Nutrition Diet: What Are the Side Effects of ACCRUFeR Iron?

October 7, 2025 •

4 min read

Clinical studies show that fewer than 5% of patients discontinue ACCRUFeR treatment due to adverse reactions, but understanding what are the side effects of ACCRUFeR iron? is still crucial for anyone considering this oral iron therapy. Its unique formulation is designed to minimize gastrointestinal upset compared to traditional oral iron options.

Quick Summary

This article explores the most common gastrointestinal side effects and potential serious risks associated with the prescription iron supplement ACCRUFeR, providing guidance on how to manage them and outlining important safety precautions.

Key Points

Gastrointestinal Effects: Common side effects of ACCRUFeR are generally mild and include gas, bloating, diarrhea, constipation, and abdominal pain.
Less Irritating Formulation: ACCRUFeR's maltol shield allows for better iron absorption in the small intestine, which often results in fewer and milder GI issues compared to traditional oral iron supplements.
Serious Risks: Rare but serious side effects include severe allergic reactions and iron overload, which can be monitored by a healthcare provider.
Not for IBD Flares: Patients with active inflammatory bowel disease (IBD) should avoid ACCRUFeR, as it may worsen intestinal inflammation.
Overdose in Children: Accidental overdose of iron products is a leading cause of fatal poisoning in children under 6; keep ACCRUFeR out of their reach.
Drug Interactions: Certain medications like some antibiotics and dimercaprol can interact with ACCRUFeR, requiring timed administration or avoidance.
Discolored Stools: A common, expected side effect is a dark green or black discoloration of the feces.

Understanding ACCRUFeR and Its Unique Approach

ACCRUFeR (ferric maltol) is a prescription oral iron supplement used to treat iron deficiency in adults. Unlike traditional oral iron salts, which often cause significant gastrointestinal (GI) side effects, ACCRUFeR features a 'maltol shield'. This design protects the iron until it reaches the small intestine, where it is absorbed more efficiently and with less irritation. While this approach reduces the risk of GI upset, side effects can still occur and it's important to be aware of them.

Common Gastrointestinal Side Effects

The most frequently reported side effects of ACCRUFeR are related to the digestive system and are generally mild to moderate. A summary of findings from clinical trials indicates the following common adverse reactions, each experienced by fewer than 5% of patients in some studies:

Gas or Flatulence: Patients may experience an increase in gas production and passing wind.
Diarrhea: Loose stools or an increase in bowel movements can occur.
Constipation: Some individuals may experience hardened stools or difficulty with bowel movements.
Abdominal Pain or Discomfort: Stomach pain, discomfort, or general soreness in the abdominal area has been reported.
Nausea and Vomiting: Feeling sick to your stomach or vomiting, though less common, can happen.
Discolored Feces: It is normal for iron supplements, including ACCRUFeR, to cause stools to appear dark green or black. This is not typically a cause for concern unless the stools are tarry and accompanied by other symptoms, which could indicate stomach bleeding.

Less Common and Serious Side Effects

Beyond the more common GI issues, there are important safety considerations and potential serious, though less frequent, side effects associated with ACCRUFeR.

Increased Risk of IBD Flare

Individuals with inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis, should avoid taking ACCRUFeR during an active flare-up. The medication could potentially increase inflammation in the gastrointestinal tract and worsen symptoms like diarrhea, cramps, and stomach pain.

Iron Overload (Hemosiderosis)

Excessive iron therapy can lead to an accumulation of too much iron in the body, a condition known as hemosiderosis. This can cause organ damage if left untreated. It is critical that iron parameters are monitored regularly by a healthcare provider while on ACCRUFeR therapy. People with certain iron overload syndromes, such as hemochromatosis, or those receiving repeated blood transfusions should not take ACCRUFeR.

Severe Allergic Reactions

In rare cases, a serious allergic reaction (anaphylaxis) can occur. Symptoms to watch for include hives, difficult breathing, swelling of the face, lips, tongue, or throat, fever, racing heart, or dizziness. If any of these occur, stop taking the medication and seek immediate emergency medical help.

Managing ACCRUFeR Side Effects

Several strategies can help mitigate the side effects of ACCRUFeR, though always consult a healthcare professional first:

Take as Directed: Follow the prescription instructions exactly. ACCRUFeR is typically taken twice daily on an empty stomach, at least one hour before or two hours after a meal.
Stay Hydrated: Drinking plenty of water can help with both constipation and diarrhea.
Monitor Symptoms: Report any bothersome or persistent side effects to your doctor. For mild GI discomfort, your pharmacist may offer advice.
Swallow Capsules Whole: Do not chew, crush, or open the capsules, as this can affect how the medication is absorbed and potentially increase side effects.

ACCRUFeR vs. Traditional Oral Iron Supplements

ACCRUFeR is designed to improve tolerability compared to older oral iron supplements, like ferrous sulfate. Here is a comparison of their typical side effect profiles:


Feature	ACCRUFeR (Ferric Maltol)	Traditional Oral Iron (e.g., Ferrous Sulfate)
GI Tolerability	Clinically shown to have improved tolerability; lower reported incidence of GI issues.	High incidence of adverse GI reactions, leading to poor patient adherence.
Common Side Effects	Flatulence, diarrhea, constipation, abdominal discomfort, nausea, discolored feces.	Nausea, vomiting, abdominal cramps, constipation, diarrhea, and dark stools.
Mechanism of Action	Maltol shield protects iron from stomach, improving absorption in the small intestine and reducing GI irritation.	Dissociates in the stomach, leading to unabsorbed iron that can irritate the intestinal lining and cause discomfort.
Absorption	More efficient absorption, particularly for patients intolerant to other oral iron forms.	Poor absorption, with a large percentage of unabsorbed iron contributing to side effects.
Prescription Status	Prescription only.	Available over-the-counter.

Drug and Food Interactions

Taking ACCRUFeR on an empty stomach is crucial for optimal absorption. Food can decrease the bioavailability of the iron, making the treatment less effective. Additionally, ACCRUFeR can interact with other medications, affecting their absorption. It is recommended to separate the administration of ACCRUFeR from certain oral drugs by at least four hours. It's essential to inform your healthcare provider about all medications and supplements you are taking, including:

Dimercaprol, which should be avoided due to increased risk of nephrotoxicity.
Tetracyclines and fluoroquinolones (e.g., ciprofloxacin, doxycycline), which may have reduced absorption.
Certain supplements containing iron, which can increase the risk of iron overload.

Conclusion

While ACCRUFeR's unique formulation with a maltol shield is designed to minimize the gastrointestinal side effects common with many oral iron supplements, it is not without risks. Common adverse effects include mild to moderate GI disturbances like flatulence, diarrhea, or constipation. More serious risks, such as an increased risk of an IBD flare, iron overload, or a severe allergic reaction, require immediate medical attention. Understanding these potential issues, combined with proper dosage and open communication with a healthcare provider, can help ensure safe and effective treatment for iron deficiency.

Disclaimer: This article is for informational purposes and is not a substitute for professional medical advice. Always consult with a healthcare provider regarding ACCRUFeR and its side effects. For detailed FDA-approved patient information, visit the manufacturer's website.

Frequently Asked Questions

The most common side effects are mild to moderate gastrointestinal issues, including gas, bloating, diarrhea, constipation, abdominal pain or discomfort, and nausea.

Yes, it is normal for ACCRUFeR and other oral iron supplements to cause stools to turn a dark green or black color. This is typically not a concern unless the stools are tarry and accompanied by other signs of gastrointestinal bleeding.

To help manage side effects, ensure you take the capsules whole and on an empty stomach as prescribed. Drinking plenty of water and discussing persistent issues with a healthcare professional can also be helpful.

ACCRUFeR can interact with some medications, affecting their absorption. It is often necessary to separate doses by at least four hours. Always consult your doctor or pharmacist about all medications and supplements you take.

You should not take ACCRUFeR if you have an active inflammatory bowel disease (IBD) flare, a history of iron overload conditions like hemochromatosis, or are receiving repeated blood transfusions.

Signs of an iron overdose can include nausea, vomiting, abdominal pain, diarrhea, and in more severe cases, confusion, drowsiness, and rapid breathing. Accidental overdose in children is a medical emergency.

The manufacturer notes that ACCRUFeR is not systemically absorbed as an intact complex and is not expected to pose a risk to the fetus or breastfed child. However, it is important to discuss its use with your healthcare provider during pregnancy or lactation.