Class: Essential Mineral Supplement
Indications
- Prevention and treatment of iron-deficiency anemia
- Commonly used in pregnancy, menstruation, or in conditions causing chronic blood loss
- Dietary supplementation in individuals with low dietary iron intake
Mechanism of Action
- Replenishes body’s iron stores required for hemoglobin production
- Improves oxygen transport in blood and alleviates symptoms of anemia
Dosage
- Adults: 100-200 mg elemental iron daily, divided into 2-3 doses
- Children: 3-6 mg/kg of elemental iron daily, divided into doses
- Pregnancy: 30-60 mg elemental iron daily for prevention, 60-120 mg for treatment of anemia
- Best taken on an empty stomach for maximum absorption, but can be taken with food to reduce stomach upset
Forms Available
- Tablets: 325 mg ferrous sulfate (equivalent to 65 mg elemental iron)
- Liquid solution: Varies by brand, e.g., 44 mg elemental iron per 5 mL
- Extended-release tablets or capsules
Brand Names and Manufacturers
- Fer-In-Sol (Sanofi)
- Slow Fe (Bayer)
- Ferro-Gradumet (Abbott)
- Ferrosanol (Hälsa Pharma GmbH)
- Feosol (GlaxoSmithKline)
Cost
- Tablets: $5–$15 per 100 tablets (varies by region and brand)
- Liquid solution: $10–$20 per bottle (varies by size and brand)
Contraindications
- Hypersensitivity to ferrous sulfate or any component
- Hemochromatosis or other iron overload disorders
- Active gastrointestinal ulcers or colitis
Precautions
- Use with caution in patients with a history of gastrointestinal issues such as ulcers or Crohn’s disease
- Risk of iron poisoning in children; keep out of reach of children
- Avoid taking with calcium, antacids, or high-phytate foods as they reduce absorption
Side Effects
- Common: Nausea, constipation, dark stools, stomach upset
- Less common: Diarrhea, metallic taste in mouth, abdominal cramping
- Rare but serious: Iron toxicity symptoms like vomiting, dizziness, or shock
Drug Interactions
- Antacids and proton pump inhibitors: Reduce iron absorption
- Tetracyclines and quinolones: Reduced efficacy of antibiotics and iron when taken together
- Levothyroxine: Decreased absorption; separate doses by at least 4 hours
- Calcium and dairy products: Reduce iron absorption
Monitoring Parameters
- Hemoglobin and hematocrit levels to monitor treatment response
- Ferritin and serum iron levels to assess iron stores
- Watch for signs of iron toxicity, especially in pediatric patients
Patient Counseling Points
- Take iron supplements with water or orange juice to enhance absorption
- Avoid taking with tea, coffee, or dairy products to prevent reduced absorption
- Expect dark stools as a normal side effect; does not indicate harm
- Maintain a balanced diet including iron-rich foods like red meat, leafy greens, and fortified cereals
- Do not exceed recommended dose to avoid toxicity, especially in children
- Report severe symptoms such as persistent stomach pain or vomiting immediately
FAQs About Ferrous Sulfate
Q1: How long does it take for iron supplements to work?
- Significant improvements in hemoglobin levels can be seen within 2-4 weeks, but full replenishment of iron stores may take 3-6 months
Q2: Can I take iron supplements during pregnancy? - Yes, they are often prescribed to prevent or treat anemia during pregnancy
Q3: Why do I need to take iron supplements with vitamin C? - Vitamin C enhances the absorption of iron from supplements
Q4: Can iron supplements cause constipation? - Yes, constipation is common; increase fiber and fluid intake to manage symptoms
Q5: What should I do if I miss a dose? - Take it as soon as you remember, but do not double doses if it’s close to the next scheduled dose
Q6: Are there any natural alternatives to iron supplements? - Diet rich in iron-containing foods (e.g., lean meats, legumes, spinach) can help, but supplementation may still be required in significant deficiencies
Q7: Can I stop taking iron supplements once I feel better? - No, continue taking them for the duration prescribed to replenish iron stores fully