What is the difference between ferrous sulfate (iron supplement) 325mg and Vitron C (ferrous sulfate + vitamin C) for treating iron deficiency anemia?

Ferrous Sulfate 325mg vs. Vitron C for Iron Deficiency Anemia

Vitron C (ferrous sulfate + vitamin C) is preferred over plain ferrous sulfate 325mg for treating iron deficiency anemia due to enhanced iron absorption from the added vitamin C, though both formulations contain similar amounts of elemental iron. 1

Comparison of Formulations

Elemental Iron Content

• Ferrous sulfate 325mg tablet: Contains 65mg of elemental iron 2
• Ferrous sulfate with ascorbic acid (Vitron C): Contains approximately 65mg of elemental iron plus vitamin C 1

Key Differences

1. Vitamin C Addition: Vitron C contains ascorbic acid (vitamin C), which enhances iron absorption 1
2. Absorption Rate: The vitamin C in Vitron C improves iron absorption by converting ferric iron to the more readily absorbed ferrous form 1
3. Cost: Plain ferrous sulfate is generally less expensive than combination products 1

Clinical Recommendations Based on Guidelines

Dosing Recommendations

• Once-daily dosing is recommended rather than multiple daily doses 1
• No more than 100mg elemental iron per day is recommended for optimal absorption 1
• Every-other-day dosing may be better tolerated with similar absorption rates 1

Vitamin C Co-Administration

• The American Gastroenterological Association (AGA) specifically recommends adding vitamin C to oral iron supplementation to improve absorption 1
• This supports the use of Vitron C which already contains vitamin C, eliminating the need for separate supplementation

Duration of Treatment

• Continue iron supplementation for 3 months after correction of anemia to replenish iron stores 1
• Monitor hemoglobin at 3-4 weeks to assess response to therapy

Managing Common Side Effects

Gastrointestinal Side Effects

• Both formulations can cause GI side effects including constipation, nausea, and abdominal discomfort
• Taking iron with food may reduce GI side effects but can decrease absorption by 40-50%
• Consider polyethylene glycol (PEG) for managing constipation if it occurs 3

Special Considerations

When to Consider IV Iron Instead

• If patient doesn't tolerate oral iron
• If ferritin levels don't improve with oral iron trial
• If patient has a condition where oral iron absorption is compromised 1

Monitoring Response

• Check hemoglobin after 3-4 weeks of therapy
• Monitor iron parameters every 3 months for at least a year after correction 1

Practical Administration Tips

• Take on an empty stomach if tolerated
• Avoid taking with tea, coffee, or calcium (wait at least 1 hour)
• Space doses away from antacids, tetracyclines, and quinolone antibiotics

Bottom Line

While both ferrous sulfate 325mg and Vitron C contain similar amounts of elemental iron, the addition of vitamin C in Vitron C enhances iron absorption, making it a preferred option according to current guidelines. However, if cost is a significant concern, plain ferrous sulfate with separate vitamin C supplementation is a reasonable alternative.