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ferrous sulfate
Apo-Ferrous Sulfate†,
Feosol*OTC, Fer-gen-sol, Fer-In-Sol Drops*OTC, Fer-In-Sol Syrup*OTC, Fer-Iron DropsOTC, Fero-Grad, Mol-Iron*OTC

ferrous sulfate, dried
Fe50, FeosolOTC, Feospan§, Feratab, Novoferrosulfa†, PMS-Ferrous Sulfate†, Slow FEOTC

Pregnancy Risk Category A

How supplied
Ferrous sulfate is 20% elemental iron; dried and powdered, about 32% elemental iron.
Tablets:
324 mg, 325 mgOTC; 200 mg (dried)
Tablets (extended-release):
160 mg (dried)OTC, 525 mg
Caplets (extended-release):
160 mg (dried)
Capsules:
250 mgOTC
Elixir:
220 mg/5 ml*OTC
Syrup:
90 mg/5 mlOTC
Drops:
125 mg/ml

Action
Provides elemental iron, an essential component in the formation of hemoglobin.

Indications & dosage
Iron deficiency--

Adults:
100 to 200 mg P.O. of elemental iron t.i.d.
Children:
4 to 6 mg/kg/day P.O. of elemental iron in three divided doses.

Adverse reactions
GI:
nausea, epigastric pain, vomiting, constipation, black stools, diarrhea, anorexia.
Other:
temporarily stained teeth from liquid forms.

Interactions
Drug-drug.
Antacids, cholestyramine resin, cimetidine, vitamin E: decreased iron absorption. Separate doses if possible.
Chloramphenicol:
delayed response to iron therapy. Monitor patient.
Fluoroquinolones
, penicillamine, tetracyclines: decreased GI absorption, possibly resulting in decreased serum levels or efficacy. Separate doses by 2 to 4 hours.
Levodopa, methyldopa:
decreased absorption and efficacy of levodopa and methyldopa. Monitor for decreased effect of these drugs.
l
-thyroxine: decreased l-thyroxine absorption. Separate doses by at least 2 hours. Monitor thyroid function.
Vitamin C:
may increase iron absorption. Give together.
Drug-food.
Cereals, cheese, coffee, eggs, milk, tea, whole-grain breads, yogurt: may impair oral iron absorption. Don't administer together.
Drug-herb.
Oregano: may reduce iron absorption. Separate administration of oregano by at least 2 hours when given with iron supplements or iron-containing foods.

Effects on diagnostic tests
Ferrous sulfate blackens feces and may interfere with tests for occult blood in the stool; the guaiac test and orthotoluidine test may yield false-positive results, but benzidine test isn't usually affected. Iron overload may decrease uptake of technetium 99m and thus interfere with skeletal imaging.

Contraindications
Contraindicated in patients with hemosiderosis, primary hemochromatosis, hemolytic anemia (unless iron deficiency anemia is also present), peptic ulceration, ulcerative colitis, or regional enteritis and in those receiving repeated blood transfusions.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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