Hematology and Oncology Book

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Iron SupplementationAka: Ferrous Sulfate, Iron Sulfate, Ferrous Gluconate, Feosol, Fer-In-Sol, Ferrous Fumarate, Hemocyte

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  1. See also
    1. Dietary Iron
    2. Iron
  2. Indications
    1. Iron Deficiency Anemia
  3. Preparations
    1. Ferrous Sulfate (FeSO4)
      1. Elemental Iron: 15 mg per 0.6 ml dropper
      2. Elemental Iron: 18 mg per 5 ml Syrup
      3. Elemental Iron: 65 mg per 325 mg tablet
    2. Ferrous Gluconate (Fergon)
      1. Elemental Iron: 36 mg per 325 mg tablet
      2. Elemental Iron: 30 mg per 300 mg/5 ml syrup
    3. Iron Dextran (Imferon)
      1. See Parenteral iron
  4. Dosing
    1. General Anemia management
      1. Ferrous sulfate 325 mg PO tid
    2. Postpartum Iron Deficiency Anemia
      1. Hemoglobin 7-9
        1. Ferrous sulfate 325 mg PO tid
      2. Hemoglobin 9-10
        1. Ferrous sulfate 325mg PO bid
      3. Hemoglobin >10
        1. Ferrous sulfate 325mg PO qd
    3. Pediatric Anemia
      1. Severe Pediatric Anemia
        1. Ferrous Sulfate 4-6 mg/kg/day PO tid
      2. Mild Pediatric Anemia or Prophylaxis
        1. Ferrous Sulfate 1-2 mg/kg/day PO qd-bid
  5. Drug Interactions
    1. Food and drugs reducing iron absorption
      1. Antacids (raise pH, low acidity)
        1. Tums, Maalox, or Mylanta
        2. Histamine H2 Receptor Blockers (e.g. Ranitidine)
        3. Proton Pump Inhibitors (e.g. Prilosec)
      2. Inhibitors of iron absorption
        1. Polyphenol (in vegetables)
        2. Tannins (in tea)
        3. Phytate (in bran, cereal)
        4. Calcium (dairy products)
    2. Drugs increasing iron absorption
      1. Vitamin C (Ascorbic acid)
    3. Drugs with decreased absorption when taken with iron
      1. Levodopa
      2. Methyldopa
      3. Penicillamine
      4. Quinolones
      5. Tetracyclines
  6. Adverse Effects
    1. Gastrointestinal distress
      1. Ferrous iron causes mucosal irritation
      2. Start with once daily dosing and titrate to tid
      3. Tolerance is directly related to iron concentration
        1. Start with normal concentration elemental iron
          1. Decrease to lower concentrations as needed
        2. Lower elemental iron concentration better tolerated
          1. Ferrous gluconate
          2. More expensive iron preparations
      4. Enteric coated Iron has decreased absorption
    2. Black stools
    3. Hemochromatosis
      1. Prolonged, excessive iron supplementation
  7. References
    1. Little (1999) Am Fam Physician 59(6):1598

Hemocytes (C0019000)

Definition (MSH)Any blood or formed element especially in invertebrates.
ConceptsCell (T025)
MSHD006434
EnglishHemocyte, Hemocytes
Parent ConceptsBlood Cells (C0005773)
SourcesMSH, MTH
Derived from the NIH UMLS (Unified Medical Language System)


Ferrous fumarate (C0060276)

Definition (NCI)The fumarate salt form of the mineral iron. Administration of ferrous fumarate results in elevation of serum iron concentration, which is then assimilated into hemoglobin, required for the transport of oxygen, or trapped in the reticuloendothelial cells for storage. This agent is used as a dietary supplement, and to prevent or treat iron deficiency related syndromes.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC031621
EnglishFerrous fumarate, FERROUS FUMARATE PREPARATION, fumar
Spanishfumarato ferroso
Parent ConceptsDietary Supplements (C0242295), Ferrous Compounds (C0015889), Iron (C0302583), Unclassified Ingredients (C1372954), TO BE DELETED INGREDIENT PREPARATIONS (C1377153), Oral form iron preparation (C0304932), Ferrous salt product (C0360672), Ferrous salt agent (C1298637), Oral iron agent (C1298638)
SourcesMSH, MTH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


ferrous gluconate (C0060277)

Definition (NCI)A form of mineral iron for oral administration, Ferrous Gluconate is absorbed in the stomach and small intestine and combines with apoferritin to form ferritin, which is stored in the liver, spleen, red bone marrow, and intestinal mucosa. Important in transport of oxygen by hemoglobin to the tissues, iron is also found in myoglobin, transferrin, and ferritin, and is as a component of many enzymes such as catalase, peroxidase, and cytochromes. (NCI04)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC011819
Englishferroglucon, ferrous gluconate, FERROUS GLUCONATE PREPARATION
Spanishgluconato ferroso
Parent ConceptsDietary Supplements (C0242295), Ferrous Compounds (C0015889), Iron (C0302583), Inactive Ingredient Preparations (C1375189), Oral form iron preparation (C0304932), Ferrous salt product (C0360672), Ferrous salt agent (C1298637), Oral iron agent (C1298638)
SourcesMSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Feosol (C0720403)

ConceptsPharmacologic Substance (T121)
MSHD007505
EnglishFeosol, GlaxoSmithKline Brand of Iron-Dextran Complex
SourcesMSH, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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