Failure to Separate Administration of Iron and Calcium Resulting in Drug Interaction
Penalty
Summary
The facility failed to ensure the effective use of medications for a resident who was prescribed Ferosul (iron supplement) and Calcium Citrate. According to the resident's clinical record, there were physician orders for Ferosul 325 mg every 48 hours at 9 a.m. for anemia, and Calcium Citrate 250 mg every day at 9 a.m. and 5 p.m. As a result, both medications were administered together at 9 a.m. every 48 hours starting from the date the iron supplement was ordered. During an interview, the pharmacist consultant confirmed that Ferosul and Calcium Citrate should be administered at least two hours apart due to a significant drug-drug interaction that decreases iron absorption. Reference to Lexicomp, a nationally recognized drug information resource, indicated that concurrent administration of calcium and ferrous sulfate can decrease iron absorption by an average of 60%. The facility's policy required the pharmacy to assess medication profiles for potential adverse drug interactions at admission and with each new order, but this was not effectively implemented in this case.