Can IFA Be Taken During Fever?
Yes, iron and folic acid (IFA) supplements can be safely taken during fever and should generally be continued without interruption.
General Safety During Febrile Illness
IFA supplementation does not need to be stopped during fever. There are no contraindications to continuing iron and folic acid supplements when a person has a fever from common illnesses 1.
The primary concern with iron supplementation relates to active inflammatory conditions affecting iron absorption, not fever itself 1.
Key Considerations for Iron Absorption
In patients with active inflammatory disease (not simple fever), systemic inflammation inhibits iron absorption, making oral iron tablets less effective 1.
For individuals with inactive disease or simple febrile illness without significant systemic inflammation, no more than 100 mg elemental iron should be taken daily 1.
Iron tablets may be taken with food to avoid stomach upset, which can be particularly helpful during illness 1.
Special Populations
Pregnant Women
Pregnant women should continue routine IFA supplementation during fever 1.
IFA should be administered routinely from the earliest contact in pregnancy until delivery, regardless of minor illnesses 1.
Iron status and folate levels should be monitored regularly during pregnancy, and supplementation continued even during intercurrent illnesses 1.
Malaria-Endemic Areas
In malaria-endemic regions, IFA can be continued during fever, but the underlying cause should be investigated 2, 3.
If fever is due to malaria and antifolate antimalarials (like sulfadoxine-pyrimethamine) are being used for treatment, IFA supplementation does not need to be stopped 2.
The concern about iron supplementation in malaria relates to untreated or poorly controlled malaria infection, not to the presence of fever itself 3.
Practical Recommendations
Continue IFA supplementation during simple febrile illnesses without interruption 1.
If gastrointestinal symptoms accompany the fever and oral iron causes additional discomfort, consider taking iron with food or temporarily reducing to alternate-day dosing 1.
Seek medical evaluation if fever persists beyond a few days to identify and treat the underlying cause, but IFA can generally continue during this evaluation 1.
In refugee or resource-limited settings where anemia prevention is critical, routine IFA supplements should be provided to pregnant and lactating women regardless of minor illnesses 1.