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ferrous sulfate
generic
Adult Dosing .
Dosage forms: TAB: 27 mg, 65 mg; DR TAB: 65 mg; ER TAB: 45 mg, 50 mg; SOLUTION: 15 mg per mL, 44 mg per 5 mL, 60 mg per 5 mL
Special Note
- [strength clarification]
- Info: FeSO4 contains approximately 20% elemental Fe; 325 mg FeSO4 = 65 mg elemental Fe; supplements with dried FeSO4 may contain more elemental Fe; doses expressed as elemental Fe
iron deficiency
- [65-130 mg PO qod or 65-130 mg PO 3x/wk on Monday, Wednesday, Friday x2-6mo]
- Alt: 65-130 mg PO qd x2-6mo
dietary supplementation
- [individualize dose]
- Info: see Dietary Reference Intakes, Iron table
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: TAB: 27 mg, 65 mg; DR TAB: 65 mg; ER TAB: 45 mg, 50 mg; SOLUTION: 15 mg per mL, 44 mg per 5 mL, 60 mg per 5 mL
Special Note
- [strength clarification]
- Info: FeSO4 contains approximately 20% elemental Fe; 325 mg FeSO4 = 65 mg elemental Fe; supplements with dried FeSO4 may contain more elemental Fe; doses expressed as elemental Fe
iron deficiency tx
- [infants/children]
- Dose: 3 mg/kg/dose PO qd for at least 3mo; Alt: 1-2 mg/kg/dose PO tid x3-6mo
- [adolescents]
- Dose: 65-130 mg PO qd for at least 3mo; Info: 65-130 mg PO qod or 65-130 mg PO 3x/wk on Monday, Wednesday, Friday for at least 3mo may be considered for mild iron deficiency
iron deficiency prophylaxis
- [<1 yo]
- Dose: 1 mg/kg/day PO divided qd-bid; Max: 15 mg/day; Info: for full-term infants who are not fully breast-fed; for premature or low birth wt neonates incr. to 2-4 mg/kg/day PO divided bid-tid
dietary supplementation
- [individualize dose]
- Info: see Dietary Reference Intakes, Iron table
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hemochromatosis, primary
- hemosiderosis
- hemolytic anemia
- PUD
- ulcerative colitis
- regional enteritis
- blood transfusion, chronic
- caution: premature infants
- caution: chronic use
- caution: HIV infection
- caution: hypochlorhydria
Drug Interactions .
Overview
ferrous sulfate
iron oral
- gastric pH sensitive
- heavy metal
- iron oral
- polyvalent cation
Avoid/Use Alternative
- acetohydroxamic acid
- baloxavir marboxil
- cimetidine
- deferasirox
- dexlansoprazole
- famotidine
- ferric derisomaltose
- ferumoxytol
- iron dextran
- lansoprazole
- methyldopa
- nizatidine
- omeprazole
- pantoprazole
- potassium phosphate
- rabeprazole
- sodium ferric gluconate complex
- trientine
Monitor/Modify Tx
- alendronate
- allopurinol
- aluminum hydroxide
- bictegravir
- cabotegravir
- calcium acetate
- calcium citrate
- calcium gluconate
- carbidopa
- cefdinir
- chloroquine
- ciprofloxacin
- deferiprone
- delafloxacin
- demeclocycline
- diflunisal
- digoxin
- dolutegravir
- doxycycline
- eltrombopag
- elvitegravir
- entacapone
- ethambutol
- gabapentin enacarbil
- hyoscyamine
- ibandronate
- levodopa
- levofloxacin
- levothyroxine
- methscopolamine
- minocycline
- moxifloxacin
- naproxen
- ofloxacin
- omadacycline
- pancrelipase
- penicillamine
- phenytoin
- potassium acid phosphate
- raltegravir
- rifampin
- risedronate
- sarecycline
- sodium bicarbonate
- sodium zirconium cyclosilicate
- tetracycline
- thyroid
- tipranavir
- ursodiol
- vadadustat
Therapeutic Advantage
- rose hip
Caution Advised
- calcium carbonate
- esomeprazole
- ferric carboxymaltose
- fosamprenavir
- iron sucrose
- magnesium carbonate
- magnesium hydroxide
- magnesium oxide
- peppermint
- sodium citrate
- sodium polystyrene sulfonate
- vonoprazan
Adverse Reactions .
Serious Reactions
may occur but none reported
Common Reactions
- dyspepsia
- nausea
- vomiting
- constipation
- diarrhea
- fecal discoloration, dark
- epigastric pain
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Look/Sound-Alike Drug Names
ferrous sulfate confused with: Feosol; ferrous fumarate; ferrous gluconate
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; no known risk of fetal harm at recommended doses based on human data
Lactation
Clinical Summary
may use while breastfeeding; no known risk of infant harm, though possible risk of infant constipation and diarrhea based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for iron: other; CYP450: unknown
Excretion: for iron: minimal; Half-life: unknown
Subclass: Iron Homeostasis ; Minerals
Mechanism of Action
for iron: provides an essential component in hemoglobin, myoglobin, and various enzymes
Formulary .
No Formulary Selected
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