Before Using This Dietary Supplement

If you are taking this dietary supplement without a prescription, carefully read and follow any precautions on the label. For iron supplements, the following should be considered:

Allergies—Tell your health care professional if you have ever had any unusual or allergic reaction to iron medicine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—It is especially important that you are receiving enough vitamins and minerals when you become pregnant and that you continue to receive the right amount of vitamins and minerals throughout your pregnancy. Healthy fetal growth and development depend on a steady supply of nutrients from mother to fetus. During the first 3 months of pregnancy, a proper diet usually provides enough iron. However, during the last 6 months, in order to meet the increased needs of the developing baby, an iron supplement may be recommended by your health care professional.

However, taking large amounts of a dietary supplement in pregnancy may be harmful to the mother and/or fetus and should be avoided.

Breast-feeding—It is especially important that you receive the right amounts of vitamins and minerals so that your baby will also get the vitamins and minerals needed to grow properly. Iron normally is present in breast milk in small amounts. When prescribed by a health care professional, iron preparations are not known to cause problems during breast-feeding. However, nursing mothers are advised to check with their health care professional before taking iron supplements or any other medication. Taking large amounts of a dietary supplement while breast-feeding may be harmful to the mother and/or infant and should be avoided.

Children—Problems in children have not been reported with intake of normal daily recommended amounts. Iron supplements, when prescribed by your health care professional, are not expected to cause different side effects in children than they do in adults. However, it is important to follow the directions carefully, since iron overdose in children is especially dangerous.

Studies on sodium ferric gluconate have been done only in adult patients, and there is no specific information comparing the use of sodium ferric gluconate in children with use in other age groups.

Older adults—Problems in older adults have not been reported with intake of normal daily recommended amounts. Elderly people sometimes do not absorb iron as easily as younger adults and may need a larger dose. If you think you need to take an iron supplement, check with your health care professional first. Only your health care professional can decide if you need an iron supplement and how much you should take.

Medicines or other dietary supplements—Although certain medicines or dietary supplements should not be used together at all, in other cases they may be used together even if an interaction might occur. In these cases, your health care professional may want to change the dose, or other precautions may be necessary. When you are taking iron supplements, it is especially important that your health care professional know if you are taking any of the following:

• Acetohydroxamic acid (e.g., Lithostat)—Use with iron supplements may cause either medicine to be less effective

• Antacids—Use with iron supplements may make the iron supplements less effective; iron supplements should be taken 1 or 2 hours before or after antacids

• Dimercaprol—Iron supplements and dimercaprol may combine in the body to form a harmful chemical

• Etidronate or
• Fluoroquinolones (e.g., ciprofloxacin, enoxacin, lomefloxacin, norfloxacin, ofloxacin) or
• Tetracyclines (taken by mouth) (medicine for infection)—Use with iron supplements may make these medicines less effective; iron supplements should be taken 2 hours before or after these medicines

Other medical problems—The presence of other medical problems may affect the use of iron supplements. Make sure you tell your health care professional if you have any other medical problems, especially:

• Alcohol abuse (or history of) or
• Blood transfusions (with high red blood cell iron content) or
• Kidney infection or
• Liver disease or
• Porphyria cutaneous tarda—Higher blood levels of the iron supplement may occur, which may increase the chance of side effects

• Arthritis (rheumatoid) or
• Asthma or allergies or
• Heart disease—The injected form of iron may make these conditions worse

• Colitis or other intestinal problems or
• Iron overload conditions (e.g., hemochromatosis, hemosiderosis) or
• Stomach ulcer—Iron supplements may make these conditions worse

• Other anemias—Iron supplements may increase iron to toxic levels in anemias not associated with iron deficiency