Generic Name: Ferrous sulfate Brand Name(s): Ferrous sulfate.

Uses

What is Ferrous sulfate used for?

Ferrous sulfate is an iron supplement used to treat or prevent low blood levels of iron (e.g., for anemia or during pregnancy). Iron is an important mineral that the body needs to produce red blood cells and keep you in good health.

How should I take Ferrous sulfate?

Iron is best absorbed on an empty stomach (usually if taken 1 hour before or 2 hours after meals). If stomach upset occurs, you may take this medication with food. See the instructions below for the liquid drops for infants/children. Avoid taking antacids, dairy products, tea, or coffee within 2 hours before or after this medication because they will decrease its effectiveness.

Take tablets or capsules with a full glass of water (8 ounces or 240 milliliters) unless otherwise directed by your doctor. Do not lie down for 10 minutes after taking your tablet or capsule dose.

Swallow extended-release capsules whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

If you are taking chewable tablets, chew the medication thoroughly, then swallow.

If you are taking a liquid suspension form of this medication, shake the bottle well before each dose.

If you are taking the liquid form for adults, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Mix the dose in a glass of water or juice, and drink the mixture through a straw to prevent staining the teeth.

If you are giving the liquid drops to an infant or child, use the dropper provided to carefully measure the dose. The dose may be placed directly into the mouth (towards the back of the tongue) or it may be mixed in formula (not milk), fruit juice, cereal, or other food as directed to increase your child’s acceptance. It is best to give this medication right after a meal. Follow the directions on the product package for the brand that you use.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day.

How do I store Ferrous sulfate?

Ferrous sulfate is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Ferrous sulfate in the bathroom or the freezer. There may be different brands of Ferrous sulfate that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Ferrous sulfate down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Ferrous sulfate?

This medication should not be used if you have certain medical conditions. Before taking this medication, consult your doctor or pharmacist if you have: iron overload disorder (e.g., hemochromatosis, hemosiderosis).

Before taking this medication, tell your doctor or pharmacist your medical history, especially of: use/abuse of alcohol, liver problems, stomach/intestinal problems (e.g., ulcer, colitis).

If your brand of iron supplement also contains folic acid, be sure to tell your doctor or pharmacist if you have vitamin B12 deficiency (pernicious anemia) before taking it. Folic acid may falsely improve certain laboratory tests for vitamin B12 deficiency without actually treating this anemia. Untreated vitamin B12 deficiency may result in serious nerve problems (e.g., peripheral neuropathy symptoms such as numbness/pain/tingling sensations). Consult your doctor or pharmacist for details.

Chewable tablets of this medicine may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to restrict your intake of aspartame (or phenylalanine), consult your doctor or pharmacist about using this drug safely.

Liquid preparations of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Ferrous sulfate during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Ferrous sulfate. Ferrous sulfate is pregnancy risk category N according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Ferrous sulfate?

Constipation, diarrhea, stomach cramps, or upset stomach may occur. These effects are usually temporary and may disappear as your body adjusts to this medication. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

Iron may cause your stools to turn black, an effect that is not harmful.

If your doctor has prescribed this drug, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Ferrous sulfate?

Before taking this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: certain antibiotics (e.g., penicillamine, chloramphenicol, quinolones such as ciprofloxacin/norfloxacin), bisphosphonates (e.g., alendronate), levodopa, methyldopa, thyroid replacement drugs (e.g., levothyroxine).

Avoid taking this medication at the same time as antacids or tetracycline antibiotics. Wait at least 2 hours between taking this medication and an antacid or tetracycline.

If your brand of iron also contains folic acid, be sure to tell your doctor or pharmacist if you take certain anti-seizure drugs (e.g., hydantoins such as phenytoin).

This medication may interfere with certain laboratory tests (e.g., fecal occult blood tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Ferrous sulfate may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Ferrous sulfate?

Ferrous sulfate may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Ferrous sulfate?

Ferrous sulfate may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Ferrous sulfate.

What is the dose of Ferrous sulfate for an adult?

Usual Adult Dose for Iron Deficiency Anemia

Initial dose: 600 mg/day ferrous sulfate (120 mg/day elemental iron) for 3 months

-Give in divided doses (1 to 3 times daily)

Usual Adult Dose for Anemia Associated with Chronic Renal Failure

Initial dose: 1000 mg/day ferrous sulfate (200 mg/day elemental iron) orally in divided doses (1 to 3 times daily)

Comments:

-If goals are not met with oral iron after 1 to 3 months, consider IV iron supplementation.

-Smaller daily doses may be better tolerated.

Usual Adult Dose for Vitamin/Mineral Supplementation

Initial dose: 1 tablet orally once a day

or

Initial dose: 30 to 90 mg/day ferrous sulfate (FeSO4) (6 to 18 mg/day elemental iron) orally, in divided doses (1 to 3 times daily)

51 and over: 25 to 40 mg/day FeSO4 (5 to 8 mg/day elemental) orally, in divided doses (1 to 3 times daily)

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Dose Adjustments

Vitamin supplementation/Prevention of anemia:

14 to 18 years: Pregnancy: 115 to 135 mg/day ferrous sulfate (FeSO4) (23 to 27 mg/day elemental iron)

14 to 18 years: Lactation: 35 to 50 mg/day FeSO4 (7 to 10 mg/day elemental)

19 to 50 years: Pregnancy: 110 to 135 mg/day FeSO4 (22 to 27 mg/day elemental)

19 to 50 years: Lactation: 32.5 to 45 mg/day FeSO4 (6.5 to 9 mg/day elemental)

Maximum dose: 225 mg FeSO4 (45 mg/day elemental)

Treatment of anemia:

Pregnancy: 300 to 600 mg FeSO4 (60 to 120 mg/day elemental)

Dialysis

Iron supplementation is routinely provided to peritoneal dialysis and hemodialysis patients for prevention or treatment of anemia associated with chronic renal failure.

Other Comments

Administration advice:

-Coffee, tea, milk, cereal, dietary fiber, and phosphate containing carbonated drinks decrease iron absorption.

-Supplements containing calcium, zinc, manganese, or copper decrease iron absorption.

-Antacids, H2 blockers, and proton pump inhibitors decrease iron absorption; do not use within 1 to 2 hours of iron administration.

-Vitamin C and acidic foods increase iron absorption.

-Delayed release and enteric coated formulations are better tolerated, but are not as well absorbed.

Patient advice:

-Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.

-Keep out of reach of children.

-In case of accidental overdose, call a doctor or poison center immediately.

What is the dose of Ferrous sulfate for a child?

Usual Pediatric Dose for Iron Deficiency Anemia

0 to 5 years: 15 to 30 mg/kg/day ferrous sulfate (FeSO4) (3 to 6 mg/kg/day elemental iron)

5 to 12 years: 300 mg FeSO4 (60 mg/day elemental)

12-18 years male: Two 300 mg FeSO4 (60 mg elemental) tablets orally daily

12-18 years female: 300 to 600 mg/day FeSO4 (60 to 120 mg/day elemental)

-Give in divided doses (1 to 3 times daily)

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Preterm infant (less than 37 weeks gestation), 0 to 12 months: 10 mg/kg/day ferrous sulfate (FeSO4) (2 mg/kg/day elemental iron)

0 to 6 months: 1 to 1.35 mg/day FeSO4 (0.2 to 0.27 mg/day elemental)

7 to 12 months: 35 to 55 mg/day FeSO4 (7 to 11 mg/day elemental)

1 to 3 years: 20 to 45 mg/day FeSO4 (4 to 9 mg/day elemental)

4 to 8 years: 20 to 50 mg/day FeSO4 (4 to 10 mg/day elemental)

9 to 13 years: 30 to 40 mg/day FeSO4 (6 to 8 mg/day elemental)

14 to 18 years: 40 to 75 mg/day FeSO4 (8 to 15 mg/day elemental)

-Give in divided doses (1 to 3 times daily)

or

Tablets (325 mg FeSO4, 65 mg elemental iron)

12 years and older: 1 tablet orally once a day

Precautions

-Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.

-Keep out of reach of children.

-In case of accidental overdose, call a doctor or poison center immediately.

How is Ferrous sulfate available?

Ferrous sulfate is available in the following dosage forms and strengths:

  • Oral liquid
  • Oral tablet
  • Oral tablet, extended release
  • Oral syrup
  • Oral capsule, extended release
  • Oral elixir
  • Oral delayed release tablet
  • Compounding powder

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Ferrous sulfate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: February 1, 2018 | Last Modified: February 1, 2018

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