Ferrous gluconate

Oral
Iron-deficiency anaemia

Should be taken on an empty stomach. Best taken on an empty stomach. May be taken w/ meals to reduce GI discomfort.

Haemochromatosis, haemosiderosis, haemoglobinuria, anaemias not caused by Fe deficiency (e.g. thalassaemia), active peptic ulcer, regional enteritis, ulcerative colitis, alcoholism, hepatitis. Patients receiving repeated blood transfusions or parenteral Fe therapy.

Patient w/ intestinal strictures and diverticular disease, haemolytic anaemia, Fe absorption disorders. Childn. Pregnancy and lactation.

GI: GI discomfort, anorexia, nausea, vomiting, heartburn, constipation or diarrhroea, faecal impaction, dark stools, dental discolouration.
Genitourinary: Urine discolouration.
Dermatologic: Allergic reactions, contact dermatitis.

This drug may cause black discolouration of the stool.

Monitor serum Fe, total Fe binding capacity, Hb, and reticulocyte count.

Symptoms: Nausea, vomiting, diarrhoea, abdominal pain, haematemesis, rectal bleeding, lethargy and circulatory collapse. Hyperglycaemia, hypotension, tachycardia, and metabolic acidosis may also occur. Management: Administer an emetic then perform gastric lavage w/ desferrioxamine soln 2g/L. This is followed by instillation of desferrioxamine 5 g in 50-100 mL of water in the stomach. Adult patients may be given mannitol or sorbitol to include small bowel emptying. For severe poisoning, when shock and coma are present, give immediate supportive treatment and administer IV infusion of desferrioxamine 15 mg/kg/hr in childn or 5 mg/kg/hr in adults (Max 80 mg/kg/24 hr). In less severe cases, IM desferrioxamine 1 g 4-6 hrly in childn or 50 mg/kg (Max 4 g) in adults may be given.

May form a chelate w/ acetohydroxamic acid, resulting in reduced absorption of both drugs. Toxic compounds may be formed w/ concomitant use of dimercaprol. Decreased absorption w/ antacids containing Ca salts, carbonates or Mg trisilicate, and other drugs containing bicarbonates, carbonates, oxalates or phosphates due to formation of less soluble or insoluble complexes. Reduced absorption w/ trientine, cholestyramine, tetracyclines, Zn, PPIs. Increased absorption w/ ascorbic and succinic acid. Haematologic response may be impaired when used w/ vit E. Antagonises the hypotensive effect of methyldopa. May reduce the absorption of penicillamine, bisphosphonates, fluoroquinolones, entacapone, mycophenolate, tetracyclines, Zn, levothyroxine, levodopa, carbidopa, nalidixic acid, eltrombopag. Neomycin may alter the absorption of Fe. Oral chloramphenicol delays plasma Fe clearance, incorporation into RBC and interferes w/ erythropoiesis.

Delayed absorption w/ food esp coffee, eggs, milk, tea, whole grain breads and cereals.

May interfere w/ tests used for detection of occult blood in stool.

Description: Ferrous gluconate is used in the prevention and treatment of iron-deficiency anaemia. It replaces Fe found in Hb, myoglobin and enzymes. It also allows transportation of oxygen via Hb.
Onset: Haematologic response: 3-10 days.
Pharmacokinetics:
Absorption: Absorbed in the duodenum and proximal jejunum. Reduced absorption w/ food.
Distribution: Plasma protein binding: High.
Excretion: Via faeces, urine, breast milk, perspiration, menses, and shedding of hair, skin and nails.

Store between 20-25°C.

Vitamins & Minerals (Pre & Post Natal) / Antianemics

B03AA03 - ferrous gluconate ; Belongs to the class of oral iron bivalent preparations. Used in the treatment of anemia.

Anon. Ferrous Gluconate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 28/02/2017 .

Buckingham R (ed). Ferrous Gluconate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 28/02/2017 .

Ferrous Gluconate Tablet (Paddock Laboratories, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 28/02/2017 .

Joint Formulary Committee. Ferrous Gluconate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 28/02/2017 .