Usual Adult Dose for Iron Deficiency Anemia

Initial dose: 960 mg/day ferrous gluconate (120 mg/day elemental iron) for 3 months

• Give in divided doses (1 to 3 times daily)

Usual Adult Dose for Vitamin/Mineral Supplementation

Initial dose: 1 tablet orally three to four times a day

or

Initial dose: 48 to 144 mg/day ferrous gluconate (6 to 18 mg/day elemental iron) orally, in divided doses (1 to 3 times daily)

51 and over: 40 to 64 mg/day ferrous gluconate (5 to 8 mg/day elemental) orally, in divided doses (1 to 3 times daily)

Usual Adult Dose for Anemia Associated with Chronic Renal Failure

Initial dose: 1600 mg/day ferrous gluconate (200 mg/day elemental iron) orally in divided doses (1 to 3 times daily)

Comments:

• If goals are not met with oral iron after 1 to 3 months, consider IV iron supplementation.
• Smaller daily doses may be better tolerated

Usual Pediatric Dose for Iron Deficiency Anemia

0 to 5 years: 24 to 48 mg/kg/day ferrous gluconate (3 to 6 mg/kg/day elemental iron)
5 to 12 years: 480 mg ferrous gluconate (60 mg/day elemental)
12 to 18 years male: 480 mg ferrous gluconate (60 mg elemental) orally daily
12 to 18 years female: 480 to 960 mg/day ferrous gluconate (60 to 120 mg/day elemental)

• Give in divided doses (1 to 3 times daily)

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Preterm infant (less than 37 weeks gestation), 0 to 12 months: 16 mg/kg/day ferrous gluconate (2 mg/kg/day elemental iron)
0 to 6 months: 1.6 to 2.16 mg/day ferrous gluconate (0.2 to 0.27 mg/day elemental)
7 to 12 months: 56 to 88 mg/day ferrous gluconate (7 to 11 mg/day elemental)
1 to 3 years: 32 to 72 mg/day ferrous gluconate (4 to 9 mg/day elemental)
4 to 8 years: 32 to 80 mg/day ferrous gluconate (4 to 10 mg/day elemental)
9 to 13 years: 48 to 64 mg/day ferrous gluconate (6 to 8 mg/day elemental)
14 to 18 years: 64 to 120 mg/day ferrous gluconate (8 to 15 mg/day elemental)

• Give in divided doses (1 to 3 times daily)

Renal Dose Adjustments

No adjustments recommended

Liver Dose Adjustments

No adjustments recommended

Dose Adjustments

Vitamin supplementation/Prevention of anemia:
14 to 18 years: Pregnancy: 184 to 216 mg/day ferrous gluconate (23 to 27 mg/day elemental iron)
14 to 18 years: Lactation: 56 to 80 mg/day ferrous gluconate (7 to 10 mg/day elemental)
19 to 50 years: Pregnancy: 176 to 216 mg/day ferrous gluconate (22 to 27 mg/day elemental)
19 to 50 years: Lactation: 52 to 72 mg/day ferrous gluconate (6.5 to 9 mg/day elemental)
Maximum dose: 360 mg ferrous gluconate (45 mg/day elemental)

Treatment of anemia:
Pregnancy: 480 to 960 mg ferrous gluconate (60 to 120 mg/day elemental)

Precautions

US BOXED WARNING(S):

• Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.
• Keep out of reach of children.
• In case of accidental overdose, call a doctor or poison center immediately.

Dialysis

Iron supplementation is routinely provided to peritoneal dialysis and hemodialysis patients for prevention or treatment of anemia associated with chronic renal failure.

Other Comments

Administration advice:

• Coffee, tea, milk, cereal, dietary fiber, and phosphate containing carbonated drinks decrease iron absorption.
• Supplements containing calcium, zinc, manganese, or copper decrease iron absorption.
• Antacids, H2 blockers, and proton pump inhibitors decrease iron absorption; do not use within 1 to 2 hours of iron administration.
• Vitamin C and acidic foods increase iron absorption.
• Delayed release and enteric coated formulations are better tolerated, but are not as well absorbed.

• Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.
• Keep out of reach of children.
• In case of accidental overdose, call a doctor or poison center immediately.