Ferrous gluconate

Alcohol generally enhances the absorption of iron.

Concurrent administration of antacids may reduce absorption of iron.

Proton pump inhibitors may reduce absorption of oral iron.

Absorption of both iron and antibiotic may be reduced if ferrous gluconate is given with tetracycline antibiotics. Administration of iron preparations and tetracyclines should be separated by 2 to 3 hours.

Iron compounds impair the bioavailability of fluoroquinolones (ciprofloxacin, norfloxacin, ofloxacin). Administration should be separated by at least 2 hours.

The absorption of bisphosphonates is reduced when taken concurrently with iron preparations. Administration should be separated by at least 2 hours.

Oral iron preparations may reduce the absorption of dopaminergics such as levodopa, entacapone and co-careldopa.

Iron and possibly other heavy metals are chelated with concurrent oral administration of acetohydroxamic acid resulting in reduced intestinal absorption of both drugs.

Iron salts may reduce the absorption of aluminium and zinc salts and absorption of both iron and zinc are reduced if taken concomitantly.

Compounds containing calcium, magnesium, bicarbonates, carbonates, oxalates or phosphates may impair the absorption of iron because of the formation of less soluble or insoluble complexes and should be administered at least 2 hours apart.

Iron compounds impair the bioavailability of carbidopa.

Oral chloramphenicol delays plasma iron clearance, incorporation of iron into red blood cells and interferes with erythropoiesis.

Absorption of iron is impaired by cholestyramine.

Avoid concomitant administration of oral iron with dimercaprol or use of dimercaprol for treatment of iron poisoning due to the formation of toxic compounds.

Iron possibly reduces the absorption of eltrombopag (a period of 4 hours should elapse between administration of eltrombopag and iron) and nalidixic acid.

Iron reduces the absorption of thyroxine and so should be taken at least 2 hours apart.

Administration of oral iron may reduce the hypotensive effect of methyldopa.

Iron reduces absorption of mycophenolate mofetil.

Neomycin may alter the absorption of iron.

Iron reduces the absorption of penicillamine, and may decrease the effect of penicillamine. Also the absorption of iron is impaired by penicillamine. A period of 2 hours should elapse between administration of penicillamine and iron.

Absorption of oral iron preparations is reduced by trientine. Administration should be separated by at least 2 hours.

Ascorbic acid (vitamin C) increases iron absorption.

Concurrent use of Vitamin E may impair the hematologic response in patients with iron deficiency anaemia. Large doses of iron may increase daily requirements of vitamin E.

Iron preparations colour the faeces black, which may interfere with tests used for detection of occultblood in the stools.

Ferrous gluconate should be used with caution in patients with haemolytic anaemia.

Absorption of iron is impaired by tea (contains tannic acid), eggs, milk and milk products and whole grain breads and cereals (contain phytic acid). Coffee may be a factor in reducing iron bioavailability.

Use of any drug during the first trimester of pregnancy should be avoided if possible. Thus administration of iron during the first trimester requires definite evidence of iron deficiency. There is no evidence of any harmful effects due to normal doses of ferrous gluconate in pregnant women, but as with all drugs care should be exercised in administering this preparation during pregnancy.

Prophylaxis of iron deficiency during the remainder of pregnancy is justified.

There is no evidence of any harmful effects due to normal doses of ferrous gluconate in nursing mothers, but as with all drugs care should be exercised in administering this preparation during lactation.

Iron is excreted in breast milk but not in significant amounts (about 0.5 mg/day).

None known.