Ferrous Salts

A to Z Drug Facts

(FER-uhs salts)

DexFerrum, ED-IN-SOL, Fe 50, Femiron, Feosol, Feostat, Feratab, Fer-gen-sol, Fergon, Fer-In-Sol, Fer-Iron, Ferrex 150, Ferro-Sequels, Hemocyte, Hytinic, Icar, Ircon, Nephro-Fer, Niferex, Niferex–150, Nu-Iron, Nu-Iron 150, Slow-FE, Vitron-C, Apo-Ferrous Sulfate, Ferodan, Fero-Grad, Palafer, PMS-Ferrous Sulfate, Scheinpharm Ferrous Fumarate

Class: Iron product

 Action Iron is major factor in oxygen transport and essential mineral component of hemoglobin, myoglobin, and several enzymes.

 Indications Prevention and treatment of iron-deficiency anemia. unlabeled use(s): Use with epoetin to ensure hematologic response to epoetin.

 Contraindications Hypersensitivity to any ingredient, hemosiderosis, hemolytic anemia.

 Route/Dosage

Stated iron dose is for elemental iron. Dosage must be calculated based on salt form. Ferrous sulfate is 20% elemental iron. Ferrous sulfate, exsiccated, is approximately 30% elemental iron. Ferrous gluconate is approximately 12% elemental iron. Ferrous fumarate is 33% elemental iron. ADULT MALES: PO 10 mg. ADULT FEMALES 11 to 50 YR: PO 15 mg. ADULT FEMALES ³ 51 YR: PO 10 mg; pregnancy: 30 mg; lactation: 15 mg.

Iron Replacement in Deficiency States

ADULTS: PO 100 to 200 mg tid. CHILDREN (2 to 12 YR): 3 mg/kg/day in 3 to 4 divided doses. CHILDREN (6 MO to 2 YR): Up to 6 mg/kg/day in 3 to 4 divided doses. INFANTS: 10 to 25 mg qd in 3 to 4 divided doses.

 Interactions

Antacids: May decrease iron absorption. Chloramphenicol: May increase serum iron concentrations. Food: May decrease iron absorption; eggs and milk decrease iron absorption. Levodopa: Effects of levodopa may be decreased. Penicillamine: Decreased absorption of penicillamine. Quinolones: Iron may decrease quinolone absorption. Tetracyclines: Absorption of both drugs may be decreased.

 Lab Test Interferences None well documented.

 Adverse Reactions

GI: Irritation; anorexia; nausea; vomiting; diarrhea; constipation; dark stool. OTHER: Teeth staining with liquid formulation.

 Precautions

GI effects: Discomfort, such as nausea, may be minimized by taking with food. Sulfite sensitivity: Some products contain sulfites, which cause allergic-type reactions in susceptible individuals. Tartrazine sensitivity: Some products contain tartrazine, which may cause allergic-type reactions in susceptible individuals.

 Administration/Storage

• Administer drug orally only.
• Do not crush sustained release tablets.
• Administer between meals for maximum absorption. Give with food or meals if GI upset occurs.
• When giving liquid preparation, dilute to decrease staining of teeth. Patient may drink through straw to avoid staining.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Document baseline Hbg, Hct, bilirubin and reticulocyte count and monitor at regular intervals.
• Monitor color of stool.
• If anorexia, nausea, vomiting, constipation, or diarrhea develops, report to physician.
• Test stool for occult blood if bleeding is suspected.

 Patient/Family Education

• Tell patient to take drug on an empty stomach unless GI upset develops. Instruct patient to then take drug after meals or with food, but not to take with eggs or milk.
• Advise patient taking sustained release preparation not to chew, open, or crush drug.
• Advise patient to dilute liquid iron preparations in water or juice, to drink through a straw, and to rinse mouth after taking.
• Instruct patient not to take drug with antacids.
• Tell patient that drug may cause black stools, constipation, or diarrhea, and to report anorexia, nausea, vomiting, or pronounced diarrhea or constipation.
• Identify foods to include for iron-rich diet.
• Warn patient that iron poisoning may occur if more than prescribed amount of medication is taken.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts