Fesovit

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What is Fesovit?

Fesovit is a popular oral iron capsule combining ferrous fumarate (the iron salt) with vitamin C (which improves non-haem iron absorption by approximately doubling it) and B-complex vitamins (folate and B12 are common cofactors in iron-deficiency anaemia). Ferrous fumarate provides about 33% elemental iron by weight and is well absorbed in the duodenum and proximal jejunum.

Indicaties

• Iron-deficiency anaemia — menstrual loss, pregnancy, GI blood loss, dietary insufficiency
• Iron deficiency without anaemia — ferritin < 30 ng/ml with fatigue, restless legs, hair loss, pica
• Zwangerschap — routine prophylaxis after the first trimester in many guidelines
• Adolescent menarche — particularly in vegetarian / vegan diets
• Post-partum anaemia
• Pre-operative optimisation for elective surgery in anaemic patients
• Bariatric surgery follow-up — iron malabsorption is common
• Chronische nierziekte with iron deficiency (often combined with ESA therapy)

How to take

One capsule once or twice daily — preferably alternate days for better absorption efficiency (see green box below). Take with food if needed for tolerance, ideally alongside a vitamin C source (orange juice, citrus). Avoid simultaneous tea, coffee, milk, or calcium-rich meals — tannins and calcium meaningfully reduce iron absorption.

Bijwerkingen

• Black or dark stools — expected, not a problem
• Constipation, abdominal cramps, nausea — the most common reasons for adherence failure; alternate-day dosing or switching iron salt helps
• Dyspepsia, metallic taste
• Tooth staining with liquid iron preparations (rinse mouth after dosing)
• Iron overdose — serious in children; keep well out of reach

Geneesmiddelinteracties

• Calcium, antacids, tetracyclines, fluoroquinolones, levothyroxine, bisphosphonates — chelation; separate by 2–4 hours
• Vitamin C — intentional combination; vitamin C improves iron absorption
• Tea, coffee, cocoa — tannins inhibit iron absorption; separate by 1–2 hours
• Levodopa, methyldopa, penicillamine — reduced absorption
• PPIs and H2 blockers — reduced ferrous iron absorption (acid environment helps)

Contra-indicaties

• Iron overload (haemochromatosis, repeated transfusions, thalassaemia)
• Haemolytic anaemia without iron deficiency
• Active gastrointestinal bleeding without correction of source

Opslag

Store below 25°C, dry, in original packaging. Keep out of reach of children — iron overdose is a leading cause of fatal pediatric poisoning.

Veelgestelde vragen

Why is my stool dark?

Unabsorbed iron passes through and turns stool black or dark green. Expected, harmless — not a sign of GI bleeding.

How long until I feel better?

Reticulocyte response by day 5–7. Haemoglobin rises ~1 g/dl per 2–3 weeks. Full ferritin replenishment takes 3–6 months — do not stop at first normal Hb. Symptoms (fatigue, breathlessness) improve over 4–8 weeks.

Should I take it on an empty stomach?

Empty stomach (1 hour before food) gives best absorption but worst tolerability. With food reduces absorption by ~40–50% but improves tolerability and adherence. Most patients do better with food — just take it for longer to make up.

When should I take vitamin C with it?

Take vitamin C (Celin 500 mg) at the same time as the iron tablet. Vitamin C reduces ferric to ferrous iron and chelates it for transport — roughly doubles non-haem iron absorption.

Why alternate-day dosing?

Daily iron triggers hepcidin (the master iron-blocker hormone) for 24 hours, so the next dose absorbs poorly. Alternate-day dosing lets hepcidin fall between doses, improving total absorption per week with fewer GI side effects.

How long do I need to take it?

Until ferritin is > 50 ng/ml AND haemoglobin is normal AND the underlying cause has been managed. Typically 3–6 months total. Stopping at first normal Hb leaves ferritin low and the deficiency relapses within months.

Should I have IV iron instead?

Oral iron is first-line for most. IV iron is preferred when: oral iron is not tolerated despite alternate-day dosing, malabsorption (coeliac, IBD, post-bariatric), severe deficiency needing rapid correction (third-trimester pregnancy, pre-op), CKD on ESA therapy, ongoing blood loss outpacing oral absorption.

Can I take it in pregnancy?

Yes — iron deficiency in pregnancy worsens fatigue, increases preterm-birth risk, and impairs fetal iron stores. Routine third-trimester iron is widely recommended. Severe anaemia in late pregnancy may need IV iron.

Why is iron deficiency tested for in adults?

Common causes: heavy menstrual bleeding (often the answer in pre-menopausal women), pregnancy, GI blood loss (peptic ulcer, colon cancer, hookworm), dietary inadequacy, malabsorption (coeliac, post-bariatric), chronic disease. New iron deficiency in a man or post-menopausal woman warrants GI investigation.

What if it makes me really nauseous?

Try: take with food, alternate-day dosing, halve the dose, switch iron salt (ferrous fumarate vs ferrous gluconate vs ferrous bisglycinate — tolerability varies). If still intolerant after these adjustments, consider IV iron.

Andere Vitamines & Mineralen

• Fesovit — ferrous fumarate + vitamin C + B-complex
• Feronia-XT — ferrous ascorbate + folic acid
• Cheri — iron + protein + calcium + vitamins
• Vitamin B12 1500 mcg — oral cyanocobalamin for combined-deficiency anaemia
• Celin — vitamin C 500 mg (improves iron absorption)
• Multivite Gold — uitgebreide multivitamine

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