Can I take two Maltofer (iron supplements) tablets at once?

Can You Take Two Maltofer Tablets at Once?

No, you should not take two Maltofer tablets at once—the maximum recommended dose is 100 mg of elemental iron once daily, and taking higher doses does not improve absorption and may increase side effects. 1

Standard Dosing Guidelines

• The recommended dose for adults with iron deficiency anemia is 50-100 mg of elemental iron once daily, as recommended by the British Society of Gastroenterology 1
• One Maltofer tablet typically contains 100 mg of elemental iron, which represents the maximum daily dose 1
• The FDA labeling for oral iron products states "take 1 tablet daily or as directed by a doctor" and explicitly warns "do not exceed recommended dosage" 2

Why Once-Daily Dosing Is Optimal

Recent evidence demonstrates that taking iron once daily is actually more effective than splitting doses or taking multiple tablets:

• Oral doses of 60 mg elemental iron stimulate hepcidin levels (a hormone that blocks iron absorption), reducing subsequent iron absorption by 35-45% for the next 24 hours 1
• The overall absorption of iron from 60 mg taken once daily was similar to 60 mg taken twice daily, meaning you don't gain additional benefit from splitting the dose 1
• In iron-deficient anemic women, fractional iron absorption on alternate days was 40-50% higher than on consecutive days, suggesting that even daily dosing may be excessive 3

Safety Concerns with Double Dosing

Taking two tablets at once (200 mg elemental iron) poses several risks:

• Higher doses increase gastrointestinal side effects including nausea, constipation, and diarrhea without improving efficacy 2, 4
• The FDA warns that "accidental overdose of iron-containing products is a leading cause of fatal poisoning" and emphasizes not exceeding recommended dosage 2
• While 200 mg daily may be used in specific conditions like chronic kidney disease, this is not standard for most patients and requires physician supervision 1

What to Do Instead

If you feel you need more iron supplementation:

• Continue with one tablet (100 mg) daily as prescribed 1, 2
• Consider alternate-day dosing (one tablet every other day), which may actually increase absorption compared to daily dosing 5, 3
• Take the tablet on an empty stomach for maximum absorption, at least 1 hour before or 2 hours after meals 6
• Avoid taking with tea, coffee, milk, or calcium-containing foods which inhibit absorption 6

Monitoring Your Response

• Hemoglobin should increase by approximately 1 g/dL within 2 weeks of starting supplementation 6
• If there is no hemoglobin rise of at least 10 g/L after 2 weeks, this strongly predicts treatment failure and warrants reassessment 5, 1
• Continue iron therapy for 2-3 months after hemoglobin normalizes to replenish iron stores 1

If one tablet daily is not adequately treating your iron deficiency after 2-4 weeks, consult your physician about alternative formulations or intravenous iron rather than doubling your oral dose. 7, 8