Carbonyl Iron
Pronunciation: (kar-BOH-nil EYE-urn).
- Generic name
- carbonyl iron
- Brand names
- Palafer, Niferex, Ferrograd, Feosol, Ferretts Iron, Ferodan
- Drug class
- Iron supplement (oral hematinic)
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What carbonyl iron is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how carbonyl iron works
Carbonyl iron provides elemental iron, which is absorbed in the duodenum and upper jejunum. Once absorbed, iron is incorporated into hemoglobin and myoglobin, essential for oxygen transport and storage. Carbonyl iron is a highly pure form of iron with a slow dissolution rate, reducing the risk of acute toxicity compared to other iron salts. (1) (3)
What carbonyl iron is used for
Iron deficiency anemia
Nutritional supplementation
Before taking carbonyl iron
Do not take / not appropriate for
- Iron overload syndromes (hemochromatosis, hemosiderosis), non-iron deficiency anemias, known hypersensitivity to iron products. (Contraindication) (2)
Tell your clinician about
(2) (3)How to take carbonyl iron
- General Instructions: Take carbonyl iron exactly as prescribed by your healthcare provider. Do not take more or less than directed.. Adult Dosing: Typical adult dose for iron deficiency anemia: 50–100 mg elemental iron orally 1–3 times daily, depending on severity and clinical response.. Pediatric Dosing: Children: Dose is based on age and weight. Typical range is 3–6 mg/kg/day of elemental iron, divided into 2–3 doses.. Administration: Take on an empty stomach (1 hour before or 2 hours after meals) for best absorption. If stomach upset occurs, it may be taken with food. Avoid taking with milk, antacids, or calcium supplements.. When To Stop: Continue until your doctor advises stopping, usually after iron stores are replenished (often 3–6 months). Do not stop early without consulting your healthcare provider.. Storage: Store at room temperature, away from moisture and heat. Keep out of reach of children, as accidental overdose can be fatal.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2) (3)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not double up to make up for a missed dose.
Overdose
Iron overdose can be very dangerous, especially in children. Symptoms include severe vomiting, diarrhea, abdominal pain, drowsiness, and even coma. Seek emergency medical help or contact a poison control center immediately if overdose is suspected. (2) (3)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Unpleasant or metallic taste
Incidence: Reported in 40% to 70% of patients
Dark or black stools
Incidence: Common, usually harmless — indicates the supplement is being absorbed
Darkening of urine
Incidence: Reported; frequency not established
Stomach upset, nausea, or constipation
Incidence: Reported; frequency not established
Signs of an allergic reaction: hives, difficulty breathing, or swelling of the face, lips, tongue, or throat
(2)Signs of iron overdose: bloody or tarry stools, severe stomach pain, pale skin or blue-tinged lips/fingernails, a weak but rapid pulse, shallow breathing, or seizure — seek emergency care immediately
(2)Serious warnings
Keep out of reach of children — serious
Symptoms: Keep out of reach of children; accidental overdose is a leading cause of fatal poisoning in children under 6. Do not use if you have iron overload conditions. Monitor for signs of allergic reaction. May cause dark stools, which are usually harmless. Long-term use without medical supervision is not recommended.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindications: Iron overload syndromes (hemochromatosis, hemosiderosis), non-iron deficiency anemias, known hypersensitivity to iron products. Precautions: Use cautiously in patients with peptic ulcer disease, inflammatory bowel disease, or those at risk of iron overload. Monitor for allergic reactions and gastrointestinal intolerance.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Carbonyl iron may interact with certain antibiotics (such as tetracyclines and quinolones), antacids, calcium supplements, and some thyroid medications. These interactions can reduce the effectiveness of either medication. Take iron supplements at least 2 hours before or after these medications. Always inform your healthcare provider about all medicines and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
MedlinePlus drug information for iron supplements notes no evidence of fetal risk from oral iron use; iron deficiency anemia in pregnancy is commonly treated with oral iron (including carbonyl iron), and supplementation is often continued for 6-8 weeks after delivery to replenish maternal iron stores. Confirm dose and duration with the prescribing clinician. (2) (3)
Breastfeeding
MedlinePlus drug information for iron supplements advises telling your doctor if you are breastfeeding, but does not identify a specific breastfeeding contraindication. Iron passes into breast milk in only small, physiologic amounts and is generally considered compatible with breastfeeding when taken at recommended doses; discuss with your doctor or pharmacist before use. (2) (3)
Children
The clinician database's blanket 'not recommended for pediatric use' framing is contradicted by an independent dosing reference, which gives specific weight-based pediatric dosing under medical supervision: premature neonates 2-4 mg elemental iron/kg/day (max 15 mg/day); infants and children under 12, prevention 1-2 mg/kg/day (max 15 mg/day), mild-to-moderate anemia around 3 mg/kg/day, severe anemia 4-6 mg elemental iron/kg/day in 3 divided doses. This independent-source dosing is used in place of the DB's blanket restriction; any pediatric use should still be determined and supervised by a pediatric clinician. (2) (3)
Renal_impairment
MedlinePlus drug information for iron supplements does not describe a renal or hepatic dose-adjustment table for oral iron. No routine dose adjustment is specified for renal or hepatic impairment; iron overload itself can injure the liver, so patients with liver disease or iron-storage disorders should use iron supplements only under medical supervision, and dialysis patients with poor oral iron absorption/tolerance are often switched to intravenous iron by their clinician. (2) (3)
Hepatic_impairment
MedlinePlus drug information for iron supplements does not describe a renal or hepatic dose-adjustment table for oral iron. No routine dose adjustment is specified for renal or hepatic impairment; iron overload itself can injure the liver, so patients with liver disease or iron-storage disorders should use iron supplements only under medical supervision, and dialysis patients with poor oral iron absorption/tolerance are often switched to intravenous iron by their clinician. (2) (3)
Monitoring
(2) (3)Storage
Store at room temperature, away from light, excess heat, and moisture (not in the bathroom), in the original container, tightly closed, and out of reach of children — accidental pediatric overdose of iron is a leading cause of fatal poisoning in young children.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Iron deficiency anemia
Dose summary: 100-200 mg of elemental iron per day, divided into 1-3 doses.
Renal context: MedlinePlus drug information for iron supplements does not specify a renal dose-adjustment table. No dose adjustment is typically required for oral iron in renal impairment; hemodialysis patients frequently have reduced oral absorption/tolerance and are often managed with intravenous iron instead, per the treating clinician. (1) (3)
Hepatic guidance
No specific hepatic dose-adjustment table for carbonyl iron was found in the sources reviewed for this page. Iron overload from excessive or unsupervised iron intake can itself injure the liver; patients with pre-existing liver disease or iron-storage disorders should use iron supplements only under medical supervision.
Frequently asked questions
What is carbonyl iron used for?
Carbonyl iron is used to treat and prevent iron deficiency anemia by replenishing the body's iron stores.
How should I take carbonyl iron for best absorption?
Take carbonyl iron on an empty stomach, 1 hour before or 2 hours after meals. If it causes stomach upset, you may take it with food, but avoid milk and antacids.
What should I do if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not take two doses at once.
What are the signs of iron overdose?
Symptoms include severe vomiting, diarrhea, abdominal pain, drowsiness, and confusion. Overdose can be fatal, especially in children. Seek emergency help immediately.
Can I take carbonyl iron with other medications?
Some medications, such as certain antibiotics and antacids, can interact with carbonyl iron. Take iron at least 2 hours apart from these medications and inform your doctor about all medicines you use.
Is carbonyl iron safe during pregnancy?
Carbonyl iron is commonly used during pregnancy to prevent or treat iron deficiency anemia, but always use it under medical supervision.
Why does carbonyl iron cause dark stools?
Dark stools are a harmless side effect of iron supplements and indicate that the medication is being absorbed.
What happens if I take too much Carbonyl iron?
Taking too much Carbonyl iron can lead to iron toxicity, characterized by symptoms such as severe abdominal pain, vomiting, diarrhea, and in severe cases, liver damage or cardiovascular collapse. If an overdose is suspected, it is crucial to seek immediate emergency medical attention. Do not induce vomiting unless instructed by a healthcare professional.
Can I drink alcohol while taking Carbonyl iron?
While there isn't a direct contraindication, excessive alcohol consumption can irritate the gastrointestinal tract, potentially worsening common side effects of iron supplements like stomach upset or constipation. Additionally, chronic alcohol use can impair iron absorption and may exacerbate iron deficiency. It is generally advisable to limit or avoid alcohol while taking Carbonyl iron and to discuss alcohol intake with your healthcare provider.
What is the mechanism of action of carbonyl iron?
Carbonyl iron provides elemental iron, which is absorbed in the duodenum and upper jejunum. Once absorbed, iron is incorporated into hemoglobin and myoglobin, essential for oxygen transport and storage. Carbonyl iron is a highly pure form of iron with a slow dissolution rate, reducing the risk of acute toxicity compared to other iron salts. (1) (3)
What is the generic name of Carbonyl Iron?
The generic name is carbonyl iron. It is sold under brand names including Palafer, Niferex, Ferrograd, Feosol, Ferretts Iron, Ferodan.
What class of drug is carbonyl iron?
Carbonyl Iron is classed as: Iron supplement (oral hematinic).
References
- MedGuideGlobal clinician-authored medicine record — carbonyl ironMedGuideGlobal clinical team (internal medicine record) · global (generic supplement) · accessed 2026-08-06 · source 1
- Carbonyl iron consumer drug information and dosage guideDrugs.com (multi-source consumer drug information) · United States (general consumer reference) · accessed 2026-08-06 · source 2
- Iron Supplement (Oral Route)MedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-08-07 · source 3
- HEMAX (ASCORBIC ACID, DL-ALPHA TOCOPHERYL ACETATE, L-5-METHYLTETRAHYDROFOLATE CALCIUM, CYANOCOBALAMIN, BIOTIN, CARBONYL IRON, CUPRIC SULFATE) TABLET [PRONOVA CORPORATION] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 4
- carbonyl iron — RxNorm normalized drug concept (RXCUI 262150)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient carbonyl iron names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- MaxiYumMaxiYum
- Carwin Pharmaceutical AssociatesCarwin Pharmaceutical Associates