What is it used for?

• Preventing and treating iron deficiency anaemia.

How does it work?

• Galfer capsules and syrup both contain the active ingredient ferrous fumarate, which is a form of iron.
• Iron plays a vital role in production of haemoglobin, which is the oxygen-transporting substance found in red blood cells. If the diet does not contain enough iron, the body cannot make enough new red blood cells. This results in iron deficiency anaemia, with symptoms such as tiredness, palpitations, shortness of breath, dizziness and fainting.
• To treat iron deficiency anaemia, iron supplements such as this one are needed. The increased iron intake allows the body to increase its production of red blood cells.
• The absorption of iron from the gut is decreased if it is taken at the same time as coffee, tea, eggs or milk. Its absorption is enhanced if it is taken at the same time as foods or supplements containing vitamin C (ascorbic acid).

How do I take it?

• Adults and children over 12 years of age: To prevent iron deficiency anaemia one Galfer capsule OR two 5ml spoonfuls (10ml) Galfer syrup should be taken once a day. To treat iron deficiency anaemia one Galfer capsule should be taken twice a day OR two 5ml spoonfuls (10ml) Galfer syrup should be taken once or twice a day. Follow the instructions given by your doctor.
• The medicine should be taken before food on an empty stomach. However, if it upsets your stomach, then you may take it with or after food.
• The capsules should be swallowed whole and not chewed or broken.
• The absorption of iron may be reduced by tea, coffee, eggs and milk. You should avoid consuming these at the same time as taking Galfer capsules or syrup.
• Galfer syrup is for children under 12 years of age, as well as adults and children over 12 years of age. However, children under 12 years of age should only be given this medicine when prescribed by a doctor. The amount of syrup to be given to children depends on their bodyweight, among other things. It is important to follow the instructions given to you by your doctor and the directions printed on the label.

Not to be used in

• People with anaemia due to vitamin B12 deficiency (pernicious anaemia).
• People with anaemia due to folic acid deficiency.
• Genetic disease resulting in too much iron storage in the tissues (haemochromatosis).
• People with a disorder that affects storage of iron in the body (haemosiderosis).
• People with a condition where there is sudden loss of haemoglobin (oxygen carrying protein in the blood) in the urine at night (paroxysmal nocturnal haemoglobinuria).
• People with other disorders involving haemoglobin, such as sickle cell anaemia or thalassaemia.
• People receiving repeated blood transfusions.
• People with an active peptic ulcer.
• Inflammatory bowel disease such as ulcerative colitis or Crohn's disease.
• Galfer syrup contains maltitol and is not suitable for patients with rare hereditary problems of fructose intolerance.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine is safe to take during pregnancy. However, you should check with your doctor or midwife if it is necessary for you to take an iron supplement during your pregnancy. Not all pregnant women need to take supplements; you may be getting enough nutrients from your diet.
• There are no known harmful effects when this medicine is used by breastfeeding mothers.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Abdominal pain.
• Constipation.
• Diarrhoea.
• Nausea and vomiting.
• Loss of appetite.
• Darkening of stools.
• Black discoloration of teeth.

If you get an upset stomach after taking this medicine on an empty stomach this may be helped by taking the medicine with food.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor what medicines you are taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

Iron supplements can affect the absorption of a number of medicines from the gut, which can make these medicines less effective. For this reason, it is recommended that iron supplements are taken at least two hours before or two hours after other medicines, in order to minimise this effect. The medicines for which this is most important are listed below:

• bisphosphonates, eg alendronate
• eltrombopag
• entacapone
• levodopa
• levothyroxine
• methyldopa (iron tablets may also reduce the blood pressure lowering effect of methyldopa)
• penicillamine
• quinolone-type antibiotics, eg ciprofloxacin, norfloxacin, ofloxacin, levofloxacin
• tetracycline-type antibiotics, eg oxytetracycline, doxycycline, minocycline, tetracycline (these antibiotics also reduce the absorption of the iron supplements from the gut).

Zinc and calcium supplements reduce the absorption of iron supplements. Separate the medicines by at least two hours.

Antacids for heartburn or indigestion, such as magnesium carbonate, magnesium hydroxide, aluminium hydroxide and calcium carbonate may decrease the absorption of iron from the gut and thereby make the supplements less effective. Separate the medicines by at least two hours.

Trientene, used to treat Wilson's disease, also reduces the absorption of iron supplements from the gut, making them less effective unless the doses are separated by at least two hours.

Milk, milk-containing products, tea, coffee and eggs, may decrease iron absorption from the gut, while vitamin C (ascorbic acid) increases it.

References:

https://www.medicines.org.uk/emc/medicine/25263

http://www.netdoctor.co.uk/medicines/diet-and-nutrition/a6788/galfer-ferrous-fumarate/

https://www.eumom.ie/forums/topic/iron-tablets-7/

https://www.drugs.com/uk/galfer-capsules-spc-11461.html