an additional 10 mg per day is recommended in the third trimester. Do not take more than the normal daily requirement unless recommended by your doctor.

Breast-feeding: At normal doses, the amount or iron that passes into breast milk is not enough to affect the baby.

Children: Iron overdose is a common cause of death in children. Keep iron products out of the reach of children and get immediate medical attention in the event of accidental ingestion.

What other drugs could interact with this medication?

There may be an interaction between oral iron supplements and any of the following:

  • antacids
  • bisphosphonates (e.g., alendronate, etidronate, risedronate)
  • calcium supplements
  • chloramphenicol
  • cholestyramine
  • injectable iron
  • levodopa
  • levothyroxine
  • methyldopa
  • penicillamine
  • quinolones (e.g., ciprofloxacin, norfloxacin, ofloxacin)
  • tetracyclines
  • vitamin C

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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