Ferrous Fumarate

What is ferrous fumarate?

Ferrous fumarate is an iron supplement. Iron is a mineral that the body needs to produce red blood cells. When the body does not get enough iron, it cannot produce the number of normal red blood cells needed to keep your child in good health. This condition is called iron deficiency anemia. Ferrous fumarate is used to help replace the body's stores of iron.

You may hear ferrous fumarate called by its brand name, Palafer. Ferrous fumarate comes in tablet, capsule, and liquid forms.

Before giving this medicine to your child?

Tell your doctor if your child has any of the following conditions:

• any kind of condition that increases the risk of iron overload such as haemochromatosis (condition where the body absorbs too much iron), sickle cell disease, thalassemia, hemosiderosis (high iron stores in the body).
• allergy or sensitivity to iron supplements.

Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• liver or kidney disease
• intestinal tract inflammatory conditions, such as enteritis, diverticulitis, ulcerative colitis iron may make these conditions worse
• stomach ulcer

How should you give your child this medicine?

Follow these instructions when you give your child ferrous fumarate:

• Give your child ferrous fumarate exactly as your doctor or pharmacist tells you to, even if your child seems better.
• Talk to your child's doctor before you stop giving this medicine for any reason.
• Give your child ferrous fumarate at the same times every day (exactly as your child's doctor or pharmacist tells you). Pick times that are easy for you so that you do not miss doses.
• This medicine is best absorbed if given on an empty stomach 1 hour before or 2 hours after meals with a glass of water/juice.
• If the medicine upsets your child's stomach, you may give it with food or right after meals
• When iron supplements are combined with certain foods they may lose much of their value. The following foods should be given at least 1 hour before or 2 hours after ferrous fumarate:
  • milk, cheese, and yogurt (or any other milk products)
  • eggs
  • spinach
  • whole-grain breads and cereals and bran
• If you are giving liquid ferrous fumarate, measure the dose with the special spoon or syringe that the pharmacist gave you. Liquid forms of iron can stain the teeth. To prevent, reduce, or remove these stains:
  • Mix each dose in water, fruit juice, or tomato juice. You may use a drinking straw to help keep the iron supplement from getting on the teeth.
  • When doses of liquid iron supplement are given by dropper, the dose may be placed well back on the tongue and followed with water or juice.
  • Iron stains on teeth can usually be removed by brushing with baking soda (sodium bicarbonate) or hydrogen peroxide
  • Shake the bottle of ferrous fumarate well before you give your child each dose.

What should you do if your child misses a dose?

• Give your child the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does this medicine take to work?

It may take up to several weeks before iron takes its full effect.

What are the possible side effects of this medicine?

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to the Emergency Department if your child has black, tarry stools with red streaks.

Your child may have some of these side effects while they take ferrous fumarate. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:

• constipation (trouble having a bowel movement)
• diarrhea (watery bowel movements)
• nausea (upset stomach) and vomiting (throwing up)
• dark black stools

What safety measures should you take when your child is using this medicine?

There are some medicines that should not be taken together with iron supplements or in some cases the dose of supplements or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medications (prescription, over-the-counter, or herbal) including:

• bisphosphonates, tetracycline, penicillamine, quinolone antibiotics, levodopa, methyldopa, levothyroxine, Vitamin C

Do not give your child iron supplements and antacids or calcium supplements at the same time. It is best to space doses of these two products 1-2 hours apart to get the full benefit from each medicine.

What other important information should you know about ferrous fumarate?

• Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Make sure you always have enough ferrous fumarate to last through weekends, holidays, and vacations. Call your pharmacy at least 2 days before your child runs out of medicine to order refills.
• Keep ferrous fumarate at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep ferrous fumarate out of your child’s sight and reach and locked up in a safe place. If your child takes too much ferrous fumarate, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.