Usage
- Medical Conditions: Ferrous asparto glycinate is primarily prescribed for the treatment and prevention of iron deficiency anemia. It is also used to address nutritional deficiencies, especially during periods of increased iron demand like pregnancy and lactation. It can be beneficial in cases of chronic or acute blood loss.
- Pharmacological Classification: Hematinic, Mineral Supplement.
- Mechanism of Action: Ferrous asparto glycinate provides a readily absorbable form of iron. Iron is an essential component of hemoglobin, the protein in red blood cells responsible for carrying oxygen throughout the body. Supplemental iron replenishes depleted iron stores, enabling the production of red blood cells and improving oxygen transport.
Alternate Names
- Iron(II) asparto glycinate
- Ferrous(II) bis(aspartato)glycinate
- Brand Names: Several brand names exist depending upon the manufacturer and may contain additional vitamins and minerals including folic acid, B vitamins, and Vitamin C. Some examples of these brand names include: Niferex, Chromagen, Prenate DHA, Prenate Mini.
How It Works
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Pharmacodynamics: Ferrous asparto glycinate increases serum iron levels, which stimulates erythropoiesis (red blood cell production) in the bone marrow. This leads to a rise in hemoglobin concentration and red blood cell count, ultimately improving oxygen delivery to tissues.
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Pharmacokinetics:
- Absorption: The chelated form of iron in ferrous asparto glycinate is absorbed more efficiently in the gastrointestinal tract compared to some other iron salts. Absorption can be enhanced by the presence of vitamin C. Absorption is reduced by antacids, dairy products, and eggs.
- Metabolism: Iron is incorporated into hemoglobin within red blood cells. Excess iron is stored in the liver, spleen, and bone marrow as ferritin and hemosiderin.
- Elimination: Iron is primarily lost through shedding of cells from the skin, gastrointestinal tract, and urinary tract. Very little iron is excreted in urine or bile.
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Mode of Action: Iron from ferrous asparto glycinate is absorbed into enterocytes (cells lining the intestines). It then binds to transferrin, a protein that transports iron in the blood, and is delivered to the bone marrow for hemoglobin synthesis.
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Receptor Binding/Enzyme Inhibition/Neurotransmitter Modulation: Not directly applicable. Iron’s role is primarily structural in hemoglobin.
Dosage
Standard Dosage
Adults:
- Typical dosage: 100-200 mg of elemental iron per day, administered in divided doses. This usually corresponds to one or two tablets/capsules of commercially available formulations.
- Maximum daily dose: Should be determined based on individual patient needs and tolerance, usually not exceeding 400mg per day.
Children:
- Pediatric dosing: Determined by a physician based on the child’s age, weight, and iron status.
- Pediatric safety considerations: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep out of reach of children.
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary due to potential age-related decreases in renal or hepatic function. Start at the lower end of the dosing range.
- Patients with Renal Impairment: Caution is advised. Dose adjustments may be needed based on the degree of renal dysfunction.
- Patients with Hepatic Dysfunction: Caution is advised. Dose adjustments may be needed.
- Patients with Comorbid Conditions: Individualized dosing considerations may be needed for patients with heart disease, liver disease, or gastrointestinal disorders.
Clinical Use Cases The provided research focused on the treatment of iron-deficiency anemia and did not cover dosing in specific clinical situations. Dosing in clinical situations such as intubation, surgical procedures, mechanical ventilation, ICU, and emergency situations should be determined by the attending physician or a consulting hematologist.
Dosage Adjustments
- Dose modifications are necessary based on patient response, hemoglobin levels, and potential adverse effects. Adjustments may also be needed for patients with renal or hepatic impairment.
Side Effects
Common Side Effects
- Nausea
- Constipation
- Diarrhea
- Dark stools
- Stomach upset
Rare but Serious Side Effects
- Allergic reactions (rash, itching, swelling)
- Severe gastrointestinal upset
- Iron overload (in patients with conditions like hemochromatosis)
Long-Term Effects
- Iron overload can occur with prolonged or excessive use, potentially damaging organs like the liver and heart.
Adverse Drug Reactions (ADR)
- Anaphylaxis (rare but serious allergic reaction)
Contraindications
- Hypersensitivity to ferrous asparto glycinate or any component of the formulation.
- Hemochromatosis or hemosiderosis (iron overload disorders).
- Hemolytic anemias.
- Porphyria cutanea tarda.
Drug Interactions
- Antacids, tetracycline antibiotics, quinolone antibiotics, levothyroxine, levodopa, bisphosphonates, and penicillamine can decrease the absorption of ferrous asparto glycinate.
- Alcohol can affect iron absorption.
- Dairy products and eggs reduce absorption.
- Certain anti-seizure medications (e.g., phenytoin) and methyldopa may interact.
Pregnancy and Breastfeeding
- Pregnancy Safety Category: A (Generally considered safe when used as directed).
- Fetal risks: Although generally safe, excessive iron intake during pregnancy could potentially pose risks. Adhere to recommended dosages.
- Breastfeeding: Ferrous asparto glycinate passes into breast milk. Consult a physician before use.
- Alternative safer options: If necessary, discuss other iron supplement options with a physician.
Drug Profile Summary
- Mechanism of Action: Provides readily absorbable iron to replenish stores and promote hemoglobin synthesis.
- Side Effects: Nausea, constipation, diarrhea, dark stools, stomach upset. Rarely, allergic reactions or iron overload.
- Contraindications: Hemochromatosis, hemosiderosis, hemolytic anemias, porphyria cutanea tarda, hypersensitivity.
- Drug Interactions: Antacids, some antibiotics, levothyroxine, levodopa, bisphosphonates, alcohol, dairy, eggs.
- Pregnancy & Breastfeeding: Generally safe during pregnancy when used as directed; consult a physician for breastfeeding.
- Dosage: Adults: 100-200 mg elemental iron daily. Pediatric and special cases: physician-determined.
- Monitoring Parameters: Hemoglobin levels, red blood cell count, ferritin levels.
Popular Combinations
- Ferrous asparto glycinate is frequently combined with folic acid, vitamin B12, and vitamin C to enhance iron absorption and address common nutritional deficiencies.
Precautions
- General Precautions: Assess iron status before initiating therapy. Monitor for adverse effects and signs of iron overload.
- Specific Populations: See “Dosage - Special Cases” and “Pregnancy and Breastfeeding”.
- Lifestyle Considerations: Avoid alcohol, dairy products, and eggs near the time of taking ferrous asparto glycinate.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Ferrous asparto glycinate?
A: The recommended dosage for adults is typically 100-200 mg of elemental iron per day, divided into two doses. Pediatric dosing should be determined by a physician.
Q2: What are the common side effects?
A: Common side effects include constipation, nausea, dark stools, and stomach upset.
Q3: Can pregnant women take ferrous asparto glycinate?
A: Yes, ferrous asparto glycinate is generally considered safe during pregnancy and is often recommended to prevent or treat iron deficiency anemia. It is crucial to adhere to the prescribed dosage.
Q4: How should ferrous asparto glycinate be taken?
A: Take ferrous asparto glycinate on an empty stomach, preferably one hour before or two hours after meals, with a full glass of water. Vitamin C can enhance absorption, but avoid taking it with antacids, dairy, or eggs.
Q5: How long does it take to see results?
A: Improvement in hemoglobin levels may be seen within a few weeks of starting therapy, but several months may be required to replenish iron stores fully.
Q6: What are the signs of iron overdose?
A: Symptoms of iron overdose can include nausea, vomiting, abdominal pain, diarrhea, and bloody stools. Severe overdose can lead to shock, organ damage, and even death. Seek immediate medical attention if overdose is suspected.
Q7: What should I do if I miss a dose?
A: If a dose is missed, take it as soon as remembered, unless it is close to the next scheduled dose. Do not double the dose to catch up.
Q8: What are the contraindications to taking ferrous asparto glycinate?
A: Contraindications include hemochromatosis, hemosiderosis, hemolytic anemias, and hypersensitivity to ferrous asparto glycinate.
Q9: Can ferrous asparto glycinate interact with other medications?
A: Yes, it can interact with several medications, including antacids, certain antibiotics (tetracyclines, quinolones), levothyroxine, and levodopa. Inform your physician of all medications and supplements you are taking.
