Administration of iron for >6 months should be avoided except in patients with continued bleeding, menorrhagia, or repeated pregnancies; avoid in patients with peptic ulcer, enteritis, or ulcerative colitis. Anemia in the elderly is often caused by "anemia of chronic disease" or associated with inflammation rather than blood

loss. Iron stores are usually normal or increased, with a serum ferritin >50 ng/mL and a decreased total iron binding capacity. Hence, the "anemia of chronic disease" is not secondary to iron deficiency but the inability of the reticuloendothelial system to reclaim available iron stores.

>10 %: Gastrointestinal: GI irritation, epigastric pain, nausea, dark stool, vomiting, stomach cramping, constipation .
1% to 10 %: Gastrointestinal: Heartburn, diarrhea Genitourinary:Discoloration of urine Miscellaneous: Liquid preparations may temporarily stain the teeth.
<1 %: Contact irritation

Decreased effect: Absorption of oral preparation of iron and tetracyclines are decreased when both of these drugs are given together;

concurrent administration of antacids may decrease iron absorption;iron may decrease absorption of penicillamine when given at the same time;response to iron therapy may be delayed in patients receiving chloramphenicol; milk may decrease absorption of iron. Increased effect: Concurrent administration > or =200 mg vitamin C per 30 mg elemental Fe increases absorption of oral iron .

Symptoms of overdose include acute GI irritation; erosion of GI mucosa, hepatic and renal impairment, coma, hematemesis, lethargy, acidosis.Following treatment for fluid losses, metabolic acidosis, and shock, a severe iron overdose may be treated with deferoxamine.Deferoxamine may be administered I.V. (80 mg/kg over 24 hours) or I.M. (40-90 mg/kg every 8 hours). Usual toxic dose of elemental iron: > or = 35 mg/kg.

May color stool black, take between meals for maximum absorption; may take with food if GI upset occurs, do not take with milk or antacids; keep out of reach of children.