- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: carbonyl iron
Brand Names: Feosol (Carbonyl Fe), Icar C, Icar Pediatric, Ircon
Drug Class: Iron Products
What is carbonyl iron, and what is it used for?
Carbonyl iron is an iron supplement used as a dietary supplement and to prevent and treat iron deficiency anemia.
Iron is an important component of hemoglobin, the protein in red blood cells that delivers oxygen to all the tissues, and myoglobin, the muscle protein that stores oxygen and releases it to the muscle cells when oxygen saturation drops.
In addition to oxygen transport and storage, iron is essential for many cellular processes, synthesis of enzymes and hormones, DNA synthesis and repair, electron transport, and energy metabolism. In general, women need more iron intake because of loss of iron with menstrual bleeding, and pregnant women often need iron supplements because their requirement goes up during pregnancy and breastfeeding.
Carbonyl iron is a nonionic iron produced by vaporizing submicroscopic spheres of uncharged, highly purified metallic iron, which must be converted to ferrous iron by gastric acid before it can be absorbed. As a result, carbonyl iron is more slowly absorbed and has a higher bioavailability than ferrous sulfate, another form of iron, as well as less potential for toxicity with overdose.
Iron supplements are available over the counter (OTC) as different iron salts and are usually an ingredient of multivitamins. Dietary iron sources include lean meat, poultry, seafood, kidney beans, lentils, spinach, peas, nuts, and certain fortified foods.
- Do not use in patients with hypersensitivity to any of the components of carbonyl iron.
- Do not use supplemental iron to treat:
- Anemias not associated with iron deficiency
- Hemochromatosis, a hereditary disorder that causes excessive iron absorption in the body
- Do not use carbonyl iron in patients with gastrointestinal conditions including:
- Peptic ulcer
- Regional enteritis
- Ulcerative colitis
- Do not take carbonyl iron within 2 hours of oral tetracycline antibiotics.
- Do not use in patients who receive frequent blood transfusions.
- Do not administer to premature infants until their deficient vitamin E stores at birth are replenished. Carbonyl iron may increase red cell destruction (hemolysis) and hemolytic anemia in infants with low serum vitamin E concentrations.
- Do not take carbonyl iron for longer than 6 months unless it is prescribed for continuous bleeding or heavy menstrual bleeding (menorrhagia).
What are the side effects of carbonyl iron?
Common side effects of carbonyl iron include:
- Upper abdominal (epigastric) pain
- Dark stools
- Urine discoloration
- Dental stain by some formulations
- Iron overload in organs and tissues (hemosiderosis), with prolonged use of large amounts
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages of carbonyl iron?
- 45 mg (Feosol)
- 66 mg (Ircon)
- 15 mg/1.25 mL (Icar Pediatric)
- 15 mg (Icar Pediatric, Wee Care)
Tablet With Vitamin C
- 100 mg iron/250 mg vitamin C (Icar C)
Dietary Iron Supplement
Doses expressed as elemental iron unless otherwise noted
19-50 years old:
- Male: 8 mg orally every day
- Female: 18 mg orally every day
- Pregnant female: 27 mg orally every day
- Lactating female 9 mg orally every day
- Above 50 years old: 8 mg orally every day
- 300 mg orally every 12 hours; may increase to 300 mg every 6 hours or 250 mg extended release (ER) orally every 12 hours
- Note: Dose expressed as ferrous sulfate
Prophylaxis of Iron Deficiency
- 300 mg orally every day
- Note: Dose expressed as ferrous sulfate
- Lower doses of 10-50 mg elemental iron/day recommended may cause fewer gastrointestinal adverse effects
Dietary Iron Supplement
- Doses expressed elemental iron unless otherwise noted
- Children 0-6 months old: 0.27 mg orally every day (adequate intake)
- Children 7-12 months old: 11 mg orally every day
- Children 1-3 years old: 7 mg orally every day
- Children 3-8 years old: 10 mg orally every day
- Children 8-12 years old: 8 mg orally every day
- Children above 12 years old: Same as adult
Severe Iron Deficiency Anemia
- 4-6 mg/kg orally divided every 8 hours
Mild to Moderate Iron Deficiency Anemia
- 3 mg/kg orally every day or divided every 12 hours
- 1-2 mg/kg oral; 15 mg oral maximum
- There have been no published reports of serious or fatal poisoning from carbonyl iron overdose. Carbonyl iron has a greater safety margin than ferrous sulfate formulations because it is more slowly absorbed and must be converted to ferrous iron by gastric acid before it can be absorbed.
- Carbonyl iron overdose may be treated with supportive and symptomatic care.
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What drugs interact with carbonyl iron?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Carbonyl iron has no listed severe interactions with other drugs.
- Serious interactions of carbonyl iron include:
- baloxavir marboxil
- Carbonyl iron has moderate interactions with at least 33 different drugs.
- Mild interactions of carbonyl iron include:
- calcium acetate
- calcium carbonate
- calcium chloride
- calcium citrate
- calcium gluconate
- vitamin E
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or healthcare provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Iron requirement increases during pregnancy, and untreated iron deficiency and iron deficiency anemia can increase the risk for low birth weight, preterm birth, or newborn mortality.
- Supplemental carbonyl iron intake during pregnancy is desirable in order to prevent iron deficiency, however, it should not exceed the daily recommended dose.
- Iron deficiency during pregnancy may be treated with carbonyl iron and iron supplementation should continue for 6 to 8 weeks after delivery to replenish the mother’s iron stores.
- Iron is present in breast milk and carbonyl iron use increases iron content in the milk; iron is a beneficial mineral nutrient for the breastfeeding baby and carbonyl iron not exceeding the recommended daily dose is compatible with breastfeeding.
What else should I know about carbonyl iron?
- Do not take carbonyl iron in excess of the daily recommended dose.
- Do not take for longer than 6 months unless directed by your physician.
- Keep carbonyl iron out of reach of children.
- In case of accidental overdose, seek medical help or Contact Poison control.
Carbonyl iron is an iron supplement used as a dietary supplement and to prevent and treat iron deficiency anemia. Iron supplements are available over the counter (OTC) as different iron salts and are usually an ingredient of multivitamins. Do not use supplemental iron to treat anemias not associated with iron deficiency. Common side effects of carbonyl iron include nausea, vomiting, upper abdominal (epigastric) pain, diarrhea, constipation, dark stools, heartburn, urine discoloration, dental stain, and iron overload in organs and tissues (hemosiderosis). Consult your doctor if pregnant or breastfeeding.
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Related Disease Conditions
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased. There are several types of anemia such as iron deficiency anemia (the most common type), sickle cell anemia, vitamin B12 anemia, pernicious anemia, and aplastic anemia. Symptoms of anemia may include fatigue, malaise, hair loss, palpitations, menstruation, and medications. Treatment for anemia includes treating the underlying cause for the condition. Iron supplements, vitamin B12 injections, and certain medications may also be necessary.
Pernicious anemia is a blood disorder in which the body does not make enough red blood cells due to a lack of vitamin B12 in the blood. Pernicious anemia can develop from a lack of a protein that helps the body absorb vitamin B12, not getting enough B12 in the diet, and certain intestinal conditions that interfere with the absorption of vitamin B12 such as Crohn's disease, celiac sprue, or ulcerative colitis. There is no cure for pernicious anemia, thus treatment is life-long.
Hemochromatosis (Iron Overload)
Hereditary hemochromatosis (iron overload) is an inherited disorder in which there is excessive accumulation of iron in the body. Check out the center below for more medical references on hemochromatosis, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
Sickle Cell Disease (Anemia)
Sickle cell anemia (sickle cell disease), a blood disease that shortens life expectancy, is caused by inherited abnormal hemoglobin. Symptoms of sickle cell anemia may include bacterial infections, painful swelling of the hands and feet, fever, leg ulcers, fatigue, anemia, eye damage, and lung and heart injury. Treatment for sickle cell anemia aims to manage and prevent the worst manifestations of the disease and focuses on therapies that block red blood cells from stacking together, which can lead to tissue and organ damage and pain.
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Treatment & Diagnosis
Medications & Supplements
- Iron Supplements
- polysaccharide iron complex (Iferex 150, Ferrex 150, Niferex 150)
- iron dextran (Dexferrum, INFeD)
- iron w/stool softener sustained-release - oral
- Venofer (iron sucrose)
- heme iron polypeptide - oral, Proferrin
- multivitamins w/iron (includes prenatal vits) - oral liquids
- Side Effects of Dexferrum (iron dextran)
- multivitamins w/iron (includes prenatal vitamins) - oral
- Side Effects of Axiron (testosterone solution)
- heme iron polypeptide/folic acid - oral, Proferrin-Forte
- multivitamins/iron/fluoride chewable tablet - oral
- iron/vitamin c sustained-release - oral, Fero-Grad, Folitab
- multivitamins w/iron (includes prenatal vits) time release - oral
- multivitamins/iron (includes prenatal vits) chewable tablet - oral
Prevention & Wellness
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.