How is this?  Prescription Carbonyl with a stool softener component.

Ferralet 90 with Ferr-Ease™* contains both ferrous gluconate and carbonyl iron--dual-iron delivery for a unique, patented way to deliver oral iron therapy. With Ferralet 90, oral iron therapy is delivered to patients in sync with the timing of iron update. The ferrous gluconate enters the body in the ferrous form, for rapid uptake. The carbonyl iron works with the patient's gastric acid to become solubilized and absorbed by intestinal enterocytes in a gentle, prolonged manner.¹

Ferralet 90 is designed for dual action and gentle action, to address traditional drawbacks of iron therapy. The complete formulation includes:

• Ferr-Ease for 90 mg dual-iron delivery
• 120 mg ascorbic acid to enhance iron absorption²
• 12 µg vitamin B₁₂ to support red blood cell generation³
• 1 mg folic acid to bolster the development of red blood cells⁴
• Gentle stool softener plus a pleasing vanilla scent
• Small pill to make swallowing easier

Plus, Ferralet 90 is lactose- and gluten-free to accommodate dietary issues.

Important Safety Information

WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. KEEP THIS PRODUCT OUT OF THE REACH OF CHILDREN. In case of accidental overdose, call a doctor or poison control center immediately.

Warning

Folic acid alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B₁₂ is deficient.

Precautions

Administration of Drug

• General: Take 2 hours after meals. Do not exceed recommended dose. Discontinue use if symptoms of intolerance appear. The type of anemia and underlying cause or causes should be determined before starting therapy with Ferralet^® 90 tablets. Ensure Hgb, Hct, reticulocyte count are determined before starting therapy and periodically thereafter during prolonged treatment. Periodically review therapy to determine if it needs to be continued without change or if a dose change is indicated. This product contains FD&C Yellow No. 5 (tartrazine) which may cause allergic type reactions (including bronchial asthma) in certain susceptible persons. Although the overall incidence of FD&C Yellow No. 5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity.
• Folic Acid: Folic acid in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurological manifestations remain progressive. Pernicious anemia should be excluded before using these products since folic acid may mask the symptoms of pernicious anemia.
• Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
• Geriatric Use: Dosing for elderly patients should be cautious. Due to the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy, dosing should start at the lower end of the dosing range.

This material is intended to provide basic information. Patients should discuss all medical advice, diagnosis, and treatment with their healthcare provider.

Please see full Prescribing Information

* US Patent no. 6,521,247 B1

1. Huebers HA, Brittenham GM, Csiba E, Finch CA. Absorption of carbonyl iron. J Lab Clin Med. 1986 Nov;108(5):473-8.
2. Lynch SR, Stoltzfus RJ. Iron and ascorbic Acid: proposed fortification levels and recommended iron compounds. J Nutr. 2003 Sep;133(9):2978S-84S.
3. Vitamin B12 [Internet]. MayoClinic.com; [cited 2009 Dec 17]. Available from http://www.mayoclinic.com/health/vitamin-B12/NS_patient-vita minb12.
4. Folic acid [Internet]. WebMD; [updated 2007 Mar 5; accessed 2009 17 Dec]. Available from http://www.webmd.com/diet/folic-acid.

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Not even close to enough vitamin C for maxiumum absorption.

The ideal ratio is 200mgs C for every 30mgs of elemental iron.  This says it has 90mgs of carbonyl?  Is that 90mgs of total iron, or 90mgs of carbonyl and then how much of the gluconate as well?

(Sorry, I'd look it up, but I'm getting a bad headache and I should have been in bed an hour ago)

So let's say it's 90mg total.  Just cause I'm feeling lazy and hopeful.

90mgs of iron means 600mgs of vitamin C for max absorption.  This has 120mgs of C.  You need to add 500mgs of C when you take this.

I am just considering this as my iron component...I would definitely take my copper (5 mg) and C 1000 mg) and Folic (1 mg) with it.? I can get a prescription from my doc and get this product for $2 per month as a maintenance medication.? How much iron do I need daily as a fresh post op?

Ferralet^® Ingredients

This would be a good one to try -- but remember that you could not take copper with it.  Copper and iron don't like each other.  Copper, zinc, iron, and calcium all bind to the same receptor sites and so all have to be taken apart from each other for max absorption.  They do not play well with each other.

What you asked, though is this -- the recommendations, of course, vary.  The current ASMBS recommendation for DS is 18-27 in addition to your multi.  However, this tends to be soft in most of the population.  So the key is to remember that, and to watch your labs.  You may not need iron at the beginning, but many many many need iron heavy duty down the road (many need it via needle).

Do you know what your iron is NOW?  That would also play a key role in determining post op iron.  I was prone to anemia prior to surgery, so knowing that, I should have been more heavily fortified post-op (I wasn't).  If you have good iron going into surgery, you may have a better chance than others.  Lots of factors without having labs to look at,

I am glad you clarified the copper...I knew about the zinc being a loner in the sandbox.....Anyway.....I have thalassemia minor...and there is no recommendation for iron supplementation for that condition......I have not had any generic anemia issues. I am trying to get my "ducks in a row" before surgery. I have an appointment with a hematologist this week....just to establish a relationship for post-op care.? We all know these?vites are pricey...so I was excited to find that Ferralet (carbonyl) would be convered?by my insurance as a maintenance medication. I would jump in the Proferrin pool, but there are cons to that as well ($$$ and availability). I guess I will have to check my mileage post-op to see what works.

You are the second person with DS I've seen with that condition.  Odd that.

Yeah, people don't realize that the metals don't play well together.  There also seems to have been a conflicting piece of research.. and then there was a calcium that put zinc IN it for some ungodly known reason which mucked up the thought process even more..  I mean a tiny amount is fine, but not the amounts we're talking about.

If it were me, I'd try the script FIRST and see how it works since it's less costly.  If it works -- sweet!  If it doesn't, then you still have an Ace in your pocket to use.

Good grief, the calcium supplements I've been taking have zinc in them.  I'm glad I found out about this.  I'll switch before I have the surgery.

****** me off when companies do this.

And when I actually called the company and asked why they did this, WITH a study?  "We have studies that contradict that one."  "Will you send it to me?"  "No."  Well, okay then!  "Will you tell me about it?"  "No."  Even better!

Sheesh. 

Well, I'm glad for people like you who take the time to share their knowledge with us newbies! 

bump