Iron is a necessary part of hemoglobin, a protein which carries oxygen from our lungs throughout our bodies. Iron is also part of many other proteins and enzymes. Iron deficiency anemia is the most common type of anemia, and it occurs when your body does not have enough of the mineral iron. Iron deficiency anemia will appear as weakness and even shortness of breath.

If your physician recommends iron therapy, your Nickman’s pharmacist can help you get the most out of iron therapy.


  • Ferrous sulfate 325mg (5grain) yields 65mg elemental iron ( 20%)
  • Ferrous gluconate 300mg yields 35mg iron (12%)
  • Ferrous fumarate 300mg yields 99mg iron (33%)

Start with: Ferrous sulfate 325mg one tablet daily usually at bedtime, increasing up to three times daily.

  • NOTE: Take 1 or 2 hours before a meal
  • Food can decrease absorption by 50%
  • Extended-release or enteric-coated formulations have been found to transport iron past the duodenum and proximal jejunum, thereby reducing the absorption of iron. Vitamin C is added to some products to enhance iron absorption.
  • Orange juice (Vitamin-C) can double the absorption. About 200 of Vitamin-C mg is needed to increase absorption of 30 mg of elemental iron.
  • Take 1 hour before or 3 hours after antacids.
  • IF stomach upset occurs, may take with small snack such as crackers. NO milk or tea.
  • Iron therapy can cause black or dark green stools. Iron therapy might mask the symptoms of a stomach or intestinal bleed.

If constipation occurs initiate stool softener with docusate (Colace®) 100mg one capsule once daily, then increase if needed.

  • Up to nearly 50% of patients with heart failure have anemia, which can stem from a variety of causes. Around 20% of heart failure patients are iron deficient, contributing to about 33% of the cases of anemia in heart failure. New research indicates that repletion of iron stores can improve heart failure symptoms, even in patients who are not anemic.
  • Make sure patients are using child resistant packaging if there is ANY chance small children may be in the home. Iron is still the #1 cause of pediatric fatalities due to toxicity.

Iron can bind up drugs and keep them from being absorbed. Drugs that you want to avoid with iron therapy, within 2 hours:

  • Doxycycline and all tetracyclines
  • Ciprofloxacin (Cipro) and Levafloxacin (Levaquin)
  • Alendronate (Fosamax) and others

Levothyroxine (Synthroid) should be separated from iron by at least 4 hours.

Always feel free to consult with your Nickman’s pharmacist about drug interactions with iron, calcium, and magnesium. These supplements can bind up prescription drugs, making them less effective. You can rely on your Nickman’s pharmacist for your health care concerns!