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ferrous sulfate
(FER us SUL fate)

What is ferrous sulfate?
Ferrous sulfate is a type of iron. You normally get iron from the foods you eat. In your body, iron becomes a part of your hemoglobin (HEEM o glo bin) and myoglobin (MY o glo bin). Hemoglobin carries oxygen through your blood to tissues and organs. Myoglobin helps your muscle cells store oxygen. Ferrous sulfate is used to treat iron deficiency anemia (a lack of red blood cells caused by having too little iron in the body). Ferrous sulfate may also be used for other purposes not listed in this medication guide.

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What are the possible side effects of ferrous sulfate?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

  • constipation;

  • upset stomach;

  • black or dark-colored stools; or

  • temporary staining of the teeth.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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How should I take ferrous sulfate?
Use this medication exactly as directed on the label, or as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Take ferrous sulfate on an empty stomach, at least 1 hour before or 2 hours after a meal. Avoid taking antacids or antibiotics within 2 hours before or after taking ferrous sulfate . Take this medication with a full glass of water. Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

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What is the most important information I should know about ferrous sulfate?
Before using this medication, tell your doctor if you are allergic to any drugs, or if you have iron overload syndrome, hemolytic anemia (a lack of red blood cells), porphyria (an enzyme disorder that causes blue discoloration of the skin), thalassemia (a genetic disorder of red blood cells), if you are an alcoholic, or if you receive regular blood transfusions. Seek emergency medical attention if you think you have used too much of this medicine, or if anyone has accidentally swallowed it. An overdose of iron can be fatal, especially in a young child.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

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What other drugs will affect ferrous sulfate?
The following drugs can interact with ferrous sulfate. Tell your doctor if you use any of these: acetohydroxamic acid (Lithostat); chloramphenicol; cimetidine (Tagamet); etidronate (Didronel); dimercaprol (an injection used to treat poisoning by arsenic, lead, or mercury); levodopa (Larodopa, Dopar, Sinemet); methyldopa (Aldomet); or penicillamine (Cuprimine). This list is not complete and there may be other drugs that can interact with ferrous sulfate. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Ferrous sulfate has not been formally assigned to a pregnancy category by the FDA. There are no controlled data in human pregnancy. Human case reports have not revealed evidence of teratogenicity. Ferrous sulfate should be administered during pregnancy only if clearly indicated.

Generally, iron is considered safe for use during pregnancy and is regularly prescribed as a component of prenatal vitamin/mineral supplements. However, controversy exists as to whether or not routine iron supplementation is needed in the non-anemic pregnant patient. Anemia may be a risk factor for preterm delivery and low birth weight and should be diagnosed and treated as soon as possible, either before pregnancy or in the first trimester. Because supplementation with iron may reduce the dietary absorption of zinc, it may be important to assess zinc status as well. Most prenatal vitamins also contain adequate amounts of zinc. Absorption of iron and zinc may be reduced if calcium is also a component of the prenatal multivitamin.

Several reports suggest that iron supplementation during lactation does not significantly affect the total concentration of iron in human milk. Ferrous sulfate administration during lactation is generally considered safe for the infant by most clinicians.

One study demonstrated that a moderate iron supplementation of non-anemic nursing mothers (40 mg elemental iron daily over 3 months starting 2 days after delivery) resulted in increased maternal iron reserves, no significant alterations in milk iron concentration or lactoferrin, and no harmful effect on the infant. Another study evaluated oral iron supplementation in 19 anemic women receiving 100 mg elemental iron per day starting 2 days after delivery and continuing for 30 days. Ten non-anemic women had received iron supplementation during pregnancy. Iron and lactoferrin concentrations in milk obtained at 2 and 30 days after delivery did not differ between groups at either stage of lactation.

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Who should NOT use this medication?

  • Primary hemochromatosis.
  • Peptic ulcer, regional enteritis, or ulcerative colitis.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine, or if a child has accidentally swallowed it. An overdose of ferrous sulfate can be fatal to a child. Overdose symptoms may include nausea, severe stomach pain, bloody diarrhea, coughing up blood or vomit that looks like coffee grounds, shallow breathing, weak and rapid pulse, pale skin, blue lips, and seizure (convulsions).

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What should I discuss before taking ferrous sulfate?
Before using this medication, tell your doctor if you are allergic to any drugs or food dyes, or if you have: iron overload syndrome; hemolytic anemia (a lack of red blood cells); porphyria (an enzyme disorder that causes blue discoloration of the skin); thalassemia (a genetic disorder of red blood cells); if you are an alcoholic; or if you receive regular blood transfusions. If you have any of these conditions, you may need a dose adjustment or special tests to safely take ferrous sulfate.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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