Ferrous Fumarate + Folic acid interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Ethanol may increase folic acid elimination and folic acid absorption is decreased in chronic alcoholics. Excessive alcohol consumption may lead to folate deficiency.

  What to do: Monitoring of patient response to folic acid supplementation if they also consume alcohol regularly may be recommended.

  5 sources

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. Agencia Espa?ola de Medicamentos y Productos Sanitarios Healthcare "Centro de informaci��n online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html" (2008):
  4. Cerner Multum, Inc "ANVISA Bul��rio Eletr?nico." O 0 (2015):
  5. "Product Information. Folic Acid (folic acid)." Method Pharmaceuticals, LLC (2017):

• food

  Moderate

  Absorption

  Concomitant use of some oral medications may reduce the bioavailability of orally administered iron, and vice versa.

  What to do: Ideally, iron products should be taken on an empty stomach (i.e., at least 1 hour before or 2 hours after meals), but if this is not possible, administer with meals and monitor the patient more closely for a subtherapeutic effect. Some studies suggest administration of iron with ascorbic acid may enhance bioavailability. In addition, administration of oral iron products and some oral medications should be separated whenever the bioavailability of either agent may be decreased. Consult the product labeling for specific separation times and monitor clinical responses as appropriate.

  2 sources

  1. "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
  2. "Product Information. Accrufer (ferric maltol)." Shield Therapeutics (2021):

• orange juice

  Moderate

  Absorption

  Concomitant use of some oral medications may reduce the bioavailability of orally administered iron, and vice versa.

  What to do: Some studies have shown that taking iron with foods that are high in vitamin C (e.g., orange juice, etc.) improves bioavailability.

  2 sources

  1. "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
  2. "Product Information. Accrufer (ferric maltol)." Shield Therapeutics (2021):

Conditions

Conditions in which Ferrous Fumarate + Folic acid needs care, as documented in this source.

• Anemia

  Major

  The use of folic acid is contraindicated in patients with undiagnosed anemia. Folic acid in dosages above 1 mg/day can obscure the diagnosis of pernicious anemia by alleviating the hematologic abnormalities while allowing the progression of neurologic complications. In addition, folic acid alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient.

  3 sources

  1. Butterworth CE Jr, Tamura T "Folic acid safety and toxicity: a brief review." Am J Clin Nutr 50 (1989): 353-8
  2. Katz M "Potential danger of self-medication with folic acid." N Engl J Med 289 (1973): 1095
  3. "Product Information. Renal Multivitamin Formula Rx (folic acid)." Vitaline Corporation, Ashland, OR.

• Hemoglobinopathies

  Major

  There is no excretory mechanism for iron. Iron will correct only hemoglobin abnormalities due to iron deficiency and should not be used to treat conditions such as thalassemia, hemosiderosis, hemochromatosis, normocytic anemia (unless iron deficiency exists), or in patients receiving blood transfusions. Clinical monitoring of erythropoietic function and ferritin levels is recommended.

  2 sources

  1. "Product Information. Infed (iron dextran)." Schein Pharmaceuticals Inc
  2. "Product Information. Venofer (iron sucrose)." American Regent Laboratories Inc (2001):

• Achlorhydria

  Moderate

  Gastric acidity increases iron bioavailability by maintaining the ingested iron in a reduced form as ferrous ions, which are more readily absorbed than ferric ions. Therefore, when iron therapy is administered orally, higher dosages may be necessary for patients with decreased gastric acid production. Also, a liquid formulation is recommended in these patients because dissolution of the tablet coating depends on normal gastric acidity.

  2 sources

  1. "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
  2. "Product Information. Ferrous Gluconate (ferrous gluconate)." Paddock Laboratories Inc (2016):

• Gastrointestinal Diseases

  Moderate

  Iron can be irritating and damaging to gastrointestinal mucosa. Iron therapy should be administered cautiously in patients with peptic ulcer disease, enteritis, or ulcerative colitis.

  2 sources

  1. "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
  2. "Product Information. Ferrous Gluconate (ferrous gluconate)." Paddock Laboratories Inc (2016):