In anemic patients, the rate of iron absorption is different from that in healthy patients. Dietary iron exists in 2 main forms: heme iron (ferrous iron from animal food sources) and non-heme iron (predominantly ferric oxides and salts, ferritin, and lactoferrin).1 Dietary non-heme iron must first be reduced from the ferric to the ferrous form by iron-reductase in the duodenal lumen.

Ferrous iron is then absorbed across the brush border of duodenal enterocytes through the action of divalent metal transporter 1 (DMT1). Expression of iron-reductase and DMT1 increases in states of iron deficiency, thereby modulating iron absorption by enterocytes.1 Since intestinal enterocytes can only absorb iron when it is in the ferrous state,2 Ferralet 90® includes Ferr-Ease®*, a unique, patented way to deliver oral iron therapy.

Ferr-Ease® contains both ferrous gluconate and carbonyl iron. Since ferrous gluconate enters the body in the ferrous state, it is ready for quick dissolution and ready absorption.

Carbonyl iron, the keystone ingredient in Ferralet 90, provides gentle and prolonged solubilization and absorption. The patient’s own production of gastric acid determines the rate of carbonyl iron conversion from the particulate to the soluble ionized form.3 As a result of this gentle and prolonged action, carbonyl iron demonstrates excellent safety and tolerability.

The patient's system defines the rate of absorption3

1. (a) Ferrous gluconate enters the body ready for immediate absorption. (b) Particulate carbonyl iron is converted to soluble ionized iron at a rate determined by the rate of gastric acid production3

2. Overall bioavailability is similar for carbonyl iron and ferrous salts4

3. Ferralet 90 provides both the initial bolus of ferrous iron and the more prolonged absorption of carbonyl iron

It has been demonstrated that the bioavailability of carbonyl iron is similar to that of ferrous iron. Uptake by the intestinal mucosa and absorption of carbonyl iron were also similar to iron sulfate, except that the process occurred over a longer interval with carbonyl iron.2

* US Patent no. 6,521,247

1 Shander A, Cappellini MD, Goodnough LT. Iron overload and toxicity: the hidden risk of multiple blood tranfusions. Vox Sang. 2009;97(3):185-197. doi:10.1111/j.1423-0410.2009.01207.x. Epub 2009 Aug 3.

2 Huebers HA, Brittenham GM, Csiba E, Finch CA. Absorption of carbonyl iron. J Lab Clin Med. 1986;108(5):473-478.

3 Shah A. Iron deficiency anemia—Part III. Indian J Med Sci. 2004;58(5):214-216.

4 Gordeuk VR, Brittenham GM, Hughes M, Keating LJ, Opplt JJ. High-dose carbonyl iron for iron deficiency anemia: a randomized double-blind trial. Am J Clin Nutr. 1987;46(6):1029-1034.