Ferrous fumarate for iron-deficiency anaemia
This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Do not give ferrous fumarate to your child unless told to do so by a doctor. 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 medicine
Brand names: Fersaday®, Fersamal®, Galfer®
This leaflet is about the use of ferrous fumarate, which is a form of iron, for the prevention or treatment of iron-deficiency anaemia.
Why is it important for my child to take ferrous fumarate?
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 fumarate 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 fumarate available as?
Tablets: 210 mg (68 mg of iron), 322 mg (100 mg of iron)
Capsules: 305 mg (100 mg of iron)
Liquid medicine (suspension) or syrup: 140 mg (45 mg of iron) in 5 mL; contains glucose and sucrose
When should I give ferrous fumarate
This depends on whether it is being used to prevent or treat anaemia. Your doctor will tell you how often to give ferrous fumarate.
If ferrous fumarate is being used to prevent anaemia, it is usually given once each day. This can be in the morning OR the evening.
If ferrous fumarate is being used to treat anaemia, it is usually given twice each 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.
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 fumarate (the dose) that is right for your child. The dose will be shown on the medicine label.
It is important that you follow your doctor’s instructions about how much to give.
How should I give ferrous fumarate?
- Tablets should be swallowed with a glass of water or juice, but not milk. Your child should not chew the tablet. Do not crush the tablets.
- Capsules should be swallowed with a glass of water or juice, but not milk. Your child should not chew the capsule.
- Shake the medicine well. Measure out the right amount using an oral syringe or a medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
The ferrous fumarate 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, give it with a little food.
When should the medicine start working?
Ferrous fumarate takes some time to work.
If your child is taking it to prevent anaemia, you will not see any difference, but if they are taking it for anaemia you might notice an improvement in their symptoms when they have been taking the medicine for 3–4 weeks. Your child will need to take ferrous fumarate regularly for at least 3 months for it work properly.
If your child is taking ferrous fumarate 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 fumarate, give them the same dose again.
If your child is sick more than 30 minutes after having a dose of ferrous fumarate, 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. Just give the next dose as usual.
Never give a double dose of ferrous fumarate. If you are not sure whether to give a missed dose, don’t give it. Giving an extra dose of ferrous fumarate by mistake is more likely to do harm than missing a dose.
What if I give too much?
Children who have had too much ferrous fumarate might not show any symptoms, or only have mild symptoms. If you think your child has had too much ferrous fumarate, contact your doctor or NHS Direct (111 in England and Scotland; 111 or 0845 4647 in parts of Wales) or take your child to hospital.
If your child has one or more of the following symptoms, they may have had too much ferrous fumarate:
- stomach pains
- being repeatedly sick (vomiting)
- the vomit or stools (poo) may be blood stained, or be green or grey.
It can be dangerous to give too much ferrous fumarate. Never give your child more than the doctor has advised.
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 fumarate 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 it 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 fumarate?
- You can give your child medicines that contain paracetamol, unless your doctor has told you not to.
- Ferrous fumarate 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 fumarate.
- If your child needs to take any medicines for indigestion, do not give these with ferrous fumarate. 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?
Keep ferrous fumarate out of the reach of young children.
- The packaging for ferrous fumarate 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.
- Your child’s stool (poo) may appear darker than usual while taking ferrous fumarate. 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 the Medicines for Children website.
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.
- 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 medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
Where should I 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 the medicine.
- 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 fumarate and about other medicines used to prevent or treat iron-deficiency anaemia.
Version . © NPPG, RCPCH and WellChild, all rights reserved. Review by June 2015.
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.