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 with haemolytic anaemia, Fe absorption disorders, history of peptic ulcer and inflammatory bowel disease; intestinal strictures and diverticulae. Children. Pregnancy and lactation.

Significant: Dental carries (long-term treatment).
Gastrointestinal disorders: Gastrointestinal discomfort, epigastric pain, nausea, heartburn, vomiting, diarrhoea, constipation, fecal impaction, dark-coloured stool, gastrointestinal mucosal ulceration, necrosis and perforation.
Metabolism and nutrition disorders: Anorexia.
Renal and urinary disorders: Urine discolouration.

This drug may cause black discolouration of the stool.

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

Symptoms: Vomiting, diarrhoea, abdominal pain, haematemesis, rectal bleeding, CV disorders (e.g. hypotension, tachycardia, circulatory collapse), metabolic changes (e.g. acidosis, hyperglycaemia), CNS depression. Severe symptoms may include shock, convulsions, coma, hepatic necrosis, jaundice, hypoglycaemia, coagulation disorders, oliguria, renal failure, pulmonary oedema, gastrointestinal obstruction, and hepatic damage. Management: Administer an emetic, then perform gastric lavage with desferrioxamine solution 2g/L. This is followed by instillation of desferrioxamine 5 g in 50-100 mL of water to be retained 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/hour in children or 5 mg/kg/hour in adults (Max 80 mg/kg/24 hours). In less severe cases, IM desferrioxamine 1 g 4-6 hourly in children or 50 mg/kg (Max 4 g) in adults may be given.

May form a chelate with acetohydroxamic acid, resulting in reduced absorption of both drugs. May reduce absorption with antacids containing Ca, Mg, bicarbonates, carbonates, oxalates, or phosphates due to formation of less soluble or insoluble complexes. Reduced absorption of penicillamine, biphosphonates, levodopa, entacapone, mycophenolate mofetil, co-careldopa, Al, Zn salts, thyroxine, and eltrombopag. Reduced absorption of both drugs when administered with tetracycline antibiotics. May impair bioavailability of fluoroquinolones (e.g. ciprofloxacin, norfloxacin, ofloxacin) and carbidopa. Delay plasma clearance with oral chloramphenicol. Altered absorption with neomycin. Impaired haematologic response with vitamin E. May reduce hypotensive effect of methyldopa. Reduced absorption with trientine, colestyramine, proton pump inhibitors. Toxic compounds may be formed with concomitant use of dimercaprol. Increased absorption with ascorbic acid.

Decreased absorption with dietary fibres, tea, coffee, eggs, milk, and cereals.

May give false positive result for blood in stool by guaiac test.

Description:
Mechanism of Action: 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. Increased in Hb: Approx 2-4 weeks. Reticulocytosis: 5-10 days.
Pharmacokinetics:
Distribution: Enters breastmilk.

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 15/09/2022.

Buckingham R (ed). Ferrous Gluconate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 15/09/2022.

Ferrous Gluconate 300 mg Tablets (Bristol Laboratories Ltd). MHRA. https://products.mhra.gov.uk. Accessed 15/09/2022.

Ferrous Gluconate Tablet (Paddock Laboratories, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 15/09/2022.

Joint Formulary Committee. Ferrous Gluconate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 15/09/2022.