Maximum Daily Dose of Maltofer (Iron Polymaltose) Tablets
The maximum recommended dose of Maltofer (iron polymaltose) is 100 mg of elemental iron once daily for adults with iron deficiency anemia. 1
Dosing Recommendations
- For adults and children 12 years and over, the standard dosing is 1 tablet (100 mg elemental iron) daily or as directed by a physician 2
- For treatment of iron deficiency anemia in adults, 50-100 mg of elemental iron once daily is the generally recommended dose 3, 1
- Once-daily dosing is preferred over multiple daily doses, as research shows that higher doses stimulate hepcidin levels, which reduces subsequent iron absorption by 35-45% 3
- The overall absorption of iron from 60 mg elemental iron taken once daily is similar to that from 60 mg taken twice daily, suggesting no benefit to exceeding the once-daily dosing 3, 4
Alternative Dosing Considerations
- For patients experiencing gastrointestinal side effects, alternate-day dosing may be considered, as it leads to significantly increased fractional iron absorption in iron-depleted individuals 1, 4
- Morning dosing is preferred as the circadian increase in plasma hepcidin is augmented by a morning iron dose; therefore, iron doses should not be given in the afternoon or evening 4
- For specific conditions such as severe anemia or when rapid increase in hemoglobin is needed, higher doses or parenteral iron may be considered 5
Monitoring and Duration of Treatment
- Regular monitoring of hemoglobin is recommended every 4 weeks until hemoglobin normalizes 1
- After normalization of hemoglobin, oral iron should be continued for approximately 3 months to ensure adequate repletion of marrow iron stores 3, 1
- The absence of a hemoglobin rise of at least 10 g/L after 2 weeks of daily oral iron therapy strongly predicts subsequent failure to achieve a sustained response 1
Safety and Tolerability
- Iron polymaltose complex (Maltofer) has been shown to be well-tolerated with minimal side effects compared to other iron preparations 6
- Studies have demonstrated that supplementation with 100 mg of iron from iron polymaltose complex 6 days a week for 8 months resulted in significant improvement in iron parameters without notable side effects 6
- Maltofer can be used with aluminum hydroxide if necessary, as studies show no significant difference in iron absorption when the two are combined 7
Cautions
- Children under 12 years should only take Maltofer under physician guidance 2
- For patients with iron deficiency who also have inflammation or cancer, iron status assessment should be adjusted, with higher ferritin cut-off levels (100 ng/mL) being used to diagnose iron deficiency 3
- Oral iron should be avoided in patients with inflammatory bowel disease during active flares, as parenteral iron may be more appropriate in these cases 5