Patient/caregiver was educated on contraindications for using Ferrous gluconate as follows:
- Ferrous gluconate must be administered with extreme caution in individuals with history of hemolytic anemias, such as, sickle cell or thalassemia. Hemolytic anemias usually are inherited genetic defects, resulting in poor structural stability of the red blood cells. Structurally deficient red blood cells are prone to damage and lysis, before completion of their lifespan. Hemolytic anemia can also be secondary to autoimmunity, when individuals can develop antibodies acting against their own red blood cells, thus resulting in damage of lysis of the cells. Irrespective to the basic pathology, individuals with history of hemolysis can present with findings of anemia. As blood cells are lysed in these individuals, the released heme and iron accumulate in the body in various vital organs, leading to the symptoms of tissue iron toxicity. Administering Ferrous gluconate in these individuals, to offset anemic symptoms, can worsen the toxicity with iron overload and so, must be done with extreme caution.
- Ferrous gluconate must be avoided or administered with extreme caution in individuals with prolonged history of multiple blood transfusions. Individuals with this history can also present with iron overload and accumulation of iron in various vital organs, leading to the symptoms of tissue iron toxicity. Also, individuals with history of taking ferrous gluconate in excess to their prescribed amount have the risk for iron overload and toxicity. Administering Ferrous gluconate in these individuals can worsen the toxicity with iron overload.
- Ferrous gluconate must be avoided or administered with extreme caution in individuals with history of organ failure, such as, cirrhosis and congestive heart failure. Any amount of iron supplement administered in excess in these individuals can result in increased accumulation of iron in these end organs and lead to further deterioration of liver and heart functions.
