Iron

Are there any interactions with medications?

---

Antibiotics (Quinolone antibiotics)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Iron might decrease how much antibiotic the body absorbs. Taking iron along with some antibiotics might decrease the effectiveness of some antibiotics. To avoid this interaction take iron two hours before or two hours after taking antibiotics.

Some of these antibiotics that might interact with iron include ciprofloxacin (Cipro), enoxacin (Penetrex), norfloxacin (Chibroxin, Noroxin), sparfloxacin (Zagam), trovafloxacin (Trovan), and grepafloxacin (Raxar).

---

Antibiotics (Tetracycline antibiotics)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Iron can attach to tetracycline antibiotics in the stomach and decrease how much tetracycline antibiotics the body can absorb. Taking iron along with tetracycline antibiotics might decrease the effectiveness of tetracycline antibiotics. To avoid this interaction take iron two hours before or four hours after taking tetracyclines.

Some tetracycline antibiotics include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).

---

Bisphosphonates
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Iron can decrease how much bisphosphate the body absorbs. Taking iron along with bisphosphates can decrease the effectiveness of bisphosphates. To avoid this interaction take bisphosphonate at least two hours before iron or later in the day.

Some bisphosphonates include alendronate (Fosamax), etidronate (Didronel), risedronate (Actonel), tiludronate (Skelid), and others.

---

Levodopa
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Iron might decrease how much levodopa the body absorbs. Taking iron along with levodopa might decrease the effectiveness of levodopa. Do not take iron and levodopa at the same time.

---

Levothyroxine
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Levothyroxine is used for low thyroid function. Iron can decrease how much levothyroxine the body absorbs. Taking iron along with levothyroxine might decrease the effectiveness of levothyroxine.

Some brands that contain levothyroxine include Armour Thyroid, Eltroxin, Estre, Euthyrox, Levo-T, Levothroid, Levoxyl, Synthroid, Unithroid, and others.

---

Methyldopa (Aldomet)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Iron can decrease how much methyldopa (Aldomet) the body absorbs. Taking iron along with methyldopa (Aldomet) might decrease the effectiveness of methyldopa (Aldomet). To prevent this interaction take iron at least two hours before or after taking methyldopa (Aldomet).

---

Mycophenolate mofetil (CellCept)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Iron might decrease how much mycophenolate mofetil (CellCept) the body absorbs. Taking iron along with mycophenolate mofetil (CellCept) might decrease the effectiveness of mycophenolate mofetil (CellCept). To avoid this interaction take iron at least two hours after mycophenolate mofetil (CellCept).

---

Penicillamine (Cuprimine, Depen)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Penicillamine is used for Wilson's disease and rheumatoid arthritis. Iron might decrease how much penicillamine your body absorbs and decrease the effectiveness of penicillamine. To avoid this interaction take iron two hours before or two hours after taking penicillamine.

---

Chloramphenicol
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Iron is important for producing new blood cells. Chloramphenicol might decrease new blood cells. Taking chloramphenicol for a long time might decrease the effects of iron on new blood cells. But most people only take chloramphenicol for a short time so this interaction isn't a big problem.

Dosing considerations for Iron.

The following doses have been studied in scientific research:

BY MOUTH:

• Iron-deficiency in adults: 50-100 mg elemental iron three times daily. Doses between 30-120 mg weekly have been used in adult women. For treating children with iron deficiency anemia: the dose is 4-6 mg/kg per day divided into three doses. For both adults and children, 2-3 months of treatment can reverse anemia but might not rebuild the body's supply of stored iron. Therefore, treatment is usually continued another 6 months to build up the body's iron reserves.
• For preventing iron deficiency in children, the American Academy of Pediatrics recommends iron supplements for some groups. For breast-fed infants, elemental iron 1 mg/kg/day is recommended from ages 4-6 months. Infants from 6-12 months should get 11 mg/day from food or supplements. For pre-term infants, 2 mg/kg/day for the first year is recommended. This should be continued until the baby is switched to formula or otherwise getting enough iron from food sources. Formula-fed children get enough iron from infant formula. Toddlers aged 1-3 years usually get enough iron from foods to meet the recommended daily amount of 7 mg/day; however, a supplement can be added if needed.
• For improving learning and thinking skills in iron-deficient adolescents: 650 mg ferrous sulfate twice daily.
• For cough caused by ACE inhibitors: 256 mg ferrous sulfate daily.

The adequate intake (AI) of iron for infants 6 months of age and less is 0.27 mg/day. For older infants and children, the recommended daily allowances (RDAs) for iron are: Infants 7 to 12 months, 11 mg/day; children 1 to 3 years, 7 mg/day; 4 to 8 years, 10 mg/day; 9 to 13 years, 8 mg/day; boys 14 to 18 years, 11 mg/day; girls 14 to 18 years, 15 mg/day. For adults, the RDA for iron is 8 mg/day for men ages 19 and older, and women ages 51 and older. For women 19 to 50 years, the RDA is 18 mg/day. For pregnant women, the RDA is 27 mg/day. For breast-feeding women, the RDA is 10 mg/day for ages 14 to 18 years, and 9 mg/day for ages 19 to 50.

Tolerable Upper Intake Levels (UL), the highest intake at which no unwanted side effects are expected, for iron are: infants and children birth to age 13, 40 mg/day; people age 14 and older (including pregnancy and breastfeeding), 45 mg/day. UL recommendations do not apply to people under medical supervision for iron deficiency.

There are many forms of iron supplements which contain different amounts of elemental iron: 1 gram of ferrous gluconate = 120 mg elemental iron (12% iron); 1 gram of ferrous sulfate = 200 mg elemental iron (20% iron); 1 gram of ferrous fumarate = 330 mg elemental iron (33% iron). The effectiveness and side effects are similar for these different forms when used in equal doses of elemental iron.