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Ferrous sulfate for iron-deficiency anaemia
Ferrous sulfate for iron-deficiency anaemia
This leaflet is about the use of ferrous sulfate (ferrous sulphate), which is a form of iron, for the prevention or treatment of iron-deficiency anaemia.
This leaflet has been written specifically for parents and carers about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Do not give ferrous sulfate to your child unless a doctor has told you to. If your child’s anaemia is not due to an iron deficiency, they could end up with too much iron, which can be dangerous.
Name of drug
Ferrous sulfate (ferrous sulphate)
Brand name: Ironorm® Drops
Why is it important for my child to take this medicine?
Anaemia is a blood condition where there is a lack of a protein called haemoglobin. Haemoglobin is needed to carry oxygen in the blood and transport it around the body.
Children with anaemia are often pale, feel tired, have little energy, and may not grow or develop properly.
Ferrous sulfate is a form of iron that can be taken by mouth. It helps the body to make more haemoglobin and so treat the anaemia. It can also be used to prevent anaemia in children who are at risk of it or, for example, before surgery.
What is ferrous sulfate available as?
- Tablets: 200 mg (65 mg of iron)
- Oral drops: 125 mg (25 mg of iron) in 1 mL
When should I give ferrous sulfate?
This depends on whether it is being used to prevent or treat anaemia. Your doctor will tell you how often to give ferrous sulfate.
If ferrous sulfate is being used to prevent anaemia, it is usually given once each day. This can be in the morning OR the evening.
If ferrous sulfate is being used to treat anaemia, it is usually given twice or three times each day.
- Twice a day: this should be once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example some time between 7 and 8 am, and between 7 and 8 pm.
- Three times a day: this should be once in the morning, once in the early afternoon and once in the evening. Ideally, these times are at least 6 hours apart, for example 8 am, 2 pm and 8 pm.
Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of ferrous sulfate (the dose) that is right for your child. The dose will be shown on the medicine label. The dose may be given as a number of drops or as millilitres (mL).
It is important that you follow your doctor’s instructions about how much to give.
How should I give it?
Tablets should be swallowed with a glass of water or juice, but not milk. Your child should not chew the tablet. Do not crush these tablets.
Oral drops: Measure out the right amount (you will be told this in either drops or mL) from the dropper bottle or by using an oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
Ferrous sulfate works best when given on an empty stomach. Try to give it 30 minutes before or 2 hours after food. However, if this upsets your child’s stomach, you can give it with a little food.
When should the medicine start working?
Ferrous sulfate takes some time to work. If it is being used to treat anaemia, you might notice an improvement in your child when they have been taking the medicine for 3–4 weeks. They may be less pale, have more energy and have less shortness of breath. Your child will need to take ferrous sulfate regularly for at least 3 months for it to have its full benefits. If your child is taking ferrous sulfate to prevent anaemia, you will not see any difference in your child, but the medicine will still be working to improve your child’s levels of iron and stop them getting anaemia.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of ferrous sulfate, give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of ferrous sulfate, you do not need to give them another dose. Wait until the next normal dose.
What if I forget to give it?
- If you usually give it once a day: Give the missed dose when you remember, as long as this is at least 12 hours before the next dose is due. You do not need to wake up a sleeping child to give a missed dose.
- If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Give the next dose as usual.
- If you usually give it three times a day: Do not give the missed dose. Just give the next dose as usual.
Never give a double dose of ferrous sulfate. If you are not sure whether to give a missed dose, don’t give it. Giving an extra dose of ferrous sulfate by mistake is more likely to do harm than missing a dose.
What if I give too much?
It may be dangerous to give too much ferrous sulfate. Never give your child more than the doctor has advised.
If your child has one or more of the following symptoms, they may have had too much ferrous sulfate:
- stomach pains
- being repeatedly sick (vomiting)
- their vomit or stools (poo) are blood stained, or green or grey.
Children who have had too much ferrous sulfate might not show any symptoms or only have mild symptoms. If you think your child has had too much ferrous sulfate, contact your doctor or NHS Direct (0845 4647 in England and Wales; 08454 24 24 24 in Scotland) or take your child to hospital.
If your child appears very unwell or drowsy call for an ambulance straight away.
Take the medicine container or packaging with you, even if it is empty. This will be useful to the doctor. Have the medicine or packaging with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
- Your child may feel sick or be sick. It may help to give ferrous sulfate after some food.
- Your child might get indigestion, constipation (difficulty doing a poo) or diarrhoea/loose stools (poo).
- If these side-effects are a problem or do not wear off, contact your doctor or pharmacist, as they may suggest a different iron preparation or a lower dose. Do not reduce the dose without discussing with your doctor first.
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor.
Can other medicines be given at the same time as ferrous sulfate?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Ferrous sulfate should not be taken with some medicines that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before giving ferrous sulfate.
- If your child needs to take any medicines for indigestion, do not give these with ferrous sulfate. Give the two medicines at different times of the day.
- Check with your doctor or pharmacist before giving any other medicines to your child, other products that contain iron, and any products that contain zinc or magnesium. This includes multivitamin preparations and herbal or complementary medicines.
Is there anything else I need to know about this medicine?
- The packaging for ferrous sulfate may include the warning, ‘Important warning: Contains iron. Keep out of the reach and sight of children, as overdose may be fatal’. However, iron is not harmful when given in the amounts recommended by your doctor. You must not give your child more than this.
Keep ferrous sulfate out of the reach of young children.
- Your child’s stool (poo) may appear darker than usual while taking ferrous sulfate. This is very common and you do not need to worry about it. However, if you are concerned, your pharmacist or doctor will be able to give you more advice.
- Your doctor will do blood tests to measure how much iron is in your child’s blood and to make sure that the medicine is working.
- Separate leaflets on other medicines containing iron for the treatment and prevention of anaemia are available on www.medicinesforchildren.org.uk
General advice about medicines
- Try to give medicines at about the same times each day, to help you remember.
- If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
- Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where I should keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- Make sure that children cannot see or reach it.
- Keep the medicine in the container it came in.
Who to contact for more information
Your doctor, pharmacist or nurse will be able to give you more information about ferrous sulfate and about other medicines used to treat iron-deficiency anaemia.
You can also get useful information from:
Version 1, February 2013. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: February 2016.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.