ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Ferrous sulfate: Drug information

Ferrous sulfate: Drug information
(For additional information see "Ferrous sulfate: Patient drug information" and see "Ferrous sulfate: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • BProtected Pedia Iron [OTC];
  • Fe-Vite Iron [OTC];
  • Fer-In-Sol [OTC];
  • FeroSul [OTC];
  • Iron Infant/Toddler [OTC];
  • Iron Supplement Childrens [OTC];
  • Iron Supplement [OTC];
  • One Vite Ferrous Sulfate [OTC];
  • Slow Fe [OTC];
  • Slow Iron [OTC];
  • True Ferrous Sulfate [OTC]
Brand Names: Canada
  • PMS-Ferrous Sulfate
Pharmacologic Category
  • Iron Preparations
Dosing: Adult

Note: Dosage expression: Dose is expressed in terms of elemental iron; ferrous sulfate contains ~20% elemental iron per mg of mineral salt (eg, each 325 mg tablet contains 65 mg elemental iron). Formulation: Enteric-coated and slow/sustained-release preparations are generally not preferred due to poor absorption (Hershko 2014; Liu 2012). Route of administration: IV iron replacement is preferred over oral replacement in several clinical situations (eg, poor GI absorption, lack of response to or poor tolerability of oral iron, chronic kidney disease, active inflammatory bowel disease, cancer, chronic or extensive blood loss) (Auerbach 2021).

Iron deficiency or iron-deficiency anemia

Iron deficiency or iron-deficiency anemia: Oral: 65 mg of elemental iron (1 tablet or equivalent as liquid) once every other day or on Monday, Wednesday, and Friday. Note: Daily dosing has been shown to result in decreased absorption but may be reasonable in some individuals to improve adherence (Stoffel 2017; Stoffel 2020).

Restless legs syndrome

Restless legs syndrome (off-label use):

Note: Oral iron repletion is recommended for patients with serum ferritin ≤75 ng/mL and transferrin saturation <45% (Allen 2018).

Oral: 130 mg elemental iron (650 mg ferrous sulfate) once daily or in 2 divided doses (AAN [Winkelman 2016]; Allen 2018). Note: Some experts recommend 65 mg elemental iron (325 mg ferrous sulfate) once daily or every other day to improve absorption and tolerability (Auerbach 2021; Silber 2021).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Older Adult

Lower doses (15 to 50 mg elemental iron/day) may have similar efficacy and less GI adverse events (eg, nausea, constipation) as compared to higher doses (eg, 150 mg elemental iron/day) (Rimon 2005).

Dosing: Pediatric

(For additional information see "Ferrous sulfate: Pediatric drug information")

Note: Multiple concentrations of ferrous sulfate oral liquid exist; close attention must be paid to the concentration when ordering and administering ferrous sulfate; incorrect selection or substitution of one ferrous sulfate liquid for another without proper dosage volume adjustment may result in serious over- or underdosing.

Note: Doses expressed in terms of elemental iron; Ferrous sulfate contains ~20% elemental iron; ferrous sulfate exsiccated (dried) contains ~30% elemental iron.

Iron-deficiency anemia, prevention

Iron-deficiency anemia, prevention:

AAP recommendations:

Infants ≥4 months (exclusively fed human milk or human milk provides >50% of nutrition without iron fortified food): Oral: 1 mg elemental iron/kg/day; supplementation should be continued until sufficient iron is provided in complementary foods (AAP [Baker 2010]).

WHO recommendations:

Areas where anemia prevalence ≥40%:

Infants ≥6 months and Children <2 years: Oral: 10 to 12.5 mg elemental iron daily for 3 consecutive months in a year (WHO 2016b).

Children 2 to <5 years: Oral: 30 mg elemental iron daily for 3 consecutive months in a year (WHO 2016b).

Children ≥5 to 12 years: Oral: 30 to 60 mg elemental iron daily for 3 consecutive months in a year (WHO 2016b).

Adolescent menstruating patients (nonpregnant patients who may become pregnant): Oral: 30 to 60 mg elemental iron daily for 3 consecutive months in a year (WHO 2016a).

Areas where anemia prevalence 20% to <40%: Weekly intermittent dosing:

Children 2 to <5 years: Oral: 25 mg elemental iron once weekly for 3 consecutive months, then alternating 3 months off supplementation, 3 months on supplementation. (WHO 2011).

Children ≥5 to 12 years: Oral: 45 mg elemental iron once weekly for 3 consecutive months, then alternating 3 months off supplementation, 3 months on supplementation. (WHO 2011).

Iron-deficiency anemia, treatment

Iron-deficiency anemia, treatment: Infants, Children, and Adolescents: Oral: Initial: 3 mg elemental iron/kg/day as a single daily dose (Oski 1993; Powers 2017; Reeves 1985) up to 60 to 120 mg elemental iron once daily (AAP [Kleinman 2019]); higher doses may be needed in select patients; dosage range: 3 to 6 mg elemental iron/kg/day in 1 to 3 divided doses; usual maximum daily dose: 150 to 200 mg elemental iron/day (ASPEN [Corkins 2015]; Kliegman 2020; Zlotkin 2001); once-daily administration may be preferred for ease of administration and adherence (Zlotkin 2001). Studies in iron-depleted adults suggest that iron absorption may be improved by less frequent dosing (alternate-day dosing, or once daily versus multiple daily doses) (Moretti 2015; Stoffel 2017).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Gastrointestinal: Darkening of stools (≤80%; Tolkien 2015), abdominal pain (≤70%; Tolkien 2015), heartburn (1% to 68%; Tolkien 2015), nausea (≤63%; Tolkien 2015), constipation (≤39%; Tolkien 2015), flatulence (≤36%; Tolkien 2015), vomiting (≤34%; Tolkien 2015), diarrhea (≤23%; Tolkien 2015)

<1%, postmarketing, and/or case reports: Abdominal discomfort (Tolkien 2015)

Contraindications

Hypersensitivity to iron salts or any component of the formulation; hemochromatosis, hemolytic anemia

Warnings/Precautions

Disease-related concerns:

• Gastrointestinal disease: Avoid in patients with peptic ulcer, enteritis, or ulcerative colitis.

Special populations:

• Blood transfusion recipients: Avoid in patients receiving frequent blood transfusions.

• Older adult: Anemia in the elderly is often caused by “anemia of chronic disease” or associated with inflammation rather than blood loss. Iron stores are usually normal or increased, with a serum ferritin >50 ng/mL and a decreased total iron binding capacity. Hence, the “anemia of chronic disease” is not secondary to iron deficiency but the inability of the reticuloendothelial system to reclaim available iron stores.

• Pediatric: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6 years of age. Keep this product out of the reach of children. In case of accidental overdose call the poison control center immediately.

• Premature infants: Avoid use in premature infants until the vitamin E stores, deficient at birth, are replenished.

Dosage form specific issues:

• Oral iron formulations: Immediate release oral iron products are preferred for treatment of iron deficiency anemia; enteric coated and slow/sustained release preparations are not desired due to poor absorption (Hershko 2014; Liu 2012).

• Polysorbate 80: Some dosage forms may contain polysorbate 80 (also known as Tweens). Hypersensitivity reactions, usually a delayed reaction, have been reported following exposure to pharmaceutical products containing polysorbate 80 in certain individuals (Isaksson 2002; Lucente 2000; Shelley 1995). Thrombocytopenia, ascites, pulmonary deterioration, and renal and hepatic failure have been reported in premature neonates after receiving parenteral products containing polysorbate 80 (Alade 1986; CDC 1984). See manufacturer's labeling.

• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Zar 2007).

Other warnings/precautions:

• Duration of therapy: Administration of iron for >6 months should be avoided except in patients with continuous bleeding or menorrhagia.

Warnings: Additional Pediatric Considerations

Consider all iron sources when evaluating the dose of iron, including combination products, infant formulas, and liquid nutritional supplements. Some liquid preparations may temporarily stain the teeth.

Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).

Dosage Forms Considerations

Ferrous sulfate contains ~20% elemental iron (ie, 325 mg ferrous sulfate is equivalent to 65 mg elemental iron); ferrous sulfate exsiccated (dried) contains ~30% elemental iron.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Oral:

BProtected Pedia Iron: 75 mg/mL (15 mg/mL Fe) (50 mL) [alcohol free, gluten free; contains sodium metabisulfite; citrus flavor]

Fe-Vite Iron: 75 mg/mL (15 mg/mL Fe) (50 mL) [alcohol free, gluten free, no artificial color(s); contains sodium benzoate]

Fer-In-Sol: 75 mg/mL (15 mg/mL Fe) (50 mL) [contains alcohol, usp, sodium bisulfite]

Iron Infant/Toddler: 75 mg/mL (15 mg/mL Fe) (50 mL) [contains sodium benzoate; cherry flavor]

Iron Supplement: 220 mg/5 mL (44 mg/5 mL Fe) (473 mL) [contains fd&c yellow #6 (sunset yellow), sodium benzoate]

Iron Supplement: 75 mg/mL (15 mg/mL Fe) (50 mL) [alcohol free, gluten free, no artificial color(s); contains sodium benzoate]

Iron Supplement Childrens: 75 mg/mL (15 mg/mL Fe) (50 mL) [alcohol free, dye free, gluten free, lactose free; contains sodium bisulfite]

One Vite Ferrous Sulfate: 220 mg/5 mL (44 mg/5 mL Fe) (473 mL) [contains fd&c yellow #6 (sunset yellow), sodium benzoate]

Generic: 220 mg/5 mL (44 mg/5 mL Fe) (6.8 mL, 473 mL); 300 mg/5 mL (60 mg/5 mL Fe) (5 mL); 75 mg/mL (15 mg/mL Fe) (50 mL)

Tablet, Oral:

FeroSul: 325 mg (65 mg Fe) [contains fd&c blue #1 (brill blue) aluminum lake, fd&c red #40(allura red ac)aluminum lake, fd&c yellow #5 (tartrazine)aluminum lake]

FeroSul: 325 mg (65 mg Fe) [contains fd&c blue #2 (indigo carm) aluminum lake, fd&c red #40(allura red ac)aluminum lake]

FeroSul: 325 mg (65 mg Fe) [DSC] [contains fd&c red #40(allura red ac)aluminum lake, fd&c yellow #6(sunset yellow)alumin lake]

Generic: 325 mg (65 mg Fe)

Tablet, Oral [preservative free]:

Generic: 325 mg (65 mg Fe)

Tablet Delayed Release, Oral:

True Ferrous Sulfate: 324 mg (65 mg Fe)

Generic: 324 mg (65 mg Fe), 325 mg (65 mg Fe)

Tablet Extended Release, Oral:

Slow Fe: 142 mg (45 mg Fe) [contains fd&c blue #1 (brill blue) aluminum lake, fd&c red #40(allura red ac)aluminum lake, fd&c yellow #6(sunset yellow)alumin lake]

Tablet Extended Release, Oral [preservative free]:

Slow Iron: 160 mg (50 mg Fe equivalent) [gluten free]

Generic Equivalent Available: US

Yes

Pricing: US

Solution (BProtected Pedia Iron Oral)

75 (15 Fe) mg/mL (per mL): $0.17

Solution (Fer-In-Sol Oral)

75 (15 Fe) mg/mL (per mL): $0.21

Solution (Ferrous Sulfate Oral)

75 (15 Fe) mg/mL (per mL): $0.12

220 (44 Fe) mg/5 mL (per mL): $0.01 - $0.05

300 (60 Fe) mg/5 mL (per mL): $0.52 - $0.81

Solution (One Vite Ferrous Sulfate Oral)

220 (44 Fe) mg/5 mL (per mL): $0.03

Tablet, controlled release (Slow Fe Oral)

142 (45 Fe) mg (per each): $0.23

Tablet, EC (Ferrous Sulfate Oral)

324 (65 Fe) mg (per each): $0.06 - $0.11

325 (65 Fe) mg (per each): $0.05 - $0.82

Tablets (FeroSul Oral)

325 (65 Fe) mg (per each): $0.01

Tablets (Ferrous Sulfate Oral)

325 (65 Fe) mg (per each): $0.01 - $0.15

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Oral:

Generic: 150 (30 Fe) MG/5ML (10 mL, 250 mL, 500 mL)

Administration: Adult

Oral: Do not chew or crush ER preparations; administer with water or juice on an empty stomach.

Bariatric surgery: Tablet, extended or delayed release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Switch to IR tablet, chewable, or oral solution. Of note, many specialty bariatric multivitamins contain the recommended amount of daily iron for bariatric surgery patients.

Administration: Pediatric

Oral: Do not chew or crush extended-release preparations; administer with water or juice on an empty stomach prior to breakfast and/or between meals for maximum absorption (Kliegman 2020; Reeves 1985); may administer with food if GI upset occurs; do not administer with milk or milk products (Powers 2017).

Use: Labeled Indications

Iron deficiency or iron-deficiency anemia: Prevention and treatment of iron-deficiency anemias.

Use: Off-Label: Adult

Restless legs syndrome

Medication Safety Issues
Sound-alike/look-alike issues:

Feosol may be confused with Fer-In-Sol

Fer-In-Sol may be confused with Feosol

Slow FE may be confused with Slow-K

Administration issues:

Multiple concentrations of liquid iron preparations exist. Fer-In-Sol drops (manufactured by Mead Johnson) and a limited number of generic products are available at a concentration of 15 mg/mL. However, a suspension product, MyKidz Iron 10 drops, is available at a concentration of 15 mg/1.5 mL. Check concentration closely prior to dispensing. Prescriptions written in milliliters (mL) should be clarified.

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alpha-Lipoic Acid: Iron Preparations may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Iron Preparations. Management: Separate administration of alpha-lipoic acid from that of any iron-containing compounds by several hours. If alpha-lipoic acid is given 30 minutes before breakfast, then administer oral iron-containing products at lunch or dinner. Risk D: Consider therapy modification

Antacids: May decrease the absorption of Iron Preparations. Management: No action is likely necessary for the majority of patients who only use antacids intermittently or occasionally. Consider separating doses of oral iron and antacids in patients who require chronic use of both agents and monitor for reduced iron efficacy. Risk D: Consider therapy modification

Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Risk X: Avoid combination

Bictegravir: Iron Preparations may decrease the serum concentration of Bictegravir. Management: Bictegravir, emtricitabine, and tenofovir alafenamide can be administered with iron preparations under fed conditions, but coadministration with or 2 hours after an iron preparation is not recommended under fasting conditions. Risk D: Consider therapy modification

Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Risk D: Consider therapy modification

Cabotegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Cabotegravir. Management: Administer polyvalent cation containing products at least 2 hours before or 4 hours after oral cabotegravir. Risk D: Consider therapy modification

Cefdinir: Iron Preparations may decrease the serum concentration of Cefdinir. Red-appearing, non-bloody stools may also develop due to the formation of an insoluble iron-cefdinir complex. Management: Avoid concurrent cefdinir and oral iron when possible. Separate doses by at least 2 hours if combined. Iron-containing infant formulas do not appear alter cefdinir pharmacokinetics, but red-appearing, non-bloody stools may develop when combined. Risk D: Consider therapy modification

Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Risk D: Consider therapy modification

Dimercaprol: May enhance the nephrotoxic effect of Iron Preparations. Risk X: Avoid combination

Dolutegravir: Iron Preparations may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral iron. Administer dolutegravir/rilpivirine at least 4 hours before or 6 hours after oral iron. Alternatively, dolutegravir and oral iron can be taken together with food. Risk D: Consider therapy modification

Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Risk D: Consider therapy modification

Elvitegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Elvitegravir. Management: Administer elvitegravir 2 hours before or 6 hours after the administration of polyvalent cation containing products. Risk D: Consider therapy modification

Entacapone: Iron Preparations may decrease the serum concentration of Entacapone. Management: Consider separating doses of the agents by 2 or more hours to minimize the effects of this interaction. Monitor for decreased therapeutic effects of levodopa during concomitant therapy, particularly if doses cannot be separated. Risk D: Consider therapy modification

Ferric Hydroxide Polymaltose Complex: May decrease the serum concentration of Iron Preparations. Specifically, the absorption of oral iron salts may be reduced. Management: Do not administer intravenous (IV) ferric hydroxide polymaltose complex with other oral iron preparations. Therapy with oral iron preparations should begin 1 week after the last dose of IV ferric hydroxide polymaltose complex. Risk D: Consider therapy modification

Levodopa: Iron Preparations may decrease the serum concentration of Levodopa. Only applies to oral iron preparations. Management: Consider separating doses of the agents by 2 or more hours to minimize the effects of this interaction. Monitor for decreased therapeutic effects of levodopa during concomitant therapy, particularly if doses cannot be separated. Risk D: Consider therapy modification

Levonadifloxacin: Iron Preparations may decrease the serum concentration of Levonadifloxacin. Risk X: Avoid combination

Levothyroxine: Iron Preparations may decrease the serum concentration of Levothyroxine. Management: Separate oral administration of iron preparations and levothyroxine by at least 4 hours. Separation of doses is not required with parenterally administered iron preparations or levothyroxine. Risk D: Consider therapy modification

Methyldopa: Iron Preparations may decrease the serum concentration of Methyldopa. Management: Consider separating doses of methyldopa and orally administered iron preparation by 2 or more hours. Monitor for decreased efficacy of methyldopa if an oral iron preparation is initiated/dose increase, or increased efficacy if discontinued/dose decreased. Risk D: Consider therapy modification

PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Risk D: Consider therapy modification

Phosphate Supplements: Iron Preparations may decrease the absorption of Phosphate Supplements. Management: Administer oral phosphate supplements as far apart from the administration of an oral iron preparation as possible to minimize the significance of this interaction. Risk D: Consider therapy modification

Polyethylene Glycol-Electrolyte Solution: May decrease the absorption of Iron Preparations. Management: Give oral iron products at least 2 hours before or at least 6 hours after polyethylene glycol-electrolyte solutions that contain magnesium sulfate (Suflave brand). Other products without magnesium do not require dose separation. Risk D: Consider therapy modification

Quinolones: Iron Preparations may decrease the serum concentration of Quinolones. Management: Give oral quinolones at least several hours before (4 h for moxi- and sparfloxacin, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome-, 3 h for gemi-, and 2 h for enox-, levo-, nor-, oflox-, peflox, or nalidixic acid) oral iron. Risk D: Consider therapy modification

Raltegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Raltegravir. Management: Administer raltegravir 2 hours before or 6 hours after administration of the polyvalent cations. Dose separation may not adequately minimize the significance of this interaction. Risk D: Consider therapy modification

Roxadustat: Polyvalent Cation Containing Products may decrease the serum concentration of Roxadustat. Management: Administer roxadustat at least 1 hour after the administration of oral polyvalent cation containing products. Risk D: Consider therapy modification

Tetracyclines: May decrease the absorption of Iron Preparations. Iron Preparations may decrease the serum concentration of Tetracyclines. Management: Avoid this combination if possible. Administer oral iron preparations at least 2 hours before, or 4 hours after, the dose of the oral tetracycline derivative. Monitor for decreased therapeutic effect of oral tetracycline derivatives. Risk D: Consider therapy modification

Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant use of trientine and polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. For other oral polyvalent cations, give trientine 1 hour before, or 1 to 2 hours after the polyvalent cation. Risk D: Consider therapy modification

Unithiol: May diminish the therapeutic effect of Polyvalent Cation Containing Products. Risk X: Avoid combination

Food Interactions

Cereals, dietary fiber, tea, coffee, eggs, and milk may decrease absorption.

Pregnancy Considerations

Iron transfer to the fetus is regulated by the placenta (BSH [Pavord 2020]; NAS 2020).

Maternal iron requirements increase during pregnancy. Untreated iron deficiency and iron deficiency anemia (IDA) in pregnant patients are associated with adverse pregnancy outcomes, including low birth weight, preterm birth, and increased perinatal mortality (ACOG 2021; BSH [Pavord 2020]). Maternal iron deficiency is also associated with fatigue, increased risk of postpartum depression, and possibly postpartum hemorrhage (BSH [Pavord 2020]).

Oral and parenteral iron are effective at replacing iron stores in pregnant patients (ACOG 2021). Most studies note iron therapy improves maternal hematologic parameters; however, data related to clinical outcomes in the mother and neonate are limited (FIGO 2019; NAS 2020; USPSTF [Siu 2015]). Use of low-dose supplemental iron is recommended for all pregnant patients beginning in the first trimester or first prenatal visit to prevent anemia at term (ACOG 2021).

Ferrous sulfate has been evaluated for the treatment of IDA during pregnancy (Abraha 2019; Govindappagari 2019; Peña-Rosas 2015; Lewkowitz 2019; Reveiz 2011; Rogozińska 2021). Ferrous salts are preferred over ferric salts for the oral management of IDA in pregnancy due to better absorption and bioavailability (BSH [Pavord 2020]). Iron supplementation is recommended for 3 months once hemoglobin is within the normal range and at least 6 weeks postpartum to replenish maternal iron stores (BSH [Pavord 2020]; FIGO 2019). Iron supplementation is recommended in addition to use of prenatal vitamins in pregnant patients diagnosed with IDA (ACOG 2021). Enteric-coated and slow/sustained-release preparations may be less effective due to decreased absorption, and use should be avoided (ACOG 2021; BSH [Pavord 2020]).

Oral iron supplementation may be considered for the treatment of restless legs syndrome in pregnant patients with serum ferritin <75 ng/mL (Picchietti 2015).

Breastfeeding Considerations

Iron is present in breast milk.

Endogenous iron concentrations in breast milk vary by postpartum age and are lower than concentrations in the maternal plasma (Dorea 2000; Emmett 1997). The iron content of breast milk was not significantly changed in patients without iron deficiency anemia (IDA) administered ferrous sulfate from 2 weeks to 4 months postpartum (Yalçin 2009). Ferrous sulfate supplementation was not found to alter the iron status of exclusively breastfed infants following administration to healthy postpartum patients without anemia. Patients were administered ferrous sulfate (doses equivalent to elemental iron 80 mg) from 2 to 5 weeks postpartum. Adverse events were not observed the exclusively breastfed infants (Baykan 2006).

Breast milk concentrations of iron are maintained in lactating patients with mild to moderate IDA, but concentrations decrease if IDA is moderate to severe (El-Farrash 2012) or severe (Kumar 2008). Ferrous sulfate supplementation during pregnancy improves the postpartum iron content of breast milk in patients with IDA (Marin 2012). Ferrous sulfate has been evaluated in multiple studies for the treatment of postpartum IDA (Sultan 2019).

Iron deficiency and IDA are associated with adverse effects in postpartum patients (eg, altered cognition, depression, fatigue), which may influence interactions with the infant. Iron supplementation in the postpartum patient should be initiated as soon as possible following delivery when gestational anemia is a concern (WHO 2016c). The World Health Organization considers ferrous salts used for anemia to be compatible with breastfeeding (WHO 2002). All postpartum patients at risk of gestational anemia (regardless of breastfeeding status) may be given oral iron with or without folic acid for 6 to 12 weeks postpartum to reduce the risk of anemia (WHO 2016c). Oral iron therapy is recommended for postpartum patients with uncorrected anemia at delivery who are hemodynamically stable and are asymptomatic or have only mild symptoms; treatment should continue for at least 3 months (BSH [Pavord 2020]).

Oral iron supplementation may be considered for the treatment of restless legs syndrome in lactating patients with serum ferritin <75 ng/mL (Picchietti 2015).

Dietary Considerations

May be administered with food to prevent irritation; however, not with cereals, dietary fiber, tea, coffee, eggs, or milk.

Dietary sources of iron include beans, cereal (enriched), clams, beef, lentils, liver, oysters, shrimp, and turkey. Foods that enhance dietary absorption of iron include broccoli, grapefruit, orange juice, peppers, and strawberries. Foods that decrease dietary absorption of iron include coffee, dairy products, soy products, spinach, and tea.

Dietary reference intake (IOM 2001):

0 to 6 months: Adequate intake: 0.27 mg elemental iron/day.

7 to 12 months: RDA: 11 mg elemental iron/day.

1 to 3 years: RDA: 7 mg elemental iron/day.

4 to 8 years: RDA: 10 mg elemental iron/day.

9 to 13 years: RDA: 8 mg elemental iron/day.

14 to 18 years: RDA:

Males: 11 mg elemental iron/day.

Females: 15 mg elemental iron/day.

Pregnant females: 27 mg elemental iron/day.

Lactating females: 10 mg elemental iron/day.

19 to 50 years: RDA:

Males: 8 mg elemental iron/day.

Females: 18 mg elemental iron/day.

Pregnant females: 27 mg elemental iron/day.

Lactating females: 9 mg elemental iron/day.

≥50 years: RDA: 8 mg elemental iron/day.

Monitoring Parameters

Hemoglobin and hematocrit; consider RBC count, RBC indices, serum ferritin, transferrin saturation, total iron-binding capacity, serum iron concentration, erythrocyte protoporphyrin concentration (CDC 1998).

Cancer and chemotherapy-induced anemia: Serum iron, total iron-binding capacity, transferrin saturation, or ferritin levels (baseline and periodic) (Rizzo 2010).

CKD associated anemia (patients not on dialysis): To monitor response to iron therapy: Hemoglobin, serum ferritin, transferrin saturation (KDIGO 2013).

Reference Range

Adults:

Serum iron:

Males: 75 to 175 mcg/dL (SI: 13.4 to 31.3 micromole/L)

Females: 65 to 165 mcg/dL (SI: 11.6 to 29.5 micromole/L)

Serum ferritin (Ineck 2008):

Males: 15 to 200 ng/mL

Females: 12 to 150 ng/mL

Total iron binding capacity: 230 to 430 mcg/dL

Transferrin: 204 to 360 mg/dL

Percent transferrin saturation: 20% to 50%

Mechanism of Action

Replaces iron, found in hemoglobin, myoglobin, and other enzymes; allows the transportation of oxygen via hemoglobin

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Hematologic response: Oral: ~3 to 10 days

Peak effect: Reticulocytosis: 5 to 10 days; hemoglobin increases within 2 to 4 weeks

Absorption: Iron is absorbed in the duodenum and upper jejunum; in persons with normal serum iron stores, 10% of an oral dose is absorbed; this is increased to 20% to 30% in persons with inadequate iron stores. Food and achlorhydria will decrease absorption

Protein binding: To transferrin

Excretion: Urine, sweat, sloughing of the intestinal mucosa, and menses

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Babyfer | Fer in sol | Feromin | Hemadid | Iron | Ironorm | Irovit | Kdiron | Pediafer | Tardyferon;
  • (AR) Argentina: Eurofer | Factofer | Feklon | Fer in sol | Ferdromaco pediatrico | Ferlea | Ferricol | Ferrocebrina | Ferromas | Ferrometion | Hemofer | Hemoferrol | Hierro fabra | Hierro lafedar | Hierro Vannier | Iberol | Medifer | Sulfato ferroso ilab | Sulfato ferroso sant gall friburg | Tgi;
  • (AT) Austria: Ferro gradumet;
  • (AU) Australia: Ferro-liquid | Ferrogen | Ferrogradumet | Ferrovance iron | Wagner professional ferro sustain;
  • (BD) Bangladesh: Adferon | Adiron | Apeferrum | Aristoferon | Bioron | Caron | Dyaferon | Fecon h | Femeton | Feoton | Feritone | Ferroglobin | Ferrosil | Ferrosobin | Ferroson | Ferrum | Irodol | Jeferin | May flower | Premeron | Remaferon;
  • (BE) Belgium: Fer in sol | Fero gradumet;
  • (BG) Bulgaria: Ferro gradumet | Ferrous sulphate | Hemofer | Retafer;
  • (BR) Brazil: Anemifer | Anemiplus | Cimefer | Fer in sol | Ferrison | Ferromin | Ferrototal | Ferrotron | Fersil | Fixa fer | Furp sulfato ferroso | Iberol | Lomfer | Masferol | Maxtonico | Neck-fer | Perfer | Salonfer | Sidney oliveira sulfato ferroso | Sulfato ferroso | Sulfato ferroso composto | Sulfato ferroso henfer | Sulfatofer | Sulfer plus | Sulferbel | Sulfergan | Sulfermax | Sulferro | Sulferrol | Vitafer;
  • (CH) Switzerland: Ferro-gradumet | Infa-Tardyferon | Tardyferon;
  • (CL) Chile: Ferinsol | Ferrigot | Iberol | Sulfato ferroso;
  • (CN) China: Pediatric ferrous sulfate | Slow fe;
  • (CO) Colombia: Fer in sol | Ferroproff | Fortilex | Mol-Iron | Sulfato ferroso | Sulfato ferroso ecar;
  • (CZ) Czech Republic: Ceferro | Ferro gradumet;
  • (DE) Germany: Aktiferrin N | Dreisafer | Eisentabletten | Eisentabletten ratiopharm n | Ferro | Ferro aiwa | Ferroinfant | Floradix eisen | Haemoprocan | Irovit | Loma Eisen;
  • (DO) Dominican Republic: Fer in sol | Lucovit | Mason slow release iron | Sulfato ferroso | Tardyferon;
  • (EC) Ecuador: Ferinsol | Ferrigot | Ferrolent | Iberol | Mol-Iron | Sulfato ferroso;
  • (EE) Estonia: Retafer;
  • (EG) Egypt: Fer in sol;
  • (ES) Spain: Fero gradumet;
  • (ET) Ethiopia: Ferrous sulphate;
  • (FI) Finland: Depofer | Fersamal | Minifer | Retafer;
  • (GB) United Kingdom: Ferrograd | Ferrous sulphate arrow | Irofate | Iron | Ironorm | Slow fe;
  • (GR) Greece: Fer in sol;
  • (HK) Hong Kong: Ferasul | Ferinsol | Pms ferrous sulfate | Super-Fe;
  • (HR) Croatia: Retafer;
  • (HU) Hungary: Ferrogradumet | Sorbifer Durules;
  • (ID) Indonesia: Ferro Sulfat | Ferro sulphate | Ferrous sulphate | Sulfas ferrosus;
  • (IE) Ireland: Fer in sol | Ferrograd;
  • (IL) Israel: Ferrogradumet | Slow fe;
  • (IT) Italy: Ferro grad | Tardyfer;
  • (JO) Jordan: Ferinsol | Feromin | Fertonic | Irovit | Pediafer;
  • (JP) Japan: Femas | Feniko | Fero gradumet | Feroretard | Slow fe | Tetucur s;
  • (KE) Kenya: Ferrous sulphate | Fersulph;
  • (KR) Korea, Republic of: Fer in sol | Feroba u | Feroba you sr | Ferroba-U | Iron mom;
  • (KW) Kuwait: Fer in sol | Feromin | Kdiron;
  • (LB) Lebanon: Babyfer | Fer in sol | Ferrous sulphate | Irovit | Kdiron | Pharmafer;
  • (LT) Lithuania: Ceferro | Ferro gradumet | Ferromax | Ferronat | Hemofer | Irovit;
  • (LU) Luxembourg: Fero gradumet;
  • (LV) Latvia: Ceferro | Eisentabletten ratiopharm n | Ferro gradumet | Ferromax | Ferronat | Hamatopan f | Hemofer;
  • (MX) Mexico: Ansof | Biofenor | Fer in sol | Ferdepsa | Forcil | Hemobion | Sulfat ferroso | Sulfato ferroso | Sulfato ferroso mavi | Sulfato ferroso novag | Sulfato ferroso pisa | Sulfato ferroso probifasa | Sulfato ferroso sun pharma | Valdefer;
  • (MY) Malaysia: Apo-Ferrous sulfate | Retafer;
  • (NG) Nigeria: Fesulf | Jopan ferrous sulphate;
  • (NL) Netherlands: Fero gradumet | Ferrograd;
  • (NO) Norway: Duroferon | Ferro-retard | Ferromax | Nycoplus ferro;
  • (NZ) New Zealand: Ferodan | Ferrogradumet;
  • (OM) Oman: Feronic;
  • (PE) Peru: Ferinsol | Fierro Sulfato | Sulfato ferroso | Sulfato Ferroso mf;
  • (PH) Philippines: Anemicon | Anemifer | Beefer plus | Comfemic | Feosol | Feovit | Fer in sol | Ferlum | Ferustab | Irobon | Vamsler ferrous sulphate;
  • (PK) Pakistan: Aferone | F-S | Ferric m | Ferrosil | Ferrous sulphate | Hifer | Iron prime | Neo-fe | Siron;
  • (PL) Poland: Ceferro | Ferro | Ferro gradumet | Tardyferon;
  • (PR) Puerto Rico: Feosol | Fer in sol | Fer iron | Gericare iron | Iron sulfate | Pediatric fe vite | Slow fe;
  • (PT) Portugal: Ferro gradumet | Sulfato ferroso;
  • (PY) Paraguay: Eribell | Ferdromaco pediatrico | Ferrocal | Ferroforte | Iberol | Oraferrol | Sulfato ferroso dutriec | Sulferron;
  • (QA) Qatar: Feromin | Feromin Drops | Feronic | Kdiron | Sentinel Ferrous Sulphate | Tardyferon;
  • (RO) Romania: Ferro gradumet | Retafer;
  • (RU) Russian Federation: Ferro gradumet | Ferrogradumet | Ferromax | Hemofer prolongatum;
  • (SA) Saudi Arabia: Fer in sol | Feromin | Fertonic | Irovit | Kdiron;
  • (SE) Sweden: Duroferon;
  • (SG) Singapore: Ferrous sulphate;
  • (SI) Slovenia: Aktiferrin | Eisensulfat lomapharm | Retafer | Tardyfer;
  • (SK) Slovakia: Tardyferon;
  • (SL) Sierra Leone: Ferrous sulphate;
  • (TH) Thailand: Fer in sol | Ferisan | Ferrosol | Ferrous | Ferrous sulphate | Fugon | K.b.temaron | Kidiron | Pediron;
  • (TR) Turkey: Ferro gradumet | Newvit demir | Purferro;
  • (UA) Ukraine: Ferro gradumet | Ferrous sulphate | Hemofer;
  • (UG) Uganda: Ferrous sulphate;
  • (UY) Uruguay: Ferdromaco pediatrico | Ferro C | Ferrosterol | Iberol | Ibofer | Sulfato ferroso;
  • (VE) Venezuela, Bolivarian Republic of: Fer in sol | Iberol | Sulfato ferroso;
  • (ZA) South Africa: Fero gradumet | Ferrous sulphate;
  • (ZM) Zambia: Ferrous sulphate | Fesate
  1. Abraha I, Bonacini MI, Montedori A, et al. Oral iron-based interventions for prevention of critical outcomes in pregnancy and postnatal care: an overview and update of systematic reviews. J Evid Based Med. 2019;12(2):155-166. doi:10.1111/jebm.12344 [PubMed 31144465]
  2. Agostoni C, Buonocore G, Carnielli VP, et al. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50(1):85-91. doi:10.1097/MPG.0b013e3181adaee0 [PubMed 19881390]
  3. Alade SL, Brown RE, Paquet A. Polysorbate 80 and E-Ferol toxicity. Pediatrics. 1986;77(4):593-597. [PubMed 3960626]
  4. Allen RP, Picchietti DL, Auerbach M, et al; International Restless Legs Syndrome Study Group (IRLSSG). Evidence-based and consensus clinical practice guidelines for the iron treatment of restless legs syndrome/Willis-Ekbom disease in adults and children: an IRLSSG task force report. Sleep Med. 2018;41:27-44. doi:10.1016/j.sleep.2017.11.1126 [PubMed 29425576]
  5. American Academy of Pediatrics Committee on Nutrition. Kleinman RE, Greer FR, eds. Pediatric Nutrition Handbook. 8th ed. Itasca, IL: American Academy of Pediatrics; 2019.
  6. American Academy of Pediatrics, Committee on Nutrition, “Nutritional Needs of the Premature Infant,” In: Kleinman RE, ed, Pediatric Nutrition Handbook, 6th ed, Elk Grove Village, IL: American Academy of Pediatrics; 2009, 79-112.
  7. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics. Anemia in pregnancy: ACOG practice bulletin, number 233. Obstet Gynecol. 2021;138(2):e55-e64. doi:10.1097/AOG.0000000000004477 [PubMed 34293770]
  8. Auerbach M. Treatment of iron deficiency anemia in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed October 13, 2021.
  9. Baker RD, Greer FR; Committee on Nutrition American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5):1040-1050. [PubMed 20923825]
  10. Baykan A, Yalçin SS, Yurdakök K. Does maternal iron supplementation during the lactation period affect iron status of exclusively breast-fed infants? Turk J Pediatr. 2006;48(4):301-307. [PubMed 17290563]
  11. Carney LN, Nepa A, Cohen SS, et al. Parenteral and Enteral Nutrition Support: Determining the Best Way to Feed. In: Corkins MR, Balint J, Bobo E, et al, eds. The A.S.P.E.N Pediatric Nutrition Support Core Curriculum. American Society of Parenteral and Enteral Nutrition. Silver Spring, MD: 2010; 440-441.
  12. Centers for Disease Control (CDC). Unusual syndrome with fatalities among premature infants: association with a new intravenous vitamin E product. MMWR Morb Mortal Wkly Rep. 1984;33(14):198-199. http://www.cdc.gov/mmwr/preview/mmwrhtml/00000319.htm [PubMed 6423951]
  13. Centers for Disease Control and Prevention (CDC), “Recommendations to Prevent and Control Iron Deficiency in the United States,” MMWR Recomm Rep, 1998, 47(RR-3):1-29. [PubMed 9563847]
  14. Corkins MR, Balint J, Bobo E, et al, eds. The A.S.P.E.N Pediatric Nutrition Support Core Curriculum. 2nd ed. Silver Spring: MD: American Society of Parenteral and Enteral Nutrition, 2015.
  15. Domellöf M, Braegger C, Campoy C, et al. Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr. 2014;58(1):119-129. doi:10.1097/MPG.0000000000000206 [PubMed 24135983]
  16. Dorea JG. Iron and copper in human milk. Nutrition. 2000;16(3):209-220. doi:10.1016/s0899-9007(99)00287-7 [PubMed 10705077]
  17. Eichenwald EC. Manual of Neonatal Care. 8th edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2017.
  18. El-Farrash RA, Ismail EA, Nada AS. Cord blood iron profile and breast milk micronutrients in maternal iron deficiency anemia. Pediatr Blood Cancer. 2012;58(2):233-238. doi:10.1002/pbc.23184 [PubMed 21548016]
  19. Emmett PM, Rogers IS. Properties of human milk and their relationship with maternal nutrition. Early Hum Dev. 1997;(49)(suppl):S7-S28. doi:10.1016/s0378-3782(97)00051-0 [PubMed 9363415]
  20. Fer-In-Sol (ferrous sulfate) [prescribing information]. Evansville, IN: Mead Johnson & Company; received December 2018.
  21. Ferrous Sulfate oral solution (USP) [prescribing information]. Skokie, IL: Patrin Pharma; May 2020.
  22. Ferrous Sulfate oral solution (USP) [prescribing information]. Upper Saddle River, NJ: Dash Pharmaceuticals LLC; October 2020.
  23. Ferrous Sulfate tablets [prescribing information]. Livonia, MI: Rugby Laboratories; December 2019.
  24. FIGO Working Group on Good Clinical Practice in Maternal-Fetal Medicine. Good clinical practice advice: Iron deficiency anemia in pregnancy. Int J Gynaecol Obstet. 2019;144(3):322‐324. doi:10.1002/ijgo.12740 [PubMed 30710364]
  25. Garcia-Borreguero D, Silber MH, Winkelman JW, et al. Guidelines for the first-line treatment of restless legs syndrome/Willis-Ekbom disease, prevention and treatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-foundation. Sleep Med. 2016;21:1-11. doi: 10.1016/j.sleep.2016.01.017. [PubMed 27448465]
  26. Govindappagari S, Burwick RM. Treatment of iron deficiency anemia in pregnancy with intravenous versus oral iron: systematic review and meta-analysis. Am J Perinatol. 2019;36(4):366-376. doi:10.1055/s-0038-1668555 [PubMed 30121943]
  27. Guideline: Intermittent Iron Supplementation in Preschool and School-Age Children. Geneva: World Health Organization; 2011. [PubMed 24479203]
  28. Haider BA, Olofin I, Wang M, et al, "Anaemia, Prenatal Iron Use, and Risk of Adverse Pregnancy Outcomes: Systematic Review and Meta-analysis," BMJ, 2013, 346:f3443. [PubMed 23794316]
  29. Hershko C, Camaschella C. How I treat unexplained refractory iron deficiency anemia. Blood. 2014;123(3):326-333. doi:10.1182/blood-2013-10-512624 [PubMed 24215034]
  30. "Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Pediatrics. 1997;99(2):268-278. [PubMed 9024461]
  31. Ineck B, Mason BJ, Lyons W. Chapter 104. Anemias. Pharmacotherapy: A Pathophysiologic Approach. DiPiro JT, ed. New York, NY: McGraw-Hill Medical; 2008.
  32. IOM (Institute of Medicine), Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc, Washington, DC: National Academy Press, 2001.
  33. Isaksson M, Jansson L. Contact allergy to Tween 80 in an inhalation suspension. Contact Dermatitis. 2002;47(5):312-313. [PubMed 12534540]
  34. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guidelines for the evaluation and management of chronic kidney disease. Kidney Inter. 2013;3(suppl):1-150. http://kdigo.org/clinical_practice_guidelines/pdf/KDIGO-Anemia%20GL.pdf
  35. Kliegman RM and St. Geme J, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Saunders Elsevier; 2020.
  36. Kumar A, Rai AK, Basu S, et al. Cord blood and breast milk iron status in maternal anemia. Pediatrics. 2008;121(3):e673-e677. doi:10.1542/peds.2007-1986 [PubMed 18310187]
  37. Lapillonne A, Fidler Mis N, Goulet O, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Lipids. Clin Nutr. 2018;37(6 Pt B):2324-2336. [PubMed 30143306]
  38. Lee CS, Lee SD, Kang SH, Park HY, Yoon IY. Comparison of the efficacies of oral iron and pramipexole for the treatment of restless legs syndrome patients with low serum ferritin. Eur J Neurol. 2014;21(2):260-266. doi: 10.1111/ene.12286. [PubMed 24267148]
  39. Lewkowitz AK, Gupta A, Simon L, et al. Intravenous compared with oral iron for the treatment of iron-deficiency anemia in pregnancy: a systematic review and meta-analysis. J Perinatol. 2019;39(4):519-532. doi:10.1038/s41372-019-0320-2 [PubMed 30692612]
  40. Lipschitz DA, “The Anemia of Chronic Disease,” J Am Geriatr Soc, 1990, 38(11):1258-64. [PubMed 2123218]
  41. Liu K, Kaffes AJ. Iron deficiency anaemia: a review of diagnosis, investigation and management. Eur J Gastroenterol Hepatol. 2012;24(2):109-116. [PubMed 22157204]
  42. Lucente P, Iorizzo M, Pazzaglia M. Contact sensitivity to Tween 80 in a child. Contact Dermatitis. 2000;43(3):172. [PubMed 10985636]
  43. Marin GH, Mestorino N, Errecalde J, et al. Personalised iron supply for prophylaxis and treatment of pregnant women as a way to ensure normal iron levels in their breast milk. J Med Life. 2012;5(1):29-32. [PubMed 22574084]
  44. Marx JJM, “Normal Iron Absorption and Decreased Red Cell Iron Uptake in the Aged,” Blood, 1979, 53:204-11. [PubMed 760850]
  45. McArdle HJ, Lang C, Hayes H, et al, "Role of the Placenta in Regulation of Fetal Iron Status," Nutr Rev, 2011, 69(Suppl 1):17-22. [PubMed 22043877]
  46. Meyer MP, Haworth C, Meyer JH, et al, "A Comparison of Oral and Intravenous Iron Supplementation in Preterm Infants Receiving Recombinant Erythropoietin," J Pediatr, 1996, 129(2):258-63. [PubMed 8765624]
  47. Moretti D, Goede JS, Zeder C, et al. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women. Blood. 2015;126(17):1981-1989. doi:10.1182/blood-2015-05-642223 [PubMed 26289639]
  48. National Academies of Sciences, Engineering, and Medicine 2020. Nutrition During Pregnancy and Lactation: Exploring New Evidence: Proceedings of a Workshop. The National Academies Press; 2020. https://doi.org/10.17226/25841
  49. National Institutes of Health (NIH). Iron fact sheet for health professionals. https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/. Published March 30, 2021. Accessed October 28, 2021.
  50. Oski FA. Iron deficiency in infancy and childhood. N Engl J Med. 1993;329(3):190-193. doi:10.1056/NEJM199307153290308 [PubMed 8515791]
  51. Pavord S, Daru J, Prasannan N, et al. UK guidelines on the management of iron deficiency in pregnancy. Br J Haematol. 2020;188(6):819‐830. doi:10.1111/bjh.16221 [PubMed 31578718]
  52. Pediatric Iron Drops (ferrous sulfate) [prescribing information]. Williston Park, NY: Simple Diagnostics; received September 2020.
  53. Peña-Rosas JP, De-Regil LM, Garcia-Casal MN, et al. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015;7:CD004736. doi:10.1002/14651858.CD004736.pub5 [PubMed 26198451]
  54. Picchietti DL, Hensley JG, Bainbridge JL, et al; International Restless Legs Syndrome Study Group (IRLSSG). Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. Sleep Med Rev. 2015;22:64-77. doi:10.1016/j.smrv.2014.10.009 [PubMed 25553600]
  55. Powers JM, Buchanan GR, Adix L, Zhang S, Gao A, McCavit TL. Effect of low-dose ferrous sulfate vs iron polysaccharide complex on hemoglobin concentration in young children with nutritional iron-deficiency anemia: a randomized clinical trial. JAMA. 2017;317(22):2297-2304. doi:10.1001/jama.2017.6846 [PubMed 28609534]
  56. Rao R and Georgieff MK, "Iron Therapy for Preterm Infants," Clin Perinatol, 2009, 36(1):27-42. [PubMed 19161863]
  57. Reeves JD, Yip R. Lack of adverse side effects of oral ferrous sulfate therapy in 1-year-old infants. Pediatrics. 1985;75(2):352-355. [PubMed 3969339]
  58. Reveiz L, Gyte GM, Cuervo LG, et al. Treatments for iron-deficiency anaemia in pregnancy. Cochrane Database Syst Rev. 2011;10:CD003094. doi:10.1002/14651858.CD003094.pub3 [PubMed 21975735]
  59. Rimon E, Kagansky N, Kagansky M, et al, “Are We Giving Too Much Iron? Low-Dose Iron Therapy is Effective in Octogenarians,” Am J Med, 2005, 118(10):1142-7. [PubMed 16194646]
  60. Rizzo JD, Brouwers M, Hurley P, et al. American Society of Clinical Oncology/American Society of Hematology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer. J Clin Oncol. 2010;28(33):4996-5010. [PubMed 20975064]
  61. Rogozińska E, Daru J, Nicolaides M, et al. Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis. Lancet Haematol. 2021;8(7):e503-e512. doi:10.1016/S2352-3026(21)00137-X [PubMed 34171281]
  62. Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259. [PubMed 19188870]
  63. Shelley WB, Talanin N, Shelley ED. Polysorbate 80 hypersensitivity. Lancet. 1995;345(8980):1312-1313. [PubMed 7746084]
  64. Silber MH. Treatment of restless legs syndrome and periodic limb movement disorder in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 18, 2021.
  65. Siu AL; US Preventive Services Task Force. Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes: US Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2015;163(7):529-536. doi:10.7326/M15-1707 [PubMed 26344176]
  66. Stoffel NU, Cercamondi CI, Brittenham G, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. Lancet Haematol. 2017;4(11):e524-e533. doi: 10.1016/S2352-3026(17)30182-5. [PubMed 29032957]
  67. Stoffel NU, Zeder C, Brittenham GM, Moretti D, Zimmermann MB. Iron absorption from supplements is greater with alternate day than with consecutive day dosing in iron-deficient anemic women. Haematologica. 2020;105(5):1232-1239. doi:10.3324/haematol.2019.220830 [PubMed 31413088]
  68. Stoltzfus RJ, Dreyfuess ML. Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia. International Nutritional Anemia Consultative Group (INACG). 1998. http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/1-57881-020-5/en/
  69. Sultan P, Bampoe S, Shah R, et al. Oral vs intravenous iron therapy for postpartum anemia: a systematic review and meta-analysis. Am J Obstet Gynecol. 2019;221(1):19.e3-29.e3. doi:10.1016/j.ajog.2018.12.016 [PubMed 30578747]
  70. 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;10(2):e0117383. [PubMed 25700159]
  71. Unger SL, Fenton TR, Jetty R, Critch JN, O'connor DL. Iron requirements in the first 2 years of life. Paediatr Child Health. 2019;24(8):555-556. doi:10.1093/pch/pxz148 [PubMed 31844396]
  72. United Nations Children’s Fund, United Nations University, World Health Organization (WHO). Iron Deficiency Anaemia. Assessment, Prevention, and Control. A guide for programme managers. 2001. http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf.
  73. Wang J, O'Reilly B, Venkataraman R, Mysliwiec V, Mysliwiec A. Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: a randomized, double-blind, placebo-controlled study. Sleep Med. 2009;10(9):973-975. [PubMed 19230757]
  74. Winkelman JW, Armstrong MJ, Allen RP, et al. Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2016;87(24):2585-2593. doi:10.1212/WNL.0000000000003388 [PubMed 27856776]
  75. World Health Organization (WHO). Breastfeeding and maternal medication, recommendations for drugs in the eleventh WHO model list of essential drugs. https://apps.who.int/iris/handle/10665/62435. Published 2002.
  76. World Health Organization (WHO). Guideline: Daily Iron Supplementation in Adult Women and Adolescent Girls. Geneva, Switzerland: World Health Organization; 2016a. https://www.ncbi.nlm.nih.gov/books/NBK361888/. [PubMed 27195351]
  77. World Health Organization (WHO). Guideline: Daily Iron Supplementation in Infants and Children. Geneva, Switzerland: World Health Organization; 2016b. https://www.ncbi.nlm.nih.gov/books/NBK362032/. [PubMed 27195348]
  78. World Health Organization (WHO). Guideline: Iron Supplementation in Postpartum Women. World Health Organization; 2016c. [PubMed 27583315]
  79. World Health Organization (WHO). Iron deficiency anaemia: assessment, prevention, and control. 2001. https://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf. Accessed September 16, 2021.
  80. Yalçin SS, Baykan A, Yurdakök K, Yalçin S, Gücüş AI. The factors that affect milk-to-serum ratio for iron during early lactation. J Pediatr Hematol Oncol. 2009;31(2):85-90. doi:10.1097/MPH.0b013e31819146c2 [PubMed 19194189]
  81. Zar T, Graeber C, Perazella MA. Recognition, treatment, and prevention of propylene glycol toxicity. Semin Dial. 2007;20(3):217-219. [PubMed 17555487]
  82. Zlotkin S, Arthur P, Antwi KY, Yeung G. Randomized, controlled trial of single versus 3-times-daily ferrous sulfate drops for treatment of anemia. Pediatrics. 2001;108(3):613-616. doi:10.1542/peds.108.3.613 [PubMed 11533326]
Topic 8444 Version 469.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟