FE-rik MAWL-tol

Therapeutic Classification: antianemics

Pharmacologic Classification: iron supplements

• Iron deficiency anemia.

• Enters the bloodstream and is transported to the organs of the reticuloendothelial system (liver, spleen, bone marrow) where it becomes part of iron stores.

• Resolution of iron deficiency anemia.

Absorption: Dissociates in the GI tract allowing iron and maltol to be absorbed separately; food ↓ iron absorption.

Distribution: Unknown.

Metabolism/Excretion: Maltol is metabolized in liver via glucuronidation by UGT1A6 and via sulfation. Maltol is primarily excreted in urine as glucuronide metabolite.

Half-life: Unknown.

(plasma concentrations)

Contraindicated in:

• Hypersensitivity
• Iron overload syndromes including hemochromatosis
• Recipient of multiple blood transfusion (↑ risk of iron overload)
• Concurrent use of IV iron (↑ risk of iron overload)
• Active flare of inflammatory bowel disease (may ↑ risk of inflammation in GI tract).

Use Cautiously in:

• OB: Not absorbed systemically as an intact complex; not expected to result in fetal exposure
• Lactation: Not absorbed systemically as an intact complex; not expected to result in exposure to infant
• Pedi: Safety and effectiveness not established in children.

GI: abdominal pain, constipation, diarrhea, discolored feces, flatulence, nausea, vomiting.

Hemat: iron overload.

Drug-Drug:

• Concurrent use with dimercaprol may ↑ risk of nephrotoxicity; avoid concurrent use.

• PO (Adults): 30 mg twice daily for 12 wk (until ferritin levels normal).

• Capsules: 30 mg;

• Assess nutritional status and dietary history to determine need for patient teaching.

• Assess iron parameters before starting and periodically during therapy.

• PO: Administer twice daily, 1 hr before or 2 hrs after a meal. Swallow capsules whole; do not open, break, or chew.

• Instruct patient to take ferric maltol as directed. Advise patient to read Patient Information before starting therapy and with each Rx refill in case of changes.
• Advise patient that ferric maltol may cause dark stools; this is normal for medications containing iron.
• Inform patient that ferric maltol may cause diarrhea, constipation, gas, stomach pain, nausea, vomiting, bloating. Notify health care professional if GI symptoms become severe or persistent.
• Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications. Medications may need to be taken separately from ferric maltol.
• Advise patient to store ferric maltol out of reach of children; if accidentally ingested by a child seek immediate medical attention.
• Advise female patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

• Resolution of iron deficiency anemia.

Accrufer

• Deficient knowledge, Relate med (Patient/Family Teaching).