Hemafer (Iron Supplement) Administration: Swallow, Do Not Chew
Ferrous sulfate tablets (Hemafer) should be swallowed whole and not chewed or crushed. 1
Proper Administration of Oral Iron Supplements
- Ferrous sulfate tablets should be swallowed whole with water, as indicated in the FDA drug label directions for use 1
- Crushing or chewing iron tablets can cause tooth staining, mouth irritation, and may alter the intended absorption profile of the medication 2
- For optimal absorption, iron supplements should ideally be taken on an empty stomach, but can be taken with food if gastrointestinal side effects occur 2
- Morning dosing may be more effective than afternoon or evening dosing due to circadian variations in hepcidin levels that affect iron absorption 3
Dosing Considerations
- Standard dosing for iron deficiency is typically 50-100 mg of elemental iron daily 2
- Alternate-day dosing (e.g., 60-120 mg every other day) may improve absorption and reduce side effects compared to daily dosing 3, 4
- For patients with significant gastrointestinal intolerance to oral iron, options include:
Monitoring Response
- A hemoglobin increase of at least 10 g/L after 2 weeks of daily oral iron therapy indicates an adequate response 2
- Regular hemoglobin monitoring (approximately every 4 weeks) is recommended until normal range is achieved 2
- After hemoglobin normalization, oral iron should be continued for 2-3 months to replenish iron stores 2
- Failure to respond to oral iron may indicate non-compliance, malabsorption, continued bleeding, or other underlying conditions 2
Common Pitfalls to Avoid
- Crushing or chewing iron tablets, which can cause tooth staining and mouth irritation 1
- Taking calcium supplements or antacids simultaneously with iron, which can reduce iron absorption 4
- Continuing the same oral iron regimen despite persistent side effects, when alternate-day dosing or different formulations might improve tolerance 3
- Failing to identify and treat the underlying cause of iron deficiency while supplementing iron 4, 6
- Discontinuing iron therapy prematurely before iron stores are fully replenished 2
By following these guidelines for proper administration of Hemafer (ferrous sulfate), patients can maximize the effectiveness of their iron supplementation while minimizing potential side effects.