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ferrous sulfate

Pronunciation

Generic Name: ferrous sulfate (FARE us SUL fate)
Brand Name: Feosol, Fer-Gen-Sol, Fer-In-Sol, Fer-Iron, FeroSul, Ferra T.D. Caps, Ferro-Bob, Ferrousal, Lydia E. Pinkham, MyKidz Iron 10, Slow Fe, Slow Release Iron, ...show all 23 brand names

What is ferrous sulfate?

Ferrous sulfate is a type of iron. You normally get iron from the foods you eat. In your body, iron becomes a part of your hemoglobin (HEEM o glo bin) and myoglobin (MY o glo bin). Hemoglobin carries oxygen through your blood to tissues and organs. Myoglobin helps your muscle cells store oxygen.

Ferrous sulfate is used to treat iron deficiency anemia (a lack of red blood cells caused by having too little iron in the body).

Ferrous sulfate may also be used for purposes not listed in this medication guide.

What is the most important information I should know about ferrous sulfate?

Ask a doctor or pharmacist if it is safe for you to take this medication if you have iron overload syndrome, hemolytic anemia (a lack of red blood cells), porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system), thalassemia (a genetic disorder of red blood cells), if you are an alcoholic, or if you receive regular blood transfusions.

Avoid taking any other multivitamin or mineral product within 2 hours before or after you take ferrous sulfate. Taking similar mineral products together at the same time can result in a mineral overdose or serious side effects.

Seek emergency medical attention if you think you have used too much of this medicine, or if anyone has accidentally swallowed it. An overdose of iron can be fatal, especially in a young child.

Overdose symptoms may include nausea, severe stomach pain, bloody diarrhea, coughing up blood or vomit that looks like coffee grounds, shallow breathing, weak and rapid pulse, pale skin, blue lips, and seizure (convulsions).

Take ferrous sulfate on an empty stomach, at least 1 hour before or 2 hours after a meal. Avoid taking antacids or antibiotics within 2 hours before or after taking ferrous sulfate.

Ferrous sulfate is only part of a complete program of treatment that may also include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat to make sure you get enough iron from both your diet and your medication.

What should I discuss before taking ferrous sulfate?

Ask a doctor or pharmacist if it is safe for you to take this medication if you have:

  • iron overload syndrome;

  • hemolytic anemia (a lack of red blood cells);

  • porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system);

  • thalassemia (a genetic disorder of red blood cells);

  • if you are an alcoholic; or

  • if you receive regular blood transfusions.

It is not known whether this medication could be harmful to an unborn baby. Tell your doctor if you become pregnant during treatment.

It is not known whether ferrous sulfate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give ferrous sulfate to a child without the advice of a doctor.

How should I take ferrous sulfate?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Take ferrous sulfate on an empty stomach, at least 1 hour before or 2 hours after a meal. Avoid taking antacids or antibiotics within 2 hours before or after taking ferrous sulfate .

Take this medication with a full glass of water.

Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Ferrous sulfate can stain your teeth, but this effect is temporary. To prevent tooth staining, mix the liquid form of ferrous sulfate with water or fruit juice (not with milk) and drink the mixture through a straw. You may also clean your teeth with baking soda once per week to treat any tooth staining.

Ferrous sulfate is only part of a complete program of treatment that may also include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat to make sure you get enough iron from both your diet and your medication.

Store at room temperature, away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222, especially if a child has accidentally swallowed it. An overdose of ferrous sulfate can be fatal to a child.

Overdose symptoms may include nausea, severe stomach pain, bloody diarrhea, coughing up blood or vomit that looks like coffee grounds, shallow breathing, weak and rapid pulse, pale skin, blue lips, and seizure (convulsions).

What should I avoid while taking ferrous sulfate?

Avoid taking any other multivitamin or mineral product within 2 hours before or after you take ferrous sulfate. Taking similar mineral products together at the same time can result in a mineral overdose or serious side effects.

Avoid taking an antibiotic medicine within 2 hours before or after you take ferrous sulfate. This is especially important if you are taking an antibiotic such as ciprofloxacin (Cipro), demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), levofloxacin (Levaquin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), norfloxacin (Noroxin), ofloxacin (Floxin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).

Certain foods can also make it harder for your body to absorb ferrous sulfate. Avoid taking this medication within 1 hour before or 2 hours after eating fish, meat, liver, and whole grain or "fortified" breads or cereals.

Avoid using antacids without your doctor's advice. Use only the type of antacid your doctor recommends. Some antacids can make it harder for your body to absorb ferrous sulfate.

Ferrous sulfate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

  • constipation;

  • upset stomach;

  • black or dark-colored stools; or

  • temporary staining of the teeth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Ferrous sulfate dosing information

Usual Adult Dose for Iron Deficiency Anemia:

Initial: 300 to 325 mg of regular-release ferrous sulfate orally once a day.

Maintenance:
Regular-release ferrous sulfate: 325 mg orally 3 times a day. Alternatively, 300 mg orally 4 times a day may be given.
Extended-release ferrous sulfate: 160 mg orally 1 to 2 times a day.

Resolution of iron deficiency anemia may require ferrous sulfate supplementation for several weeks or months, depending on the duration and severity of the anemia.

Usual Adult Dose for Anemia Associated with Chronic Renal Failure:

Initial: 300 to 325 mg of regular-release ferrous sulfate orally once a day.

Maintenance:
Regular-release ferrous sulfate: 325 mg orally 3 times a day. Alternatively, 300 mg orally 4 times a day may be given.
Extended-release ferrous sulfate: 160 mg orally 1 to 2 times a day.

A transferrin saturation of less than 20%, or a serum ferritin level of less than 100 mcg/L suggests inadequate iron stores and a need for iron replacement therapy.

Continued iron replacement therapy is needed in most patients receiving epoetin alfa treatment.

Usual Adult Dose for Vitamin/Mineral Supplementation during Pregnancy/Lactation:

325 mg orally once a day.

The CDC has defined anemia during pregnancy as a hemoglobin concentration less than 100 g/L during the first and third trimesters and less than 105 g/L during the second trimester or a hematocrit value of less than 32%.

The recommended daily allowance (RDA) of elemental iron is 30 mg orally during pregnancy and 15 mg orally during lactation.

Usual Adult Dose for Vitamin/Mineral Supplementation:

325 mg orally once a day.

The recommended daily allowance (RDA) of elemental iron is 10 mg for adult males, 15 mg for adult, premenopausal women, and 10 mg for postmenopausal women.

Usual Pediatric Dose for Iron Deficiency Anemia:

Premature neonates:
2 to 4 mg elemental iron/kg/day divided every 12 to 24 hours (maximum daily dose = 15 mg).

Infants and children less than 12 years:
Prophylaxis: 1 to 2 mg elemental iron/kg/day (maximum 15 mg) in 1 to 2 divided doses.

Mild to moderate iron deficiency anemia:
3 mg elemental iron/kg/day in 1 to 2 divided doses.

Severe iron deficiency anemia:
4 to 6 mg elemental iron/kg/day in 3 divided doses.

What other drugs will affect ferrous sulfate?

Tell your doctor about all other medicines you use, especially:

  • acetohydroxamic acid (Lithostat);

  • chloramphenicol;

  • cimetidine (Tagamet);

  • etidronate (Didronel);

  • dimercaprol (an injection used to treat poisoning by arsenic, lead, or mercury);

  • levodopa (Larodopa, Dopar, Sinemet);

  • methyldopa (Aldomet); or

  • penicillamine (Cuprimine).

This list is not complete and other drugs may interact with ferrous sulfate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about ferrous sulfate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.03. Revision Date: 2012-03-30, 2:57:14 PM.

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