ferrous gluconate

Action and Spectrum

Mechanism of action 

Ferrous gluconate is a form of iron supplement commonly used to treat iron-deficiency anemia, a condition caused by a lack of iron in the body. One important thing to note is that ferrous gluconate contains 12% elemental iron; for every 100 mg of ferrous gluconate, 12 mg is elemental iron. 

Spectrum 

The spectrum of ferrous gluconate includes the following characteristics:  

Absorption: The body absorbs ferrous gluconate relatively well, but it is less absorbed than other iron supplements, such as ferrous sulfate or ferrous fumarate. 

Gastrointestinal side effects: Ferrous gluconate may cause fewer gastrointestinal side effects than other iron supplements. However, some individuals may experience side effects such as nausea, constipation, diarrhea, and abdominal pain. 

Dosing: Ferrous gluconate is available in several different dosage forms, including tablets, capsules, and liquid preparations. It’s essential to speak with a healthcare provider before taking any iron supplement to ensure you take the appropriate dose

Drug Interaction

Adverse Reaction

Frequency undefined:  

Nausea 

Staining of teeth 

Vomiting 

Diarrhea 

Dark color stools 

GI irritation 

Stomach cramps 

Heartburn 

Constipation 

Urine discoloration 

Black Box Warning

Black box warning 

Overdose of iron supplements can cause severe and even life-threatening complications, particularly in young children. Symptoms of iron overdose can include nausea, vomiting, diarrhea, stomach cramps, drowsiness, and in severe cases, coma and even death. 

Contraindication / Caution

Contraindications 

Hemochromatosis 

Hemolytic anemia 

Hypersensitivity 

Hemosiderosis 

Caution 

• oral absorption of iron supplements such as ferrous gluconate can be variable and incomplete 
• Iron supplements should be used with caution in individuals with peptic ulcer, enteritis, or ulcerative colitis. These conditions can cause irritation and bleeding in the stomach and intestines, and iron supplements can exacerbate these symptoms. 
• Individuals who receive frequent blood transfusions should also avoid taking iron supplements, as they can cause iron overload and lead to serious health problems. 
• In older adults, Iron stores are usually regular. Still, anemia of chronic disease is often seen in the elderly, which is caused by the inability of the reticuloendothelial system to use available iron stores.  
• Premature infants with vitamin E deficiency should also avoid iron supplements, as the administration of iron may cause red cell hemolysis and hemolytic anemia, which is a severe and life-threatening condition. 

Pregnancy / Lactation

Pregnancy consideration: A 

Lactation: Excretion of the drug in human breast milk is known 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology 

ferrous gluconate is usually taken orally and is absorbed in the stomach and small intestine. The rate and extent of iron absorption vary depending on the form of iron, the individual’s nutritional status, and other factors. The body absorbs ferrous gluconate relatively well, but it is less absorbed than other iron supplements, such as ferrous sulfate or ferrous fumarate. Once it is absorbed, iron is transported in the bloodstream by a protein called transferrin and is stored in various tissues, primarily in the liver and bone marrow.   

Pharmacodynamics 

The primary action of ferrous gluconate is to replenish iron stores in the body and to increase the number of red blood cells, which can help alleviate anemia symptoms. By increasing the number of red blood cells, ferrous gluconate helps to improve oxygen delivery to the body’s tissues and organs, which can help to increase energy levels and reduce fatigue. 

Pharmacokinetics 

Absorption 

The absorption rate can range from 10-35% when regular iron stores are present and can increase to 80-95% when iron stores are depleted. The presence of food in the stomach can decrease absorption by up to 60%. 

The onset of action of ferrous gluconate is usually within a week, but it may take longer for the full therapeutic effects to be seen. 

Distribution 

It is transported in the bloodstream by a protein called transferrin and is stored in various tissues, primarily in the liver and bone marrow. 

Metabolism 

In the liver, iron is stored in a protein called ferritin. When the body needs iron, it is released from ferritin and transported to the bone marrow, which is used to produce hemoglobin, a protein in red blood cells that carries oxygen throughout the body. Some iron is also stored in a protein called hemosiderin, which is found mainly in the spleen, liver, and bone marrow. 

Elimination/excretion 

Excess iron will be excreted through feces, urine, and other ways. 

Adminstartion

Administration 

• Taking it on an empty stomach is recommended for maximum absorption of ferrous gluconate. This is because the stomach’s acidity is essential for dissolving the iron in the ferrous gluconate and making it available for absorption. 
• Vitamin C may enhance the absorption of iron from ferrous gluconate. Taking vitamin C and ferrous gluconate may increase the amount of iron absorbed into the body. This can be helpful for people who have difficulty absorbing iron. 
• ferrous gluconate may also be administered in divided daily doses, usually every 8 to 12 hours. This can help to keep iron levels consistent in the body and reduce the risk of side effects. 
• It’s also important to note that antacids can interfere with the absorption of ferrous gluconate. It’s recommended to administer the supplement 2 hours before or 4 hours after taking antacids to minimize the effect of interference.

Patient Information Leaflet

Patient information leaflet 

Generic Name: ferrous gluconate 

Pronounced: [ FER-us-GLOO-koe-nate ] 

Why do we use ferrous gluconate? 

It is used to treat iron-deficiency anemia.