Patient/caregiver was educated on contraindications for using Feratab as follows:
- Feratab 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 feratab in excess to their prescribed amount have the risk for iron overload and toxicity. Administering Feratab in these individuals can worsen the toxicity with iron overload.
- Feratab must be administered with extreme caution in individuals with chronic history of severe alcoholism. Alcohol consumed in excessive amounts can result in the body absorbing dietary iron in significantly large amounts than normal. Excess of the iron absorbed results in iron overload and accumulation in various vital organs, contributing to iron toxicity.
- Feratab intake must be avoided in individuals with history of porphyria. Porphyria is a condition resulting from accumulation of porphyrins, which are natural chemicals in the body. Porphyrins bind to iron forming the heme. Heme in association with globin forms the hemoglobin of red blood cells, which binds and carries the oxygen to tissues. The association of porphyrins with iron and synthesis of heme is a multi-step process, mediated by many enzymes. Deficiency of these enzymes can be inherited, which results in poor association of porphyrins and iron, leading to compromised synthesis of heme. Deficient heme synthesis leads to poor hemoglobin and red blood cell synthesis and individuals present with findings of anemia. The deficiency in individuals with history of porphyria is with the enzymes needed for synthesis of heme, but not iron, as it manifests to be. As heme synthesis is compromised, unused porphyrins and iron in these individuals accumulate in the body in various vital organs, leading to the symptoms of porphyria and tissue iron toxicity. Administering Feratab in these individuals, to offset anemic symptoms, can worsen the toxicity with iron overload and so, must be avoided.
