FERROUS salts

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    Therapeutic action

    • Antianaemia drug

    Indications

    • Prevention of iron-deficiency
    • Treatment of iron-deficiency anaemia

    Forms and strengths

    • 140 mg/5 ml syrup of ferrous fumarate containing approximately 45 mg/5 ml of elemental iron
    • 200 mg ferrous fumarate or sulfate tablet containing approximately 65 mg of elemental iron

    Dosage

    (expressed as elemental iron)

     

    Prevention of iron-deficiency

    • Neonate: 4.5 mg once daily
    • Child 1 month to < 12 years: 1 to 2 mg/kg once daily (max. 65 mg daily)
    • Child ≥ 12 years and adult: 65 mg once daily

     

    Treatment of iron-deficiency anaemia

    • Neonate: 1 to 2 mg/kg 2 times daily
    • Child 1 month to < 6 years: 1.5 to 3 mg/kg 2 times daily
    • Child 6 to < 12 years: 65 mg 2 times daily
    • Child ≥ 12 years and adult: 65 mg 2 to 3 times daily

     

    Age

    Weight

    Prevention Treatment
    45 mg/5 ml syrup 65 mg tablet 45 mg/5 ml syrup 65 mg
    tablet
    < 1 month < 4 kg 0.5 ml 0.5 ml x 2
    1 month to < 1 year 4 to < 10 kg 1 ml 1.5 ml x 2
    1 to < 6 years 10 to < 20 kg 2.5 ml 2.5 ml x 2
    6 to < 12 years 20 to < 40 kg 5 ml 1 tab x 2
    ≥ 12 years and adult ≥ 40 kg 1 tab 1 tab x 2 or 3

     

    Duration

    • Prevention: during risk period (pregnancy, malnutrition)
    • Treatment: 3 months

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with other forms of anaemia. 
    • May cause: abdominal pain, nausea, vomiting, diarrhoea or constipation, black stools.
    • Do not exceed recommended doses in children (risk of overdose). 20 mg/kg of elemental iron (60 mg/kg of ferrous fumarate or sulfate) is considered toxic.
    • Do not give simultaneously with doxycycline, ciprofloxacin, dolutegravir, antacids (aluminium hydroxide or magnesium, etc.), levodopa or zinc sulfate (reduced absorption of both drugs). Administer each drug at least 2 hours apart.
    • Adminstration in combination with ascorbic acid (vitamin C) increases iron absorption.
    • Rince mouth or drink water after administration of syrup (risk of tooth staining).
    • Pregnancy and breast-feeding: no contra-indication

    Remarks

    • To reduce gastrointestinal disturbances, take during meals and gradually increase dosage.
    • For the prevention of iron-deficiency during pregnancy, preferably use tablets containing both ferrous salts and folic acid.

    Storage

     
    - Below 25 °C