Ferrous sulfate

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.

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).

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.

Ferrous sulfate is only part of a complete program of treatment that may also include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat to make sure you get enough iron from both your diet and your medication.

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.

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.

It is not known whether this medication could be harmful to an unborn baby. Tell your doctor if you become pregnant during treatment.

It is not known whether ferrous sulfate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give ferrous sulfate to a child without the advice of a doctor.

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.

Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Ferrous sulfate can stain your teeth, but this effect is temporary. To prevent tooth staining, mix the liquid form of ferrous sulfate with water or fruit juice (not with milk) and drink the mixture through a straw. You may also clean your teeth with baking soda once per week to treat any tooth staining.

Ferrous sulfate is only part of a complete program of treatment that may also include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat to make sure you get enough iron from both your diet and your medication.

Store ferrous sulfate at room temperature, away from moisture and heat.

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.

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).

What should I avoid while taking ferrous sulfate?

Do not take any vitamin or mineral supplements that your doctor has not prescribed or recommended.

Avoid taking an antibiotic medicine within 2 hours before or after you take ferrous sulfate. This is especially important if you are taking an antibiotic such as ciprofloxacin (Cipro), demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), levofloxacin (Levaquin), lomefloxacin (Maxaquin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), norfloxacin (Noroxin), ofloxacin (Floxin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).

Certain foods can also make it harder for your body to absorb ferrous sulfate. Avoid taking this medication within 1 hour before or 2 hours after eating fish, meat, liver, and whole grain or "fortified" breads or cereals.

Avoid using antacids without your doctor's advice. Use only the specific type of antacid your doctor recommends. Antacids contain different medicines and some types can make it harder for your body to absorb ferrous sulfate.

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.

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.

Where can I get more information?

Your pharmacist can provide more information about ferrous sulfate.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 1.07. Revision date: 11/08/2007.