Ferrous Fumarate - Gluconate - Sulphate 💊
⚠️ Iron is very toxic in overdose, especially in children. Modern practice often prefers once-daily dosing to improve absorption and reduce side effects, and IV iron should be considered if oral therapy is ineffective or not tolerated. 💉
ℹ️ About
Always check the BNF link here 📖 for the latest dosing and safety information.
- Main use: treatment of iron deficiency anaemia 🩸.
⚙️ Mode of Action
- Oral ferrous salts provide elemental iron, which is absorbed in the duodenum and jejunum.
- Iron is incorporated into haemoglobin, myoglobin, and various enzymes essential for oxygen transport and cellular metabolism.
💊 Indications & Dose
- Ferrous fumarate: 210 mg OD–TDS PO.
- Ferrous gluconate: 600 mg OD–TDS PO.
- Ferrous sulphate: 200 mg OD–TDS PO.
- Higher doses for repletion; lower doses for maintenance.
- Absorption best on an empty stomach, but GI intolerance often necessitates taking with food 🍞.
⚠️ Interactions
- See BNF - absorption reduced by tea, coffee, antacids, PPIs, tetracyclines, and quinolones.
🔎 Cautions
- See BNF - caution in patients with intestinal disease (e.g. IBD) due to risk of exacerbation.
- Consider IV iron if malabsorption, intolerance, or need for rapid correction.
🚫 Contraindications
- See BNF - avoid in haemochromatosis, haemosiderosis, and iron-loading anaemias (e.g. thalassaemia major).
❗ Side Effects
- GI: nausea 🤢, vomiting, abdominal pain, diarrhoea 💩, constipation.
- Dark stools (benign, but often alarming to patients).
- Serious: iron poisoning in overdose - causes metabolic acidosis, shock, and multi-organ failure (particularly in children ⚠️👶).
📚 References
📝 Revisions
- Latest update: clarified once-daily preference and added IV iron consideration.
