Pronunciation:

(FER us SUL fate)

U.S. Brand Names:

Synonyms:

Generic Available:

Canadian Brand Names:

Use:

Pregnancy Risk Factor:

Contraindications:

Warnings/Precautions:

Adverse Reactions:

>10%: Gastrointestinal: GI irritation, epigastric pain, nausea, dark stools, vomiting, stomach cramping, constipation

1% to 10%:

Gastrointestinal: Heartburn, diarrhea

Genitourinary: Discoloration of urine

Miscellaneous: Liquid preparations may temporarily stain the teeth

<1%: Contact irritation

Overdosage/Toxicology:

Symptoms of overdose include acute GI irritation; erosion of GI mucosa, hepatic and renal impairment, coma, hematemesis, lethargy, acidosis

Following treatment for fluid losses, metabolic acidosis, and shock, a severe iron overdose may be treated with deferoxamine. Deferoxamine may be administered I.V. (80 mg/kg over 24 hours) or I.M. (40-90 mg/kg every 8 hours). Usual toxic dose of elemental iron: 35 mg/kg.

Drug Interactions:

Antacids and H2 blockers (cimetidine): Concurrent administration may decrease iron absorption.

Chloramphenicol: Response to iron therapy may be delayed.

Levodopa, methyldopa, penicillamine: Iron may decrease absorption when given at the same time.

Quinolones: Absorption may be decreased due to formation of a ferric ion-quinolone complex

Tetracyclines: Absorption of oral preparation of iron and tetracyclines are decreased when both of these drugs are given together

Vitamin C: Concurrent administration of 200 mg vitamin C per 30 mg elemental iron increases absorption of oral iron.

Ethanol/Nutrition/Herb Interactions:

Mechanism of Action:

Pharmacodynamics/Kinetics:

Onset of action: Hematologic response: Oral: ~3-10 days

Peak effect: Reticulocytosis: 5-10 days; hemoglobin increases within 2-4 weeks

Absorption: Iron is absorbed in the duodenum and upper jejunum; in persons with normal serum iron stores, 10% of an oral dose is absorbed; this is increased to 20% to 30% in persons with inadequate iron stores. Food and achlorhydria will decrease absorption

Protein binding: To transferrin

Excretion: Urine, sweat, sloughing of the intestinal mucosa, and menses

Dosage:

Children (dose expressed in terms of elemental iron):

Severe iron-deficiency anemia: 4-6 mg Fe/kg/day in 3 divided doses

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

Prophylaxis: 1-2 mg Fe/kg/day up to a maximum of 15 mg/day

Adults (dose expressed in terms of ferrous sulfate):

Iron deficiency: 300 mg twice daily up to 300 mg 4 times/day or 250 mg (extended release) 1-2 times/day

Prophylaxis: 300 mg/day

Administration:

Monitoring Parameters:

Reference Range:

Serum iron:

Male: 75-175 mcg/dL (SI: 13.4-31.3 mol/L)

Female: 65-165 mcg/dL (SI: 11.6-29.5 mol/L)

Total iron binding capacity: 230-430 mcg/dL

Transferrin: 204-360 mg/dL

Percent transferrin saturation: 20% to 50%

Test Interactions:

Dietary Considerations:

Elemental iron content of iron salts in ferrous sulfate is 20% (ie, 300 mg ferrous sulfate is equivalent to 60 mg ferrous iron)

Patient Education:

Dental Health: Effects on Dental Treatment:

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Mental Health: Effects on Mental Status:

Mental Health: Effects on Psychiatric Treatment:

Dosage Forms:

Elixir: 220 mg/5 mL (480 mL) [elemental iron 44 mg/5 mL; contains alcohol]

Liquid, oral drops: 75 mg/0.6 mL (50 mL) [elemental iron 15 mg/0.6 mL]

Fer-Gen-Sol: 75 mg/0.6 mL (50 mL) [elemental iron 15 mg/0.6 mL]

Fer-In-Sol®: 75 mg/0.6 mL (50 mL) [elemental iron 15 mg/0.6 mL; contains alcohol 0.2% and sodium bisulfite]

Fer-Iron: 75 mg/0.6 mL (50 mL) [elemental iron 15 mg/0.6 mL]

Tablet: 324 mg [elemental iron 65 mg]; 325 mg [elemental iron 65 mg]

Feratab®: 300 mg [elemental iron 60 mg]

Tablet, exsiccated (Feosol®): 200 mg [elemental iron 65 mg]

Tablet, exsiccated, timed release (Slow FE®): 160 mg [elemental iron 50 mg]

International Brand Names: