Iron salts oral administration

Concurrent use of the fluoroquinolones with theophylline causes an increase in serum theophylline levels. When used concurrently with cimetidine, the cimetidine may interfere with the elimination of the fluoroquinolones. Use of the fluoroquinolones with an oral anticoagulant may cause an increase in the effects of the oral coagulant. Administration of the fluoroquinolones with antacids, iron salts, or zinc will decrease absorption of the fluoroquinolones. There is a risk of seizures if fluoroquinolones are given with the NSAIDs. There is a risk of severe cardiac arrhythmias when the fluoroquinolones gatifloxacin and moxifloxacin are administered with drains that increase the QT interval (eg, quini-dine, procainamide, amiodarone, and sotalol). 

The symptoms of iron deficiency anemia include fatigue, weakness, shortness of breath, and soreness of the tongue. Therapeutic iron supplementation is used to treat this type of anemia. Oral administration of ferrous salts (generic ferrous sulfate, Feosol, Slo Fe) is preferred, but parenteral iron (iron dextran, InfeD) can be given if oral therapy fails. Toxic reactions occur more frequently after parenteral iron administration. Gastrointestinal disturbances are common following oral dosages. 

The quinolones are contraindicated in patients with a history of hypersensitivity to any drug in this family. Absorption of the fluoroquinolones is reduced by antacids, iron, and zinc salts, and thus they should not be taken concurrently. Oral ciprofloxacin and enoxacin inhibit the metabolism of theophylline, and toxicity can occur when these two drugs are administered concurrently. Oral administration of the fluoroquinolones can cause convulsions and should therefore be done with caution in patients with central nervous system disorders. These drugs are not recommended for systemic administration in children, adolescents younger than age 18 years, or pregnant women. Topical administration is contraindicated for use in patients younger than 1 year of age. 

Effect of Phosphorus on Human Metabolism of Iron and Zinc. Several groups of investigators have examined the effect of orthophosphate salts on iron and zinc utilization by human subjects. Peters, et al. (35) found that the oral administration of sodium orthophosphate salts or dicalcium phosphate with a solution of radiotagged iron chloride and ascorbic acid reduced the retention of 5 Fe by human subjects (Table IV). However, Monsen Cook (36)... 

In most cases of IDA, oral administration of iron therapy with soluble Fe + iron salts is appropriate. ... 

To the best of our knowledge, no derivative of the type 5 or 6 has been commer-daUy devdoped. The number of ferrocene compounds actually used in medicine up to the present day remains very Umited, although there have been a few instances. Ferrocerone 7 (sodium salt of o-carboxybenzoyl ferrocene) (Scheme 3.3) devdoped in USSR to treat iron-deficiency anemia is one of the rare cases to come to fruition [42]. This product is well tolerated for oral administration, and can also be prescribed in the treatment of gum diseases. 

Parenteral administration of Fe + salts is indicated only when adequate oral replacement is not possible. There is a risk of overdosage with iron deposition in tissues (hemosiderosis). The binding capacity of transferrin is limited and free Fe + is toxic. Therefore, Fe + complexes are employed that can donate Fe + directly to transferrin or can be phagocytosed by macrophages, enabling iron to be incorporated into ferritin stores. Possible adverse effects are, with i.m injection persistent pain at the injection site and skin discoloration with i.v. injection flushing, hypotension, anaphylactic shock. 

The tetracyclines should be taken orally 1 h before or 2 h after meals. Absorption of these agents is impaired by the presence of milk and milk products and by the concomitant administration of aluminum hydroxide gels, sodium bicarbonate, calcium and magnesium salts, or iron preparations because of the chelation of divalent and trivalent cations by these agents. 

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