Taking iron supplements

Information

WHO SHOULD TAKE EXTRA IRON

Iron supplements may be taken as capsules, tablets, chewable tablets, and liquids. The most common tablet size is 325 mg.

Make sure your health care provider explains to you how many pills you should take each day and when you should take them. Taking more iron than your body needs can cause serious medical problems.

For most people, your blood counts should return to normal after 2 months of iron therapy. However, iron supplementation should be continued for another 6 - 12 months to replenish the body's iron stores in the bone marrow.

TIPS FOR TAKING IRON

Iron is absorbed the best when taken on an empty stomach. However, some people have stomach cramps, nausea, and diarrhea when taking iron and may need to take their iron with a small amount of food.

Milk, calcium and antacids should NOT be taken at the same time as iron supplements. You should wait at least 2 hours after ingesting these before taking your iron supplements.

Foods that you should NOT eat at the same time as you take your iron include:

• High fiber foods, such as whole grains, raw vegetables, and bran
• Foods or drinks with caffeine

Some doctors suggest taking a vitamin C supplement or drinking orange juice with your iron pill to increase absorption. Drinking 8 ounces of fluid with an iron pill is also okay.

Your health care provider should know about all the medicines you are taking. Iron tablets may cause other drugs you are taking to not work as well.

• Examples are antibiotics such as tetracycline, penicillin, and ciprofloxacin and drugs used for Parkinson's disease and seizures.
• At least 2 hours should elapse between doses of these drugs and iron supplements.

If you miss a dose or forget to take your medicine, take it as soon as you can. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose.

SIDE EFFECTS AND SAFETY

Constipation and diarrhea are very common. If constipation becomes a problem, take a stool softener such as docusate sodium (Colace).

Nausea and vomiting may occur with higher doses, but they can be controlled by taking the iron in smaller amounts. Ask your health care provider about switching to another form of iron rather than just stopping.

Black stools are normal when taking iron tablets. In fact, this is felt to be a sign that the tablets are working correctly. If the stools are tarry looking as well as black, if they have red streaks, or if cramps, sharp pains, or soreness in the stomach occur, talk to your health care provider immediately.

Liquid forms of iron may stain your teeth.

• Try mixing the iron with water or other liquids (such as fruit juice or tomato juice) and drinking the medicine with a straw.
• Iron stains can be removed by brushing your teeth with baking soda or peroxide.

Keep tablets should in a cool place. (Bathroom medicine cabinets may be too warm and humid, which may cause the pills to fall apart.)

Keep iron supplements out of the reach of children. If your child swallows an iron pill, immediately contact a poison control center.

Update Date: 2/28/2011

Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.