Dosing

The amount of iron needed to meet normal daily recommended intakes will be different for different individuals. The following information includes only the average amounts of iron.

• For oral dosage forms (capsules, tablets, oral solution):
  • To prevent deficiency, the amount taken by mouth is based on normal daily recommended intakes:
    For the U.S.
    • Adult and teenage males 10 milligrams (mg) per day.
    • Adult and teenage females 10 to 15 mg per day.
    • Pregnant females 30 mg per day.
    • Breast-feeding females 15 mg per day.
    • Children 7 to 10 years of age 10 mg per day.
    • Children 4 to 6 years of age 10 mg per day.
    • Children birth to 3 years of age 6 to 10 mg per day.
    For Canada
    • Adult and teenage males 8 to 10 mg per day.
    • Adult and teenage females 8 to 13 mg per day.
    • Pregnant females 17 to 22 mg per day.
    • Breast-feeding females 8 to 13 mg per day.
    • Children 7 to 10 years of age 8 to 10 mg per day.
    • Children 4 to 6 years of age 8 mg per day.
    • Children birth to 3 years of age 0.3 to 6 mg per day.
  • To treat deficiency:
    • Adults, teenagers, and children The dose will be determined by your doctor, based on your condition.
• For injection dosage forms:
  • Adults, teenagers, and children The dose will be determined by your doctor, based on your condition.

After you start using this dietary supplement, continue to return to your health care professional to see if you are benefiting from the iron. Some blood tests may be necessary for this.

Iron is best absorbed when taken on an empty stomach, with water or fruit juice (adults: full glass or 8 ounces; children: glass or 4 ounces), about 1 hour before or 2 hours after meals. However, to lessen the possibility of stomach upset, iron may be taken with food or immediately after meals.

For safe and effective use of iron supplements:

• Follow your health care professional's instructions if this dietary supplement was prescribed.
• Follow the manufacturer's package directions if you are treating yourself. If you think you still need iron after taking it for 1 or 2 months, check with your health care professional.

Liquid forms of iron supplement tend to stain the teeth. To prevent, reduce, or remove these stains:

• Mix each dose in water, fruit juice, or tomato juice. You may use a drinking tube or straw to help keep the iron supplement from getting on the teeth.
• When doses of liquid iron supplement are to be given by dropper, the dose may be placed well back on the tongue and followed with water or juice.
• Iron stains on teeth can usually be removed by brushing with baking soda (sodium bicarbonate) or medicinal peroxide (hydrogen peroxide 3%).

Missed dose

If you miss a dose of this dietary supplement, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this dietary supplement:

• Keep out of the reach of children because iron overdose is especially dangerous in children. As few as 3 or 4 adult iron tablets can cause serious poisoning in small children. Vitamin-iron products for use during pregnancy and flavored vitamins with iron often cause iron overdose in small children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the dietary supplement to break down.
• Keep the liquid form of this dietary supplement from freezing.
• Do not keep outdated dietary supplements or those no longer needed. Be sure that any discarded dietary supplement is out of the reach of children.

If you are taking this dietary supplement without a prescription, carefully read and follow any precautions on the label. For iron supplements, the following should be considered:

Allergies Tell your health care professional if you have ever had any unusual or allergic reaction to iron medicine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy It is especially important that you are receiving enough vitamins and minerals when you become pregnant and that you continue to receive the right amount of vitamins and minerals throughout your pregnancy. Healthy fetal growth and development depend on a steady supply of nutrients from mother to fetus. During the first 3 months of pregnancy, a proper diet usually provides enough iron. However, during the last 6 months, in order to meet the increased needs of the developing baby, an iron supplement may be recommended by your health care professional.

However, taking large amounts of a dietary supplement in pregnancy may be harmful to the mother and/or fetus and should be avoided.

Breast-feeding It is especially important that you receive the right amounts of vitamins and minerals so that your baby will also get the vitamins and minerals needed to grow properly. Iron normally is present in breast milk in small amounts. When prescribed by a health care professional, iron preparations are not known to cause problems during breast-feeding. However, nursing mothers are advised to check with their health care professional before taking iron supplements or any other medication. Taking large amounts of a dietary supplement while breast-feeding may be harmful to the mother and/or infant and should be avoided.

Children Problems in children have not been reported with intake of normal daily recommended amounts. Iron supplements, when prescribed by your health care professional, are not expected to cause different side effects in children than they do in adults. However, it is important to follow the directions carefully, since iron overdose in children is especially dangerous.

Studies on sodium ferric gluconate have shown that this supplement is safe to use in children ages 6 to 15 years. The safety of sodium ferric gluconate has not been determined in patients who are younger than 6 years of age.

Older adults Problems in older adults have not been reported with intake of normal daily recommended amounts. Elderly people sometimes do not absorb iron as easily as younger adults and may need a larger dose. If you think you need to take an iron supplement, check with your health care professional first. Only your health care professional can decide if you need an iron supplement and how much you should take.

Other medicines Medicines or other dietary supplements

Although certain medicines or dietary supplements should not be used together at all, in other cases they may be used together even if an interaction might occur. In these cases, your health care professional may want to change the dose, or other precautions may be necessary. When you are taking iron supplements, it is especially important that your health care professional know if you are taking any of the following:

• Acetohydroxamic acid (e.g., Lithostat) Use with iron supplements may cause either medicine to be less effective

• Antacids Use with iron supplements may make the iron supplements less effective; iron supplements should be taken 1 or 2 hours before or after antacids

• Dimercaprol Iron supplements and dimercaprol may combine in the body to form a harmful chemical

• Etidronate or
• Fluoroquinolones (e.g., ciprofloxacin, enoxacin, lomefloxacin, norfloxacin, ofloxacin) or
• Tetracyclines (taken by mouth) (medicine for infection) Use with iron supplements may make these medicines less effective; iron supplements should be taken 2 hours before or after these medicines

• Alcohol abuse (or history of) or
• Blood transfusions (with high red blood cell iron content) or
• Kidney infection or
• Liver disease or
• Porphyria cutaneous tarda Higher blood levels of the iron supplement may occur, which may increase the chance of side effects

• Arthritis (rheumatoid) or
• Asthma or allergies or
• Heart disease The injected form of iron may make these conditions worse

• Colitis or other intestinal problems or
• Iron overload conditions (e.g., hemochromatosis, hemosiderosis, hemoglobinopathies) or
• Stomach ulcer Iron supplements may make these conditions worse

• Other anemias Iron supplements may increase iron to toxic levels in anemias not associated with iron deficiency