Ferrous Sulfate

• Generic Name: Ferrous Sulfate
• Brand Name: N/A
• Drug Class: N/A

• Medical and Pharmacy Editor: John P. Cunha, DO, FACOEP

Last updated on RxList: 8/18/

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.

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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

• 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:

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• 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.

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-

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

BProtected Pedia Iron [OTC]; Fe-Vite Iron [OTC]; Fer-In-Sol [OTC]; FeroSul [OTC]; Iron Infant/Toddler [OTC]; Iron Supplement Childrens [OTC] [DSC]; Iron Supplement [OTC]; One Vite Ferrous Sulfate [OTC]; Slow Fe [OTC]; Slow Iron [OTC]; True Ferrous Sulfate [OTC]

Brand Names: Canada

PMS-Ferrous Sulfate

Warning

• Accidental overdose of drugs that have iron in them is a leading cause of deadly poisoning in children younger than 6 years of age. Keep away from children. If this drug is taken by accident, call a doctor or poison control center right away.

What is this drug used for?

• It is used to treat or prevent low iron in the body.
• It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have any of these health problems: Too much iron in your body or anemia from a cause other than low iron.
• If you are taking another drug that has iron in it.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• Have your blood work and other lab tests checked as you have been told by your doctor.
• This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
• Do not take more of this drug than you were told. Do not take more often than you were told.
• If you are allergic to tartrazine (FD&C Yellow No. 5), talk with your doctor. Some products have tartrazine.
• If you are allergic to sulfites, talk with your doctor. Some products have sulfites.
• This drug prevents many other drugs from getting into the body. If you take other drugs, check with your doctor or pharmacist to see if you need to take them at some other time than this drug.
• Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

• Constipation, diarrhea, stomach pain, upset stomach, or throwing up.
• Dark stools.

All liquid products:

• Staining of the mouth, teeth, or fillings.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

All products:

• This drug works better if you take it on an empty stomach. You may take this drug with food if it causes an upset stomach. Some foods like eggs, whole grain breads, cereal, dairy products, coffee, and tea may make this drug not work as well. If this drug causes an upset stomach, talk with your doctor about the best way to take this drug with food.
• If antacids are used, they may need to be taken at some other time than this drug. Talk with your doctor or pharmacist.

All tablet products:

• Take with a full glass of water.

Coated tablets, delayed-release tablets, and extended-release tablets:

• Do not swallow whole. Do not chew, break, or crush.

Liquid (drops):

• Only use the measuring device that comes with this drug.
• Shake well before use.
• You may put this drug right in the mouth or you may mix it with formula, fruit juice, cereal, or other food. Take the whole dose.

All other liquid products:

• Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.
• Mix with water or fruit juice and drink. Drinking through a straw may help to avoid stains on your teeth. Rinse your mouth after drinking. Do not mix with milk or wine-based liquids.

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

All products:

• Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom.
• Protect from heat.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

All liquid products:

• Do not freeze.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

-02-20

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