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Accrufer

ferric maltol
Used for Iron Deficiency
Used for Iron Deficiency

Accrufer (ferric maltol) is a prescription iron supplement for adults with low iron levels (iron deficiency). It comes as a 30-mg capsule that's taken by mouth twice per day on an empty stomach (1 hour before or 2 hours after a meal). Treatment typically lasts for at least 3 months, but it depends on how low your iron levels are. Side effects aren't common but can include diarrhea, constipation, discolored stool, and stomach pain.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Allison Gourley, PharmD
Last reviewed on January 6, 2025
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostContraindicationsAlternativesReferencesPricesMedicare
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What is Accrufer (ferric maltol)?

What is Accrufer (ferric maltol) used for?

How Accrufer (ferric maltol) works

Accrufer (ferric maltol) is an iron supplement that helps replenish your body with iron. Iron is an important mineral for your health. Your body needs iron to make hemoglobin, a protein in your red blood cells that helps carry and deliver oxygen through your body.

Are you looking for information on Auryxia (ferric citrate), or ferrous sulfate instead?

Drug Facts

Common BrandsAccrufer
Drug ClassIron supplement
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Avg retail price
$712.27(save 78.94%)
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$150.00
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What are the side effects of Accrufer (ferric maltol)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Passing gas (5%)

Other Side Effects

  • Diarrhea
  • Constipation
  • Discolored stool
  • Stomach pain
  • Stomach discomfort
  • Nausea
  • Vomiting

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Too much iron in the body (iron overdose): nausea, vomiting, vomiting up blood, tarry stool, stomach pain, stomach ulcer, trouble breathing, feeling confused or dizzy

Source: DailyMed

More on Accrufer (ferric maltol) side effects

iron-supplements: side effects iron supplement

From Constipation to Taste Changes: 6 Iron Supplement Side Effects, and How to Manage Them

Written by Alex Evans, PharmD, MBA

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Accrufer (ferric maltol)

thumbs-up

Pros

Starts to raise iron levels within 3 hours after you take it

Might have a lower risk of stomach-related side effects than other iron supplements

Taken by mouth

thumbs-down

Cons

Need to take twice a day on an empty stomach

Only available as a capsule that you can't open, broken, or chew

Hasn't been studied in children

pharmacist-tips

Pharmacist tips for Accrufer (ferric maltol)

pharmacist

  • Take Accrufer (ferric maltol) twice per day on an empty stomach, either 1 hour before or 2 hours after a meal.

    • Swallow the Accrufer (ferric maltol) capsules whole. Don't open, break, or chew them. Speak with your prescriber if you're having trouble swallowing the capsules.

      • Treatment with Accrufer (ferric maltol) typically lasts for at least 3 months. But your prescriber will decide how long you should take this iron supplement for based on your ferritin levels.

        • Mark your calendar to get any blood tests done while you're taking Accrufer (ferric maltol). Your prescriber will keep track of your iron levels to see how well the medication is working for you.

          • Stomach-related side effects like passing gas, diarrhea, and constipation are the most common side effects of Accrufer (ferric maltol). Contact a healthcare professional if these side effects are too bothersome. They can suggest treatment options that you can try.

            • Accrufer (ferric maltol) make your stool discolored, which is a common side effect of iron supplements. Your stool might be a dark green or black color. Be aware that tarry, black stools can be a sign of stomach bleeding. So it's best to contact a healthcare professional if you're concerned about any changes in stool color.

              • Check the labels of any other vitamins (including multivitamins) and supplements you're taking to see if they contain iron. Taking too much iron can lead to side effects, such as upset stomach, nausea, and constipation.

                • Store Accrufer (ferric maltol) out of reach of children to prevent them from accidentally taking this medication. Call your local Poison Control Center right away at 1-800-222-1222 if your child accidentally took this medication, especially if they're vomiting up blood, having diarrhea, or feeling stomach pain.

                  More on Accrufer (ferric maltol) tips

                  Pharmacy: drug interaction iron

                  8 Iron Supplement Interactions: Dairy, Coffee, Antibiotics, and More

                  Written by Austin Ulrich, PharmD, BCACP
                  faqs

                  Frequently asked questions about Accrufer (ferric maltol)

                  Is Accrufer (ferric maltol) FDA approved?
                  Yes, Accrufer (ferric maltol) is FDA approved. The FDA approved the medication in July 2019. Accrufer (ferric maltol) is approved to treat adults with iron deficiency, which can include iron-deficiency anemia.
                  Is Accrufer (ferric maltol) safe in pregnancy?
                  Yes, Accrufer (ferric maltol) is safe to take while pregnant. In fact, healthcare professionals might recommend that you take an iron supplement like Accrufer (ferric maltol) if you're pregnant and have iron-deficiency anemia. This is because iron-deficiency anemia during pregnancy can lead to delivery complications, premature birth, and low birth weight. Ask your obstetrician-gynecologist (OB-GYN) about whether you need to take an iron supplement like Accrufer (ferric maltol).
                  When is the best time to take Accrufer (ferric maltol)?
                  There are a few things to consider when you're figuring out when to take Accrufer (ferric maltol). Your body absorbs the medication best on an empty stomach. Take it 1 hour before or 2 hours after a meal. You'll also want to space your other medications apart from when you take Accrufer (ferric maltol) to avoid drug interactions. In addition, keep in mind that you'll need to take Accrufer (ferric maltol) twice a day. Ask your pharmacist if you need help finding times during the day to take Accrufer (ferric maltol) that are convenient for you.
                  Can I take Accrufer (ferric maltol) with food?
                  No. Food lessens the amount of Accrufer (ferric maltol) that's absorbed into your body. This might make it not work as well for you. Take Accrufer (ferric maltol) 1 hour before or 2 hours after a meal.
                  How long do I have to take Accrufer (ferric maltol)?
                  Accrufer (ferric maltol) is typically taken for at least 3 months. But the exact amount of time you need to take the medication will depend on how well it's working for you. You'll probably continue to take Accrufer (ferric maltol) until your ferritin levels are within the normal range and as long as you're not having any serious side effects. Discuss with your prescriber about how long to take Accrufer (ferric maltol) for.
                  Does Accrufer (ferric maltol) cause weight loss?
                  Weight loss isn't a typical side effect of Accrufer (ferric maltol). But iron-containing products typically cause stomach-related side effects like stomach pain, diarrhea, constipation, nausea, or vomiting. These side effects can sometimes lower your appetite, which might contribute to a little weight loss. Contact your prescriber if you notice extreme and unexplained weight loss after you start taking Accrufer (ferric maltol).
                  Does Accrufer (ferric maltol) cause constipation?
                  Yes, iron-containing products like Accrufer (ferric maltol) can cause constipation as a side effect. If you experience constipation, make sure to drink enough water to stay hydrated to help. If needed, you can consider over-the-counter laxatives. Speak with a healthcare professional if you need more guidance on how to prevent and relieve constipation from Accrufer (ferric maltol).
                  What's the difference between Accrufer (ferric maltol) and ferrous sulfate?
                  Both Accrufer (ferric maltol) and ferrous sulfate are oral iron supplements that are used to treat iron deficiency (low iron levels). But they have many differences. Accrufer (ferric maltol) is taken twice per day on an empty stomach, whereas ferrous sulfate is taken once per day with or without food. In addition, Accrufer (ferric maltol) is available by brand name only and requires a prescription. But ferrous sulfate is available over the counter as a generic. Ask a healthcare professional or your primary care provider if you have questions about comparing between the two different iron supplements.
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                  What are the risks and warnings for Accrufer (ferric maltol)?

                  Accrufer (ferric maltol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                  risk-warning

                  Avoid in people having a flare-up of inflammatory bowel disease (IBD)

                  People currently having an IBD flare should avoid taking Accrufer (ferric maltol). The medication can worsen inflammation in the stomach lining, which can cause some blood loss. This might further lower the amount of iron in the body.

                  risk-warning

                  Iron overdose

                  • Risk factors: Taking too much iron | Receiving blood transfusions often | Medical problems that raise your blood iron level | Children under 6 years of age

                    Your iron level can become too high if you take multiple medications that contain iron. It can also happen if you take more Accrufer (ferric maltol) than recommended. You'll need regular blood tests so your prescriber can check that your iron levels are safe while you're taking Accrufer (ferric maltol).

                    Let your care team know right away if you experience any early signs of high iron levels, such as vomiting (which can include vomiting up blood), stomach pain, diarrhea, and blood in the stool. It's important to get medical help as soon as possible because high iron levels can lead to dangerous problems like tears in the gut and liver damage if not treated quickly.

                    Keep Accrufer (ferric maltol) out of reach of children so that they don't accidentally take it. Accidental overdose of iron-containing products can be extremely harmful to children under 6 years of age. If your child accidentally took Accrufer (ferric maltol) and they're vomiting up blood, having diarrhea, or feeling stomach pain, call your local Poison Control Center right away at 1-800-222-1222.

                    dosage

                    Accrufer (ferric maltol) dosage forms

                    The average cost for 60 capsules of 30mg of Accrufer (ferric maltol) is $150.00 with a free GoodRx coupon. This is 78.94% off the average retail price of $712.27.
                    capsule
                    Capsule
                    DosageQuantityPrice as low asPrice per unit
                    30mg60 capsules$150.00$2.50

                    Typical dosing for Accrufer (ferric maltol)

                    The typical dose is 30 mg by mouth twice a day on an empty stomach (1 hour before or 2 hours after a meal).

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                    How much does Accrufer (ferric maltol) cost?

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                    Accrufer (brand)
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                    contraindications-icon

                    Accrufer (ferric maltol) contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Accrufer (ferric maltol) will not be safe for you to take.

                    • Medical conditions that cause high iron levels (e.g., hemochromatosis)

                    • Receiving many blood transfusions

                    alternatives

                    What are alternatives to Accrufer (ferric maltol)?

                    There are a number of medications that your doctor can prescribe in place of Accrufer (ferric maltol). Compare a few possible alternatives below.
                    Accrufer (ferric maltol)
                    Used for:
                    $150.00 Lowest GoodRx priceView Prices
                    Iron supplements
                    Used for:
                    $7.76 Lowest GoodRx priceView Prices

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                    References

                    Best studies we found

                    Crohns's & Colitis Foundation. (n.d.). What is a flare?

                    Howaldt, S., et al. (2022). Long-term effectiveness of oral ferric maltol vs intravenous ferric carboxymaltose for the treatment of iron-deficiency anemia in patients with inflammatory bowel disease: A randomized controlled noninferiority trial. Inflammatory Bowel Diseases.

                    Lewkowitz, A. K., et al. (2023). Identifying and treating iron deficiency anemia in pregnancy. Hematology, ASH Education Program.

                    View All References (7)

                    MedlinePlus. (2024). Ferritin blood test.

                    MedlinePlus. (2024). Hemoglobin.

                    MedlinePlus. (2024). Iron tests.

                    Nielsen, O. H., et al. (2015). Management of iron-deficiency anemia in inflammatory bowel disease: A systematic review. Medicine.

                    Shield TX (UK) Ltd. (2023). Accrufer- ferric maltol capsule [package insert]. DailyMed.

                    U.S. Food and Drug Administration. (2025). Drug trials snapshots: ACCRUFER.

                    Yuen, H. W., et al. (2023). Iron toxicity. StatPearls.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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