Iron Replacement Therapy to Minimize Constipation

Optimal Oral Iron Formulations and Dosing

• The American College of Gastroenterology recommends ferrous gluconate 300 mg (approximately 38 mg elemental iron) once daily for iron replacement therapy, which can be taken with vitamin C or citrus juice to enhance absorption, and separated from calcium supplements by 2 hours as calcium inhibits iron absorption 1
• Consider switching to IV iron instead of increasing oral doses when oral iron is ineffective after adequate trial, patient has malabsorption, severe anemia requires rapid correction, or GI side effects are intolerable despite alternate-day dosing, as suggested by the American Gastroenterological Association 2

Key Strategies to Reduce Constipation

• Take iron supplements with vitamin C or citrus juice to enhance absorption, and separate calcium supplements by 2 hours, as recommended by the Obesity Society 1