Ferrous fumarate

Do not take any vitamin or mineral supplements that your doctor has not prescribed or recommended.

Ask your doctor before using an antacid, and use only the type your doctor recommends. Some antacids can make it harder for your body to absorb ferrous fumarate.

Other drugs may interact with ferrous fumarate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Ferrous Fumarate may be found in some form under the following brand names:

• Anemagen

• Caltrate 600 with Iron and Vitamin D

• Concept OB

• Dialyvite 800 + Iron

• Ed Cyte F

• Equi-Cyte F

• Femiron

• Feogen

• Feostat

• Ferocon

• Ferotrin

• Ferotrinsic

• Ferrimin 150

• Ferro-Sequels

• Ferrocite

• Ferrocite F

• Ferrocite Plus

• Ferrogels Forte

• Fetrin

• Folivan-F

• Foltrin

• Fumasorb

• Fumatinic

• Hemaspan

• Hematogen

• Hemocyte

• Hemocyte Plus

• Hemocyte-C

• Hemocyte-F

• Integra F

• Ircon

• Ircon-FA

• Irofol

• Multigen Plus

• Natelle

• Nephro-Fer

• Nephro-Fer RX

• Nexa Select

• Nexa Select

• Prenatal Rx 1

• PreNexa

• Re Dualvit F

• RightStep

• Tandem

• Tandem F

• Tandem OB

• Tandem Plus

• Vitron-C

Ferrous fumarate is a type of iron. You normally get iron from the foods you eat. In your body, iron becomes a part of your hemoglobin (HEEM o glo bin) and myoglobin (MY o glo bin). Hemoglobin carries oxygen through your blood to tissues and organs. Myoglobin helps your muscle cells store oxygen.

Ferrous fumarate is used to treat iron deficiency anemia (a lack of red blood cells caused by having too little iron in the body).

Ferrous fumarate may also be used for purposes not listed in this medication guide.

You should not use ferrous fumarate if you have iron overload syndrome, or other red blood cell disorders.

• Iron Fumarate

Iron-deficiency anemia: Prevention and treatment of iron-deficiency anemias

Note: Doses expressed in terms of elemental iron; ferrous fumarate contains 33% elemental iron.

Dietary Reference Intake: Oral:

19 to 50 years: Males: 8 mg/day; Females: 18 mg/day; Pregnant females: 27 mg/day; Lactating females: 9 mg/day

≥50 years: 8 mg/day

Iron deficiency anemia, prevention in areas where anemia prevalence is ≥40% (off-label): Oral: Menstruating women (non-pregnant females of reproductive potential): 30 to 60 mg daily for 3 consecutive months in a year (WHO 2016a)

Iron deficiency anemia, treatment of iron deficiency: Oral: 100 to 200 mg daily in 2 to 3 divided doses (Liu 2012; Stoltzfus 1998; WHO 2001)

Note: To avoid GI upset, start with a single daily dose and increase by 1 tablet/day each week or as tolerated until desired daily dose is achieved

Should be taken with water or juice on an empty stomach; may be administered with food to prevent irritation; however, not with cereals, dietary fiber, tea, coffee, eggs, or milk.

Elemental iron content of ferrous fumarate: 33%

Dietary sources of iron include beans, cereal (enriched), clams, beef, lentils, liver, oysters, shrimp, and turkey. Foods that enhance dietary absorption of iron include broccoli, grapefruit, orange juice, peppers and strawberries. Foods that decrease dietary absorption of iron include coffee, dairy products, soy products, spinach, and tea.

Disease-related concerns:

• Gastrointestinal disease: Avoid in patients with peptic ulcer, enteritis, or ulcerative colitis.

Special populations:

• Blood transfusion recipients: Avoid in patients receiving frequent blood transfusions.

• Elderly: Anemia in the elderly is often caused by “anemia of chronic disease” or associated with inflammation rather than blood loss. Iron stores are usually normal or increased, with a serum ferritin >50 ng/mL and a decreased total iron binding capacity. Hence, the “anemia of chronic disease” is not secondary to iron deficiency but the inability of the reticuloendothelial system to reclaim available iron stores.

• Pediatric: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6 years of age. Keep this product out of the reach of children. In case of accidental overdose call the poison control center immediately.

• Premature infants: Avoid use in premature infants until the vitamin E stores, deficient at birth, are replenished.

Other warnings/precautions:

• Duration of therapy: Administration of iron for >6 months should be avoided except in patients with continuous bleeding or menorrhagia.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience diarrhea, constipation, stool discoloration, lack of appetite, or abdominal cramps. Have patient report immediately to prescriber black, tarry, or bloody stools; severe nausea; severe vomiting; severe abdominal pain; or vomiting blood (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.