From the Guidelines
When taking oral ferrous sulfate for iron deficiency, take it once a day on an empty stomach, ideally 1 hour before or 2 hours after meals with a glass of water or orange juice, as this regimen is likely to improve tolerance and minimize side effects. The typical adult dose is one tablet per day, as recommended by the British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults 1. It is essential to avoid taking ferrous sulfate with milk, antacids, calcium supplements, coffee, or tea, as these substances can decrease iron absorption 1. Common side effects of oral ferrous sulfate include constipation, black stools, nausea, and stomach discomfort, which can be managed by increasing fluid and fiber intake.
Key Considerations for Patient Education
- Take ferrous sulfate exactly as prescribed and continue for 3-6 months even after feeling better to fully replenish iron stores.
- Store the medication at room temperature away from moisture.
- If a dose is missed, take it when remembered, but skip it if it's almost time for the next dose.
- Contact a healthcare provider if severe side effects occur, such as persistent abdominal pain, vomiting, or signs of an allergic reaction.
- Keep the medication out of reach of children, as iron overdose can be fatal.
- Ferrous sulfate works by providing the iron the body needs to produce hemoglobin, the protein in red blood cells that carries oxygen throughout the body.
Dietary Manipulations to Enhance Iron Absorption
- Taking iron with vitamin C (e.g., orange juice) may improve absorption, as vitamin C forms a chelate with iron and reduces ferric to ferrous iron, although evidence is mixed 1.
- Avoid consuming tea and coffee within an hour after taking iron, as they are powerful inhibitors of iron absorption 1.
From the Research
Patient Education Regarding Oral Ferrous Sulfate
- Patient education is crucial for the effective use of oral ferrous sulfate in treating iron deficiency anemia 2, 3.
- Patients should be informed about the importance of taking the medication as directed, with food to minimize gastrointestinal side effects 4.
- The dosage and frequency of ferrous sulfate should be explained clearly, and patients should be advised to take the medication at the same time every day 3.
- Patients should also be educated on the signs and symptoms of iron deficiency anemia, such as fatigue, weakness, and pale skin, and the importance of follow-up appointments to monitor their condition 2, 3.
Administration and Dosage
- Ferrous sulfate is typically administered orally, and the dosage may vary depending on the patient's age, weight, and severity of iron deficiency anemia 2, 3.
- Patients should be advised to take ferrous sulfate with a full glass of water, and to avoid taking it with milk or antacids, as these can interfere with absorption 4.
- The medication should be taken for the full prescribed duration, even if symptoms improve, to ensure that the iron deficiency is fully corrected 3.
Side Effects and Interactions
- Patients should be informed about the potential side effects of ferrous sulfate, such as nausea, vomiting, diarrhea, and stomach cramps 2, 3.
- They should also be advised to report any severe side effects, such as allergic reactions or difficulty breathing, to their healthcare provider immediately 4.
- Patients should be cautioned about potential interactions between ferrous sulfate and other medications, such as antacids, and should be advised to inform their healthcare provider about all medications they are taking 3.
Monitoring and Follow-up
- Patients should be scheduled for regular follow-up appointments to monitor their response to treatment and to adjust the dosage as needed 2, 3.
- Laboratory tests, such as hemoglobin and ferritin levels, may be ordered to monitor the patient's iron status and to assess the effectiveness of treatment 3, 5.
- Patients should be educated on the importance of adhering to their treatment plan and attending follow-up appointments to ensure optimal outcomes 2, 3.