Wee Care

Avoid taking carbonyl iron within 2 hours before or 2 hours after you take other medicines. Carbonyl iron can make it harder for your body to absorb other medicines.

Ask a doctor or pharmacist if it is safe for you to use carbonyl iron if you are also using any of the following drugs:

• an antacid;
• an antibiotic such as ciprofloxacin, levofloxacin, doxycycline, or tetracycline; or
• a stomach acid reducer such as cimetidine (Tagamet), famotidine (Pepcid), or ranitidine (Zantac).

This list is not complete. Other drugs may interact with carbonyl iron, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Carbonyl iron may be taken with food if it upsets your stomach.

The chewable tablet must be chewed before you swallow it.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

If you need a blood transfusion, tell your caregivers that you are using carbonyl iron.

Do not take this medicine for longer than 6 months without your doctor's advice.

Store at room temperature, away from moisture and heat. Keep this medicine out of the reach of children. An accidental overdose of iron can be fatal to a child.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of carbonyl iron can be fatal, especially to a child.

Overdose symptoms may include diarrhea, bloody or tarry stools, fever, vomiting, severe stomach pain, pale skin, blue lips or fingernails, weak but rapid pulse, shallow breathing, and seizure (convulsions).

Take the missed dose as soon as you remember. However, if it is almost time to take next dose, skip the dose you missed and take the next regularly scheduled dose as directed. Do not take a double dose.

You should not use carbonyl iron if you are allergic to it, or if you have:

• a stomach ulcer or ulcerative colitis;

• hemochromatosis;

• hemolytic anemia; or

• anemia that is not caused by iron deficiency.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you do not have an iron deficiency. Carbonyl iron is generally not for use by people who have a normal iron balance.

Carbonyl iron tablets may contain milk. Tell your doctor if you have lactose intolerance or a milk allergy.

Ask a doctor before using this medicine if you are pregnant or breast-feeding. Your dose needs may be different during pregnancy or while you are nursing.

Your dose needs may be different during pregnancy or while you are breast-feeding.

Do not give this medicine to a child younger than 12 without medical advice.

Take the missed dose as soon as you remember. However, if it is almost time to take next dose, skip the dose you missed and take the next regularly scheduled dose as directed. Do not take a double dose.

Ask a doctor or pharmacist if it is safe for you to use carbonyl iron if you are also using any of the following drugs:

• an antacid;

• an antibiotic such as ciprofloxacin, levofloxacin, doxycycline, or tetracycline; or

• a stomach acid reducer such as cimetidine (Tagamet), famotidine (Pepcid), or ranitidine (Zantac).

This list is not complete. Other drugs may interact with carbonyl iron, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child's doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Black, tarry, or bloody stools.
• Fever.
• Very upset stomach or throwing up.
• Very bad belly pain.
• Throwing up blood or throw up that looks like coffee grounds.

Applies to carbonyl iron: oral suspension

Applies to carbonyl iron: oral suspension, oral tablet, oral tablet chewable

Gastrointestinal

Gastrointestinal side effects have been reported the most frequently. They have included diarrhea (45%) vs. placebo (3%), cramping (38%) vs. placebo (0%), nausea (30%) vs. placebo (8%), constipation (25%) vs. placebo (14%), heartburn (17%) vs. placebo (6%), and epigastric discomfort (16%) vs. placebo (11%).[Ref]

Constipation may be relieved by administering docusate sodium 100 mg to 200 mg per day in addition to increasing the intake of oral fluids, such as water.[Ref]

Other

Iron overload (i.e., hemosiderosis) has been reported in patients genetically predisposed, or have underlying disorders, that augment the absorption of iron. It has also occurred following administration of excessive parenteral iron therapy, combination of oral and parenteral iron, or in patients with hemoglobinopathies that were erroneously diagnosed as iron deficiency anemia. Hemosiderosis is treated with repeated phlebotomy or long-term administration of deferoxamine. The liver is particularly susceptible to toxicity in iron-overload states.

Stained teeth have been reported primarily following ingestion of iron liquid preparations. Liquid dosage forms should be diluted in juice or water and sipped through a straw to aid in prevention of staining.[Ref]

Other side effects have included iron overload (hemosiderosis) and stained teeth. Secondary hemochromatosis due to prolonged iron ingestion has been reported rarely. An unpleasant taste following carbonyl iron ingestion has been reported in 40% to 70% of patients.[Ref]

Nervous system

Nervous system side effects have included headache (29%) vs. placebo (25%), and weakness (11%) vs placebo (9%).[Ref]

Some side effects of Wee Care may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.