Ferrograd Tablets

They are designed to release the iron slowly over the day as the tablet passes through the gut. This may help to reduce the digestive side effects that can sometimes be a problem with iron supplements. However, if side effects are reduced compared to other iron tablets this may be because less iron is being absorbed, because Ferrograd tablets carry the iron into an area of the gut where absorption may be poor.

The absorption of iron from the gut is decreased if it is taken at the same time as coffee, tea, eggs or milk. Its absorption is enhanced if it is taken at the same time as foods or supplements containing vitamin C (ascorbic acid).

How do I take it?

• One Ferrograd tablet should be taken once a day, or as directed by your doctor.
• The medicine should be taken before food on an empty stomach. However, if the tablets upset your stomach, then you may take them with or after food.
• The tablets should be swallowed whole and not chewed, crushed or broken.
• The absorption of iron may be reduced by tea, coffee, eggs and milk. You should avoid consuming these at the same time as taking Ferrograd tablets.

Not to be used in

• People with anaemia due to vitamin B12 deficiency (pernicious anaemia).
• People with anaemia due to folic acid deficiency.
• Genetic disease resulting in too much iron storage in the tissues (haemochromatosis).
• People with a disorder that affects storage of iron in the body (haemosiderosis).
• People with a condition where there is sudden loss of haemoglobin (oxygen carrying protein in the blood) in the urine at night (paroxysmal nocturnal haemoglobinuria).
• People with other disorders involving haemoglobin, such as sickle cell anaemia or thalassaemia.
• People receiving repeated blood transfusions.
• People with an active peptic ulcer.
• Inflammatory bowel disease such as ulcerative colitis or Crohn's disease.
• Children under 12 years of age. Other brands of iron are available for treating iron deficiency in children.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine is safe to take during pregnancy. However, you should check with your doctor or midwife if it is necessary for you to take an iron supplement during your pregnancy. Not all pregnant women need to take supplements; you may be getting enough nutrients from your diet.
• There are no known harmful effects when this medicine is used by breastfeeding mothers.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Abdominal pain.
• Constipation.
• Diarrhoea.
• Nausea and vomiting.
• Loss of appetite.
• Darkening of stools.

If you get an upset stomach after taking these tablets on an empty stomach this may be helped by taking the tablets with food.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor what medicines you are taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

Iron supplements can affect the absorption of a number of medicines from the gut, which can make these medicines less effective. For this reason, it is recommended that iron supplements are taken at least two hours before or two hours after other medicines, in order to minimise this effect. The medicines for which this is most important are listed below:

• bisphosphonates, eg alendronate
• eltrombopag
• entacapone
• levodopa
• levothyroxine
• methyldopa (iron tablets may also reduce the blood pressure lowering effect of methyldopa)
• penicillamine
• quinolone-type antibiotics, eg ciprofloxacin, norfloxacin, ofloxacin, levofloxacin
• tetracycline-type antibiotics, eg oxytetracycline, doxycycline, minocycline, tetracycline (these antibiotics also reduce the absorption of the iron supplements from the gut).

Zinc and calcium supplements reduce the absorption of iron supplements. Separate the medicines by at least two hours.

Antacids for heartburn or indigestion, such as magnesium carbonate, magnesium hydroxide, aluminium hydroxide and calcium carbonate may decrease the absorption of iron from the gut and thereby make the supplements less effective. Separate the medicines by at least two hours.

Trientene, used to treat Wilson's disease, also reduces the absorption of iron supplements from the gut, making them less effective unless the doses are separated by at least two hours.

Milk, milk-containing products, tea, coffee and eggs, may decrease iron absorption from the gut, while vitamin C (ascorbic acid) increases it.

References:

http://www.netdoctor.co.uk/medicines/diet-and-nutrition/a6725/ferrograd-ferrous-sulphate/

https://www.drugs.com/uk/ferrograd-tablets-300mg-leaflet.html

https://www.eumom.ie/forums/topic/ferrograd-c-iron-tablets/