Oral iron: iron deficiency anaemias (Formulary)

Iron deficiency should be regarded as a symptom. Investigation of the underlying cause is vital.  Haemoglobin should rise by approximately 20 grams/litre (2 grams/100mL) over 3 to 4 weeks.  Once it has reached reference range, continue treatment for a further 3 months in order to replenish iron stores, and then stop.  Failure to respond as predicted suggests other underlying factors may be contributing to the anaemia. 

Gastric irritation is the most common side-effect of iron therapy and is related to the content of elemental iron.  A gradual increase in dose can help prevent some gastric side-effects.  Modified-release preparations are not recommended as they deliver most of their iron to the small intestine where it is poorly absorbed. 

A range of oral iron preparations is available over the counter. 

Iron absorption is increased when taken on an empty stomach and 1 tablet of ferrous sulfate/fumarate once daily is usually adequate for prophylaxis.  Where more frequent dosing is given it is important to allow at least 8 hours between doses.

FERROUS SULFATE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets (dried) 200mg (65mg iron)OTC

Dosage:

Prophylactic1 tablet daily
Therapeutic: 1 tablet 2 to 3 times daily.

FERROUS FUMARATE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 210mg (68mg iron)OTC

Dosage:

Prophylactic: 1 tablet 1 to 2 times daily
Therapeutic: 1 tablet 2 to 3 times daily

Important: Formulation and dosage details

Formulation:

Syrup 140mg (45mg iron)/5mL

Dosage:

Prophylactic: 5mL syrup twice daily.
Therapeutic: 10mL syrup twice daily.

SODIUM FEREDETATE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Elixir 190mg (27·5mg iron)/5mL (Sytron®)OTC 

Dosage:

Therapeutic: 5mL increasing gradually to 10mL 3 times daily.

Editorial Information

Document Id: F293