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What Is Ferrous Sulfate and How Does It Work?

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.

Ferrous sulfate is available under the following different brand names: Slow FE, Fer-In-Sol, Feratab, Iron, Mol-Iron, Feosol, and MyKidz Iron 10.

What Are Dosages of Ferrous Sulfate?

Dosages of Ferrous Sulfate:

Dosage Forms and Strengths

Oral solution

• 220mg (44mg Fe)/5mL
• 300mg (60mg Fe)/5mL (adult only)
• 15 mg elemental Fe/mL

Oral liquid drops

• 75mg (15mg Fe)/mL

Tablet

• 45mg elemental Fe
• 200mg (65mg Fe)
• 300mg (60mg Fe)
• 325mg (65mg Fe)

Tablet, delayed release

• 325mg (65mg Fe)

Tablet, extended release

• 160mg (50mg Fe)
• 142mg (45 mg Fe)
• 140mg (45 mg Fe)

Dosage Considerations – Should be Given as Follows:

Recommended Daily Allowance (Elemental Iron)

• Children 0-6 months: 0.27 mg/day
• Children 6-12 months: 11 mg/day
• Children 1-3 years: 7 mg/day
• Children 3-8 years: 10 mg/day
• Children 8-13 years: 8 mg/day
• Children over 13 years:
  • Males: 11 mg/day
  • Females: 15 mg/day
  • Pregnant females: 27 mg/day
  • Lactating females: 10 mg/day
• Adults 19-50 years:
  • Males: 8 mg/day
  • Females: 18 mg/day
  • Pregnant females: 27 mg/day
  • Lactating females: 9 mg/day
• Adults over 50 years: 8 mg/day

Iron Deficiency Anemia

Treatment expressed as elemental iron

• 100-200 mg orally divided every 12 hours; may administer extended-release form once daily

Prophylaxis is expressed as elemental iron

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• 60 mg orally once daily

Pediatric:

Treatment expressed as elemental iron

• 3-6 mg Fe/kg/day orally divided every 8 hours

Prophylaxis is expressed as elemental iron

• Children 4 months and older receiving human milk as an only nutritional source or greater than 50% as a source of nutrition: 1 mg/kg/day orally
• Children 6 months to 2 years in areas where anemia prevalence is greater than 40% and iron-fortified food is not available: 2 mg/kg/day
• Children 2-5 years in areas where anemia prevalence greater than 40%: 2 mg/kg/day orally; not to exceed 30 mg/day
• Children over 5 years in areas where anemia prevalence greater than 40%: 30 mg/day with folic acid
• Adolescents in areas where anemia prevalence is greater than 40%: 60 mg/day with folic acid

Administration

• For maximum absorption, an agent should be taken on an empty stomach but may be taken with or after meals to minimize gastrointestinal (GI) irritation
• Vitamin C may enhance absorption

What Are Side Effects Associated with Using Ferrous Sulfate?

Side effects of Ferrous Sulfate include:

• Constipation
• Contact irritation
• Diarrhea
• Dark stools
• Gastrointestinal (GI) hemorrhage (rare)
• Gastrointestinal (GI) irritation
• Gastrointestinal (GI) obstruction (wax matrix products; rare)
• Gastrointestinal (GI) perforation (rare)
• Nausea
• Stomach pain
• Superficial tooth discoloration (oral solutions)
• Urine discoloration
• Vomiting

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Ferrous Sulfate?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

Severe Interactions of ferrous sulfate include:

• none

Serious Interactions of ferrous sulfate include:

• demeclocycline
• dolutegravir
• doxycycline
• eltrombopag
• fleroxacin
• gemifloxacin
• levofloxacin
• lymecycline
• minocycline
• moxifloxacin
• mycophenolate
• norfloxacin
• ofloxacin
• oxytetracycline
• tetracycline

Ferrous sulfate has moderate interactions with at least 30 different drugs.

Mild Interactions of ferrous sulfate include:

• acetohydroxamic acid
• calcium acetate
• calcium carbonate
• calcium chloride
• calcium citrate
• calcium gluconate
• carbidopa
• didanosine
• gymnema
• manganese

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

For more information, please visit Ferrous Sulfate Heptahydrate.

What Are Warnings and Precautions for Ferrous Sulfate ( Vasostrict, ADH)?

Warnings

Contraindications

• N/A

Effects of Drug Abuse

• N/A

Short-Term Effects

• N/A

Long-Term Effects

• N/A

Cautions

• N/A

Pregnancy and Lactation

• This medication contains ferrous sulfate. Do not take Slow FE, Fer-In-Sol, Feratab, Iron, Mol-Iron, Feosol, or MyKidz Iron 10 if you are allergic to ferrous sulfate or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
  • Hypersensitivity
  • Hemochromatosis, hemolytic anemia
  • No information available
  • See "What Are Side Effects Associated with Using Ferrous Sulfate?"
  • See "What Are Side Effects Associated with Using Ferrous Sulfate?"
  • Avoid use in peptic ulcer disease, ulcerative colitis, regional enteritis, and patients receiving frequent blood transfusions.
  • Absorption is variable and incomplete.
  • Liquid dosage forms contain 20% elemental iron; dried forms (usual monohydrate) have 30-33%.
  • Avoid use in premature infants until vitamin E stores, which are deficient at birth, are replenished.
  • Avoid administering iron for more than 6 months except in patients with continuous bleeding or menorrhagia.
  • Unintentional iron overdose is the leading cause of fatal poisoning in children under 6 years; keep out of reach of children.
  • Hypersensitivity reactions, usually a delayed reaction, reported following exposure to pharmaceutical products containing polysorbate 80 in certain individuals; thrombocytopenia, ascites, pulmonary deterioration, and renal hepatic failure reported in premature neonates after receiving parenteral products containing polysorbate 80; some storage forms contain polysorbate 80.
  • Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated with hyperosmolality, lactic acidosis, seizures, and respiratory depression.
  • The use of ferrous sulfate during pregnancy has not been studied. Consult your doctor.
  • Ferrous sulfate is excreted in breast milk; consult your doctor before breastfeeding.

References SOURCES:
Medscape. Ferrous Sulfate.
https://reference.medscape.com/drug/slow-fe-fer-in-sol-ferrous-sulfate-