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Ferrous fumarate: Indications, Dosing, Side Effects and Interactions
Ferrous fumarate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Ferrous fumarate: Indications, Dosing, Side Effects and Interactions
Ferrous fumarate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Iron-deficiency anaemia [treatment and prophylaxis]**
- **Adult** (By Mouth Using Tablets): Initially 210 mg once daily, reduced if not tolerated to 210 mg once daily on alternate days, alternatively initially 322 mg once daily, reduced if not tolerated to 322 mg once daily on alternate days.
- **Adult** (By Mouth Using Capsules): 305 mg once daily, reduced if not tolerated to 305 mg once daily on alternate days.
- **Adult** (By Mouth Using Oral Solution): 5-10 mL once daily, reduced if not tolerated to 5-10 mL once daily on alternate days.
**Iron-deficiency anaemia [treatment and prophylaxis] for ferrous fumarate**
- **Child 6-11 years** (By mouth using tablets): 210 mg once daily on alternate days.
- **Child 12-17 years** (By mouth using tablets): Initially 210 mg once daily, reduced if not tolerated to 210 mg once daily on alternate days, alternatively initially 322 mg once daily, reduced if not tolerated to 322 mg once daily on alternate days.
- **Child 12-17 years** (By mouth using capsules): 305 mg once daily, reduced if not tolerated to 305 mg once daily on alternate days.
- **Neonate** (By mouth using oral solution): 1 mL once daily, reduced if not tolerated to 1 mL once daily on alternate days.
- **Child 1-11 months** (By mouth using oral solution): 1.2 mL once daily, reduced if not tolerated to 1.2 mL once daily on alternate days.
- **Child 1-4 years** (By mouth using oral solution): 2.5 mL once daily, reduced if not tolerated to 2.5 mL once daily on alternate days.
- **Child 5-11 years** (By mouth using oral solution): 5 mL once daily, reduced if not tolerated to 5 mL once daily on alternate days.
- **Child 12-17 years** (By mouth using oral solution): 5-10 mL once daily, reduced if not tolerated to 5-10 mL once daily on alternate days.
**Iron-deficiency anaemia [prophylaxis in preterm or low birth-weight babies who are solely or partially breast-fed] for ferrous fumarate**
- **Neonate** (By mouth using oral solution): 0.3-0.6 mL once daily, supplementation is usually started 2-6 weeks after birth.
- **Child 1-11 months** (By mouth using oral solution): 0.3-0.6 mL once daily, supplementation is usually started 2-6 weeks after birth and continued for 6-12 months or until receiving sufficient iron-rich formula, dose can be increased if necessary to 1.2 mL once daily.
Cautions
For all iron (oral) High doses in elderly Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate at oral doses greater than 200 mg elemental iron daily (no evidence of enhanced iron absorption above these doses).
Side effects
For all iron (oral) Common or very common Constipation; diarrhoea; gastrointestinal discomfort; nausea Uncommon Vomiting Frequency not known Appetite decreased; gastrointestinal disorders Side-effects, further information Iron can be constipating and occasionally lead to faecal impaction. Oral iron, particularly modified-release preparations, can exacerbate diarrhoea in patients with inflammatory bowel disease; care is also needed in patients with intestinal strictures and diverticular disease. Overdose For details on the management of poisoning, see Iron salts, under Emergency treatment of poisoning . Side-effects For ferrous fumarate Frequency not known Haemosiderosis
Interactions
**Other interactions (5):**
- Iron reduces the absorption of penicillamine, bisphosphonates, ciprofloxacin, entacapone, levodopa, levofloxacin, levothyroxine (thyroxine) (give at least 2 hours apart), moxifloxacin,...
- Absorption of both iron and antibiotic may be reduced if Fersamal 140mg/5ml is given with tetracycline.
- Absorption of oral iron is reduced by calcium salts, Magnesium salts (as magnesium trisilicate), Trientine.
- Chloramphenicol delays plasma iron clearance, incorporation of iron into red blood cells and interferes with erythropoiesis.
- Oral iron antagonises hypotensive effect of methyldopa.
Medicinal forms
Tablet,Capsule,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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