Dosing and uses of Feosol (Carbonyl Fe), Icar C (carbonyl iron)
Adult dosage forms and strengths
tablet
- 45mg (Feosol)
- 66mg (Ircon)
oral suspension
- 15mg/1.25mL (Icar Pediatric)
tablet, chewable
- 15mg (Icar Pediatric, Wee Care)
tablet with vitamin C
- 100mg iron/250mg vitamin C (Icar C)
Dietary Iron Supplement
Doses expressed as elemental iron unless otherwise noted
19-50 years old:
Male: 8 mg PO qDay
Female: 18 mg PO qDay
Pregnant female: 27 mg PO qDay
Lactating female 9 mg PO qDay
>50 years old: 8 mg PO qDay
Iron Deficiency Anemia
300 mg PO q12hr; may increase to 300 mg q6hr or 250 mg ER PO q12hr
Note: Dose expressed as ferrous sulfate
Prophylaxis of Iron Deficiency
300 mg PO qDay
Note: Dose expressed as ferrous sulfate
Administration
For maximum absorption take on empty stomach, but may take with or after meals to minimize GI irritation
Some formulations contain vitamin C; vitamin C may enhance absorption
Pediatric dosage forms and strengths
tablet
- 45mg (Feosol)
- 66mg (Ircon)
oral suspension
- 15mg/1.25mL (Icar Pediatric)
tablet, chewable
- 15mg (Icar Pediatric)
tablet with vitamin C
- 100mg iron/250mg vitamin C (Icar C)
Dietary Iron Supplement
Doses expressed elemental iron unless otherwise noted
0-6 months old: 0.27 mg PO qDay (adequate intake)
7-12 months old: 11 mg PO qDay
1-3 years old: 7 mg PO qDay
3-8 years old: 10 mg PO qDay
8-12 years old: 8 mg PO qDay
>12 years old: Same as adult
Severe Iron Deficiency Anemia
4-6 mg/kg PO divided q8hr
Mild to Moderate Iron Deficiency Anemia
3 mg/kg PO qDay or divided q12hr
Prophylaxis
1-2 mg/kg PO; 15 mg PO maximum
Administration
For maximum absorption take on empty stomach, but may take with or after meals to minimize GI irritation
Some formulations contain vitamin C; vitamin C may enhance absorption
Geriatric dosage forms and strengths
Lower doses of 10-50 mg elemental iron/day recommended may cause fewer GI adverse ements
Feosol (Carbonyl Fe), Icar C (carbonyl iron) adverse (side) effects
>10%
Constipation
Diarrhea
Nausea
Epigastric pain
Dark stools
Vomiting
Dark stools
Frequency not defined
Hemosiderosis (during long-term administration of large amounts)
Urine discoloration
Dental stain by some formulations
Heartburn
Warnings
Black box warnings
Severe iron toxicity may occur in overdose, especially when ingested by children.
Nonintentional iron overdose is the leading cause of fatal poisoning in children younger than 6 years. Keep out of reach of children
Contraindications
Hypersensitivity
Hemochromatosis, hemolytic anemia or anemia not associated with iron deficiency
Peptic ulcer, regional enteritis, ulcerative colitis
Cautions
Do not take within 2 hr of oral tetracycline antibiotics
Not for use in patients receiving frequent blood transfusions
Avoid in premature infants until their deficient vitamin E stores at birth are replenished
Avoid administering iron for >6 months except in patients with continuous bleeding or menorrhagia
May cause increased red cell hemolysis & hemolytic anemia in infants with low serum vitamin E concentrations
Pregnancy and lactation
Pregnancy category: Not available
Lactation: Excreted in breast milk
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Feosol (Carbonyl Fe), Icar C (carbonyl iron)
Mechanism of action
Replacement of iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin
Pharmacokinetics
Onset: 3-10 days (reticulocytosis); 2-4 weeks (hemoglobin values increase)
Absorption: 5-13% (20-30% during deficiency)
Excretion: Sweat, urine, menses, sloughing of intestinal mucosa
