Description

Simple

A supplement used to prevent treat low iron levels in the blood.

Clinical

An iron supplement used to prevent or treat iron deficiency anemia.

Overview

Iron deficiency anemia is a large public health concern worldwide, especially in young children, infants, and women of childbearing age.[4] This type of anemia occurs when iron intake, iron stores, and iron loss do not adequately support the formation of erythrocytes, also known as red blood cells.[8]

Ferrous sulfate is a synthetic agent used in the treatment of iron deficiency. It is the gold standard of oral iron therapy in the UK and many other countries.[14,18]

Pharmacology

Indication

Ferrous sulfate is used for the prevention and treatment of iron deficiency anemia in adults and children.[ Read more

Pharmacodynamic

Ferrous sulfate replenishes iron, an essential component in hemoglobin, myoglobin, and various enzymes. It replaces the iron that is usually found in hemoglobin and myoglobin. Iron participates in oxygen transport and storage, electron transport and energy metabolism, antioxidant and beneficial pro-... Read more

Mechanism of action

Iron is required to maintain optimal health, particularly for helping to form red blood cells (RBC) that carry oxygen around the body. A deficiency in iron indicates that the body cannot produce enough normal red blood cells.[ Read more

Absorption

Approximately 5 – 10% of dietary iron is absorbed, and this absorption rate increases to up to 30% in iron deficiency states. Oral iron supplements are absorbed up to 60% via active and passive transport processes.[17... Read more

Protein binding

The protein binding for ferrous sulfate is equal to or greater than 90%.[17] It is bound to transferrin and ferritin, ferroportin, myoglobin, and other enzymes.[ Read more

Volume of distribution

About 60% of iron is distributed the erythrocytes.[6] The remainder of the... Read more

Clearance

Information currently not available.

Half life

The half-life of orally administered iron is not readily available in the literature, with total effects lasting 2-4 months (congruent with the red blood cell life span)[ Read more

Route of elimination

Oral iron is recycled, with some loss in the urine, sweat, and desquamation. Some iron can be lost during menstrual bleeding[ Read more

Toxicity


The toxicity of ferrous sulfate in humans depends on the amount of iron ingested. Up to 20 mg/kg of elemental iron is not toxic, 20-60 mg/kg has mild toxicity, and more than 60 mg/kg can lead to severe symptoms and morbidity.[... Read more

Adverse Effects

Contraindications

  • Regions: Canada
  • Patient Conditions:
      • Name: Non-iron deficiency anemia
      • Drugbank Id: DBCOND0126284
  • Regions: Canada
  • Patient Conditions:
      • Name: Hemosiderosis
      • Drugbank Id: DBCOND0003952
  • Regions: Canada
  • Patient Conditions:
      • Name: Hemochromatosis
      • Drugbank Id: DBCOND0002672

Food Interactions

  • Take with food. This reduces gastric irritation.
  • Take with foods containing vitamin C. Foods rich in vitamin C increase the absorption of iron.

Interactions

Type in a drug name to check for interaction with Ferrous sulfate anhydrous
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
3-Aza-2,3-Dihydrogeranyl Diphosphate
Ferrous sulfate anhydrous can cause a decrease in the absorption of 3-Aza-2,3-Dihydrogeranyl Diphosphate resulting in a reduced serum concentration and potentially a decrease in efficacy.
Alendronic acid
Ferrous sulfate anhydrous can cause a decrease in the absorption of Alendronic acid resulting in a reduced serum concentration and potentially a decrease in efficacy.
Almasilate
Almasilate can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aloglutamol
Aloglutamol can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminium
Aluminium can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminium acetoacetate
Aluminium acetoacetate can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminium glycinate
Aluminium glycinate can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminium phosphate
Aluminium phosphate can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminum hydroxide
Aluminum hydroxide can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Asenapine
Asenapine can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Calcium carbonate
Calcium carbonate can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Calcium phosphate dihydrate
Ferrous sulfate anhydrous can cause a decrease in the absorption of Calcium phosphate dihydrate resulting in a reduced serum concentration and potentially a decrease in efficacy.
Calcium silicate
Calcium silicate can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Carbidopa
Ferrous sulfate anhydrous can cause a decrease in the absorption of Carbidopa resulting in a reduced serum concentration and potentially a decrease in efficacy.
Cefdinir
Ferrous sulfate anhydrous can cause a decrease in the absorption of Cefdinir resulting in a reduced serum concentration and potentially a decrease in efficacy.
Cholestyramine
Cholestyramine can cause an increase in the absorption of Ferrous sulfate anhydrous resulting in an increased serum concentration and potentially a worsening of adverse effects.
Cimetidine
Cimetidine can cause a decrease in the absorption of Ferrous sulfate anhydrous resulting in a reduced serum concentration and potentially a decrease in efficacy.
Cinoxacin
Ferrous sulfate anhydrous can cause a decrease in the absorption of Cinoxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ciprofloxacin
Ferrous sulfate anhydrous can cause a decrease in the absorption of Ciprofloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.
Clodronic acid
Ferrous sulfate anhydrous can cause a decrease in the absorption of Clodronic acid resulting in a reduced serum concentration and potentially a decrease in efficacy.
24 References
  1. 1 . Leary A, Barthe L, Clavel T, Sanchez C, Oulmi-Castel M, Paillard B, Edmond JM, Brunner V: Pharmacokinetics of Ferrous Sulphate (Tardyferon(R)) after Single Oral Dose Administration in Women with Iron Deficiency Anaemia. Drug Res (Stuttg). 2016 Jan;66(1):51-6. doi: 10.1055/s-0035-1549934. Epub 2015 May 19.PubMed: 25989284
  2. 2 . Conrad ME, Umbreit JN, Moore EG, Hainsworth LN, Porubcin M, Simovich MJ, Nakada MT, Dolan K, Garrick MD: Separate pathways for cellular uptake of ferric and ferrous iron. Am J Physiol Gastrointest Liver Physiol. 2000 Oct;279(4):G767-74. doi: 10.1152/ajpgi.2000.279.4.G767.PubMed: 11005764
  3. 3 . Tolkien Z, Stecher L, Mander AP, Pereira DI, Powell JJ: Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PLoS One. 2015 Feb 20;10(2):e0117383. doi: 10.1371/journal.pone.0117383. eCollection 2015.PubMed: 25700159
  4. 4 . Santiago P: Ferrous versus ferric oral iron formulations for the treatment of iron deficiency: a clinical overview. ScientificWorldJournal. 2012;2012:846824. doi: 10.1100/2012/846824. Epub 2012 May 2.PubMed: 22654638
  5. 5 . Waldvogel-Abramowski S, Waeber G, Gassner C, Buser A, Frey BM, Favrat B, Tissot JD: Physiology of iron metabolism. Transfus Med Hemother. 2014 Jun;41(3):213-21. doi: 10.1159/000362888. Epub 2014 May 12.PubMed: 25053935
  6. 6 . Geisser P, Burckhardt S: The pharmacokinetics and pharmacodynamics of iron preparations. Pharmaceutics. 2011 Jan 4;3(1):12-33. doi: 10.3390/pharmaceutics3010012.PubMed: 24310424
  7. 7 . Cancado RD, Munoz M: Intravenous iron therapy: how far have we come? Rev Bras Hematol Hemoter. 2011;33(6):461-9. doi: 10.5581/1516-8484.20110123.PubMed: 23049364
  8. 8 . Miller JL: Iron deficiency anemia: a common and curable disease. Cold Spring Harb Perspect Med. 2013 Jul 1;3(7). pii: cshperspect.a011866. doi: 10.1101/cshperspect.a011866.PubMed: 23613366
  9. 9 . Abbaspour N, Hurrell R, Kelishadi R: Review on iron and its importance for human health. J Res Med Sci. 2014 Feb;19(2):164-74.PubMed: 24778671
  10. 10 . Walker SE, Paton TW, Cowan DH, Manuel MA, Dranitsaris G: Bioavailability of iron in oral ferrous sulfate preparations in healthy volunteers. CMAJ. 1989 Sep 15;141(6):543-7.PubMed: 2776093
  11. 11 . Kaestner L, Bogdanova A: Regulation of red cell life-span, erythropoiesis, senescence, and clearance. Front Physiol. 2014 Jul 18;5:269. doi: 10.3389/fphys.2014.00269. eCollection 2014.PubMed: 25101005
  12. 12 . FERROUS SULFATE - National Library of Medicine HSDB Database - Toxnet Link
  13. 13 . Iron poisoning Link
  14. 14 . Ferrous Sulfate Supplementation Causes Significant Gastrointestinal Side-Effects in Adults: A Systematic Review and Meta-Analysis Link
  15. 15 . Ferrous sulfate, Daily Med Link
  16. 16 . Ferrous sulfate, epocrates Link
  17. 17 . Ferrous sulfate DavisPlus Link
  18. 18 . Ferrous Sulfate Tablet, Delayed Release (Enteric Coated) Link
  19. 19 . Antianemia Drugs Link
  20. 20 . Dailymed: Ferrous sulfate tablets Link
  21. 21 . The Science Company: Ferrous sulfate MSDS Link
  22. 22 . ODS Health Professional Fact Sheet: Iron Link
  23. 23 . Medicines UK: Ferrous sulfate 200mg oral tablets Link
  24. 24 . NIH Statpearls: Biochemistry, Iron Absorption Link