Uses
Prevention and Treatment of Iron Deficiency
Prevention and treatment of iron deficiency. Not indicated for treatment of anemia resulting from causes other than iron deficiency.
Dosage and Administration
Administration
Oral Administration
Administer orally between meals (e.g., 2 hours before or 1 hour after a meal).
For patients who have difficulty tolerating oral iron supplements, administer smaller, more frequent doses; start with a lower dose and increase slowly to the target dose; try a different form or preparation; or take with or after meals or at bedtime.
Dosage
Dosage expressed in terms of elemental iron. (See Table 1.)
Do not exceed recommended dosage.
Pediatric Patients
Iron Deficiency Anemia
Prevention
Oral
Premature or low-birthweight infants: 2–4 mg/kg daily starting preferably at 1 month, but at least by 2 months, of age. Do not exceed 15 mg daily.
Normal full-term infants who are not breast-fed or are only partially breast-fed: 1 mg/kg daily, preferably as iron-fortified formula, starting at birth and continuing during the first year of life. Do not exceed 15 mg daily.
Children ≥10 years of age who have begun their pubertal growth spurt may require daily iron supplementation of 2 or 5 mg daily in males or females, respectively.
Table 2. Recommended Dietary Allowance (RDA)/Adequate Intake (AI) of Iron for Pediatric Patients
| Age |
RDA (mg/day) |
AI (mg/day) |
| Infants 0–6 months of age |
|
0.27 |
| Infants 7–12 months of age |
11 |
|
| Children 1–3 years of age |
7 |
|
| Children 4–8 years of age |
10 |
|
| Children 9–13 years of age |
8 |
|
| Children 14–18 years of age |
Boys: 11
Girls: 15 |
|
|
Based on the need to maintain a normal functional iron concentration but only minimal stores, RDA is the goal for dietary intake in individuals.
Established for infants through 6 months of age based on the observed mean iron intake of infants fed principally human milk. |
Treatment
Oral
Children: 3–6 mg/kg daily in 3 divided doses.
If a satisfactory response is not noted after 3 weeks of oral iron therapy, consideration should be given to the possibilities of patient noncompliance, simultaneous blood loss, additional complicating factors, or incorrect diagnosis.
Adults
Iron Deficiency Anemia
Prevention
Oral
RDA for healthy men of all ages (≥19 years of age) is 8 mg daily.
RDA for healthy women 19–50 years of age is 18 mg daily, and RDA for healthy women ≥51 years of age is 8 mg daily.
Treatment
Oral
Usual therapeutic dosage: 50–100 mg 3 times daily. Smaller dosages (e.g., 60–120 mg daily) also recommended if patients are intolerant of oral iron, but the possibility that iron stores will be replenished at a slower rate should be considered.
If a satisfactory response is not noted after 3 weeks of oral iron therapy, consider possibility of patient noncompliance, simultaneous blood loss, additional complicating factors, or incorrect diagnosis.
Normal hemoglobin values usually obtained in 2 months unless blood loss continues. In severe deficiencies, continue iron therapy for approximately 6 months.
Special Populations
Dosage in Renal Impairment
Iron Deficiency Anemia
Anemia of Chronic Renal Failure in Hemodialysis Patients Receiving Epoetin Alfa
Oral
Children: 2–3 mg/kg daily in 2 or 3 divided doses.
Adults: ≥200 mg daily in 2 or 3 divided doses.
Pregnant Women
RDA for pregnant women 14–50 years of age is 27 mg daily.
Lactating Women
RDA for lactating women 14–18 or 19–50 years of age is 10 or 9 mg daily, respectively.
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