Patient/caregiver was educated on how to take Ferrous gluconate as follows:

1. Elemental iron is the total amount of iron available in the supplement for absorption by the body. Different forms of iron supplements have varying percentages of elemental iron. Ferrous gluconate is a form of iron supplementation that has about 12% of elemental iron. It means a 325 mg of the ferrous gluconate supplement tablet has about 38 mg of iron that can be absorbed by the body.
2. Take the medication at the same time, every day, to avoid forgetting the medication.
3. Maintain strict compliance with intake of the medication as ordered, with regards to dosage and frequency, to derive the benefit of the medication intake.
4. Do not change the dose on this medication without consulting your doctor.
5. This medication yields the best results, when taken on an empty stomach with a glass of water, about an hour before meal or two hours after meal. If taking this medication on empty stomach induces some nausea and vomiting, try taking the medication with a small snack or a small cup of orange juice, to help avoid any unpleasant gastrointestinal symptoms.
6. Ferrous gluconate needs acid environment in the stomach to be easily absorbed and so, avoid having any antacids for 2 hours before and after taking the Ferrous gluconate.
7. Ferrous gluconate can be taken with a small cup of orange juice or an OTC supplement of vitamin C, as vitamin C helps better absorption of Ferrous gluconate in the stomach.
8. Avoid consuming any supplements with calcium along with Ferrous gluconate, as calcium can strongly inhibit the absorption of iron in the stomach. This can compromise the therapeutic benefit of intake of Ferrous gluconate. Also, avoid milk and any milk products for 2 hours before and after taking the Ferrous gluconate, as they contain calcium that can inhibit absorption of iron in the stomach.
9. Take the regular tablet as a whole with a glass of water. If you encounter difficulty swallowing the whole regular tablet, check with your doctor if you may cut the pill and swallow it in pieces with a glass of water. Usually tablets that can be cut bear a scoreline, displaying the line of cut. Check if your tablet has any. For individuals with swallowing difficulties, other preparations of medication could also be available to help an easy intake. Check with your physician on the same.
10. Take the regular tablet capsule as a whole. If you encounter difficulty swallowing the whole capsule, check with your doctor if you may open the capsule and sprinkle the powder on a spoonful of soft jelly or applesauce and swallow the jelly or sauce along with the medication. If you are opening the capsule to empty the contents into jelly or applesauce, make sure you are swallowing it without chewing the contents in the mouth. Chewing these contents in the mouth can result in rapid release and absorption of the medication into the blood stream, thus contributing to toxicity.
11. If you are prescribed an extended-release tablet or capsule, do not cut or crush the tablet or open the capsule. Cutting or crushing the extended-release tablet or opening the extended-release capsule can result in rapid absorption of the drug into the blood stream, thus resulting in toxicity. Swallow the extended-release tablet or capsule as a whole, using a glass of water.
12. For individuals with swallowing difficulties, Ferrous gluconate can also be prescribed as an oral liquid/suspension/elixir. Use a measuring spoon/cup to measure the correct dose being taken, in order to avoid risk for over/under dosing. Also, do not forgot to shake the suspension well before you use it. The liquid form of the medication, upon plain intake, carries the risk of staining the teeth black. Mix the liquid medication with a cup of water or small amount of orange juice and drink the mixture using a straw, to avoid the teeth getting stained with Ferrous gluconate. Cleaning the teeth twice weekly with sodium bicarbonate (baking powder) also can help prevent the teeth from staining.
13. For individuals with swallowing difficulties, Ferrous gluconate can also be prescribed as an oral chewable tablet. If you are prescribed chewable iron tablets, chew the medication in the mouth thoroughly before swallowing.
14. Individuals poorly tolerant to oral intake of ferrous gluconate can present with severe nausea and vomiting upon oral intake of ferrous gluconate. Such individuals could be prescribed ferrous gluconate injections, administered into the muscle or a vein.
15. Orally administered ferrous gluconate is prepared for absorption in the stomach and is absorbed in the intestines. Individuals with history of resection of stomach and intestines, for reasons such as cancer of stomach and intestines, present with difficulty absorbing oral ferrous gluconate. Such individuals could also be prescribed ferrous gluconate injections, administered into the muscle or a vein.
16. Oral ferrous gluconate intake can result in gastric upset, slowing of bowel movements, and exacerbation of constipation episodes, especially in individuals with history of the same. Observe compliance with recommendation for liberal fluid intake, while you are continuing on Ferrous gluconate, to prevent slowing of bowels. Consult your physician for any recommendation regarding stool softeners/laxatives, while you are continuing on Ferrous gluconate. Observe compliance with the recommendations made in this regard, to prevent episodes of constipation from developing.
17. Ferrous gluconate can take some time to fairly adjust to your body and reach a therapeutic level in your blood, before producing the desired results. Do not discontinue taking the medication without your physician’s consult, as you failed to see the desired result immediately after taking the medication.
18. Observe compliance with any other dietary measures, to include more iron-enriched food items in the diet, as recommended by your physician. Iron enriched meats could include chicken liver, oysters, clams, mussels, white meat of chicken & turkey, red meat of beef & lamb, pork, and ham. Legumes such as peas, lentils, and beans, green leafy vegetables such as, kale and spinach, nuts & seeds such as, cashew, almonds, and macadamia nuts, vegetables such as, potatoes, tomatoes, and mushroom are all decent vegetable sources of iron.
19. Periodical labs could be drawn for blood levels of iron, to evaluate the therapeutic benefit of Ferrous gluconate intake. Observe compliance with any lab draws ordered.
20. Your physician could change the dose of Ferrous gluconate, based on the results of labs drawn, therapeutic relief obtained, and/or side-effects developed. So, maintain compliance with follow-up physician appointments, to update on the relief from symptoms. Be accommodative to the plan of dose changes, if need be, until you show an optimum response.
21. Continue taking Ferrous gluconate as ordered, even if you experience relief from the symptoms of anemia. Abrupt discontinuation on Ferrous gluconate intake can result in continued symptoms of anemia and weakness. Discontinuing the medication should only be on your physician’s recommendation.
22. Notify your doctor of any unresolved and worsening symptoms of anemia, such as, pale skin and mucus membranes, exacerbation of shortness of breath, and weakness or continuing unpleasant side-effects. Your dosage on the medication could be revised or alternative plan of action could be considered.
23. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.