ferrous sulfate (Rx, OTC)

Brand and Other Names:Slow FE, Fer-In-Sol, more...Feratab, Iron, Mol-Iron, Feosol, MyKidz Iron 10
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

oral solution

  • 220mg (44mg Fe)/5mL
  • 300mg (60mg Fe)/5mL
  • 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)

Recommended Daily Allowance (Elemental Iron)

19-50 years

  • Males: 8 mg/day
  • Females: 18 mg/day
  • Pregnant females: 27 mg/day
  • Lactating females: 9 mg/day

>50 years

  • 8 mg/day

Iron Deficiency Anemia

Treatment expressed as elemental iron

  • 100-200 mg PO divided q12hr; may administer extended release form once daily

Prophylaxis expressed as elemental iron

  • 60 mg PO once daily

Dosage Forms & Strengths

oral solution

  • 15mg elemental Fe/mL
  • 220mg (44mg Fe)/5mL

oral liquid drops

  • 75mg (15mg Fe)/mL

tablet

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

Recommended Daily Allowance (Elemental Iron)

0-6 months: 0.27 mg/day

6-12 months: 11 mg/day

1-3 years: 7 mg/day

3-8 years: 10 mg/day

8-13 years: 8 mg/day

>13 years

  • Males: 11 mg/day
  • Females: 15 mg/day
  • Pregnant females: 27 mg/day
  • Lactating females: 10 mg/day

Iron Deficiency Anemia

Treatment expressed as elemental iron

  • 3-6 mg Fe/kg/day PO divided q8hr

Prophylaxis expressed as elemental iron

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

Interaction Checker

and ferrous sulfate

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            Adverse Effects

            Frequency Not Defined

            Constipation

            Contact irritation

            Diarrhea

            Dark stools

            GI hemorrhage (rare)

            GI irritation

            GI obstruction (wax matrix products; rare)

            GI perforation (rare)

            Nausea

            Stomach pain

            Superficial tooth discoloration (oral solutions)

            Urine discoloration

            Vomiting

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            Warnings

            Contraindications

            Hypersensitivity

            Hemochromatosis, hemolytic anemia

            Cautions

            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 (usually monohydrate) have 30-33%

            Avoid use in premature infants until vitamin E stores, which are deficient at birth are replenished

            Avoid administering iron for >6 months except in patients with continuous bleeding or menorrhagia

            Unintentional iron overdose is leading cause of fatal poisoning in children <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

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            Pregnancy & Lactation

            Pregnancy category: Not studied

            Lactation: Drug is excreted in breast milk

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Replaces iron stores found in hemoglobin, myoglobin, and enzymes; allows transportation of oxygen via hemoglobin

            Absorption

            Bioavailability: 5-10% (20-30% during deficiency)

            Onset: Reticulocytosis, 3-10 days; increased hemoglobin values, 2-4 wk

            Protein binding: Binds to transferrin

            Elimination

            Excretion: Sweat, urine, menses, sloughed intestinal mucosa

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            Administration

            Oral Administration

            For maximum absorption, agent should be taken on empty stomach but may be taken with or after meals to minimize GI irritation

            Vitamin C may enhance absorption

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            Images

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
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            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.