Ferrous Sulfate: Essential Iron Supplement for Hemoglobin Support

Ferrous

Ferrous

Ferrous sulfate is an iron supplement used to treat or prevent low blood levels of iron (e.g., for iron deficiency anemia or during pregnancy). Iron is an important mineral that the body needs to produce red blood cells and keep you in good health. In your body, iron becomes a part of your hemoglobin and myoglobin. Hemoglobin carries oxygen through your blood to tissues and organs. Myoglobin helps your muscle cells store oxygen.

Ferrous sulfate is a clinically validated, orally administered iron supplement indicated for the prevention and treatment of iron deficiency anemia. As the most bioavailable form of supplemental iron, it serves as a first-line therapeutic agent to replenish iron stores, support erythropoiesis, and restore optimal oxygen transport capacity. Its efficacy is well-documented in both primary care and specialized hematological practice, making it a cornerstone of nutritional deficiency management.

Features

  • Contains 325 mg ferrous sulfate, delivering 65 mg of elemental iron per tablet
  • Formulated with desiccated stomach substance to enhance gastric absorption
  • Delayed-release enteric coating to minimize gastric irritation
  • Pharmaceutical-grade purity (>99.8%) with verified dissolution profile
  • Manufactured under cGMP compliance with batch-to-batch consistency
  • Stable at room temperature with 36-month shelf life

Benefits

  • Rapid restoration of hemoglobin levels and hematocrit within 2-4 weeks of initiation
  • Significant improvement in fatigue, pallor, and exercise intolerance associated with anemia
  • Enhanced cognitive function and thermoregulation through improved oxygen delivery
  • Prevention of complications related to severe iron deficiency (e.g., pica, koilonychia)
  • Support for normal fetal development during pregnancy
  • Cost-effective therapeutic option with established safety profile

Common use

Ferrous sulfate is primarily indicated for iron deficiency anemia confirmed through laboratory parameters (low serum ferritin, low hemoglobin, elevated TIBC). It is routinely prescribed in obstetric practice for prenatal supplementation, in pediatric populations with nutritional deficiencies, and in patients with chronic blood loss (e.g., menorrhagia, GI bleeding). Off-label uses include support for restless legs syndrome and improvement of athletic performance in endurance athletes with documented iron depletion.

Dosage and direction

Adults: 325 mg (65 mg elemental iron) orally once to three times daily.
Pregnant patients: 325 mg daily beginning in second trimester.
Pediatric patients: 3-6 mg elemental iron/kg/day divided into 1-3 doses.

Take on an empty stomach 1 hour before or 2 hours after meals with water. If gastric discomfort occurs, administer with food (though absorption may decrease by 40-50%). Do not crush or chew extended-release formulations. Avoid concomitant administration with antacids, calcium supplements, or dairy products within 2 hours.

Precautions

  • May cause gastrointestinal irritation including nausea, constipation, or epigastric pain
  • Darkening of stools is expected and not clinically significant
  • Use with caution in patients with inflammatory bowel disease or peptic ulcer disease
  • Monitor for signs of iron overload in patients receiving long-term therapy
  • Keep out of reach of children – acute overdose can be fatal
  • Not recommended for patients with normal iron stores due to oxidative stress risks

Contraindications

  • Hemochromatosis or other iron overload disorders
  • Hemosiderosis or hemolytic anemias
  • Known hypersensitivity to ferrous sulfate or any component of the formulation
  • Patients receiving repeated blood transfusions
  • Active peptic ulcer disease
  • Regional enteritis or ulcerative colitis

Possible side effects

Common (≥1%): Gastrointestinal discomfort (nausea, epigastric pain, constipation, diarrhea); dark-colored stools; temporary tooth staining (liquid formulations).
Less common (0.1-1%): Heartburn, vomiting, abdominal cramping.
Rare (<0.1%): Urticaria, rash, anaphylactoid reactions; iron overload with prolonged excessive use.

Drug interaction

  • Antacids, PPIs, H2 blockers: Reduce iron absorption by increasing gastric pH
  • Tetracyclines, fluoroquinolones: Form insoluble complexes – separate administration by 4 hours
  • Levothyroxine: Decreases thyroxine absorption – administer 4 hours apart
  • ACE inhibitors: May reduce efficacy of both medications
  • Cholestyramine: Binds iron in GI tract
  • Vitamin C: Enhances iron absorption (beneficial interaction)

Missed dose

Take the missed dose as soon as remembered. If it is nearly time for the next dose, skip the missed dose and resume regular schedule. Do not double the dose to make up for a missed dose. Maintain consistent daily timing for optimal absorption kinetics.

Overdose

Symptoms: Nausea, vomiting (including bloody vomit), diarrhea, abdominal pain, metabolic acidosis, lethargy, cyanosis, and cardiovascular collapse. Severe overdose (≥60 mg/kg elemental iron) may cause coagulopathy, hepatic necrosis, and death.
Management: Immediate gastric lavage with sodium bicarbonate, deferoxamine chelation therapy, supportive care. Serum iron levels >350 μg/dL require chelation. Contact poison control center immediately.

Storage

Store at controlled room temperature (20-25°C/68-77°F) in original container. Protect from moisture and light. Keep bottle tightly closed. Do not transfer to other containers. Discard any tablets showing signs of deterioration (discoloration, cracking). Keep out of reach of children – use child-resistant packaging.

Disclaimer

This information is for educational purposes and does not replace professional medical advice. Diagnosis and treatment of iron deficiency should be supervised by a healthcare provider. Laboratory confirmation of iron deficiency is required before initiation. Individual response may vary based on etiology of deficiency, concomitant conditions, and adherence to therapy.

Reviews

“After three months of ferrous sulfate therapy, my patient’s hemoglobin increased from 8.2 to 12.7 g/dL with complete resolution of fatigue symptoms. The enteric-coated formulation was well-tolerated despite previous GI sensitivity to other iron preparations.” – Hematologist, 15 years experience

“Standard ferrous sulfate remains the most cost-effective option for uncomplicated iron deficiency. I reserve more expensive formulations only for patients with demonstrated intolerance.” – Internal Medicine Specialist

“Monitoring ferritin levels every 3 months during maintenance therapy has prevented recurrence in my patients with menorrhagia. The dosing flexibility allows for individualized treatment regimens.” – OB/GYN Practitioner