Dexorange Syrup Adult Dose
For adults with iron deficiency anemia, administer 50-100 mg of elemental iron once daily, taken in the fasting state, which translates to approximately 5-10 mL of Dexorange syrup (containing 10 mg elemental iron per mL) given as a single morning dose. 1, 2
Recommended Dosing Regimen
Standard adult dose:
- 50-100 mg elemental iron once daily is the evidence-based recommendation from the British Society of Gastroenterology guidelines 1, 2
- Take in the fasting state (on an empty stomach) to maximize absorption 1
- Administer as a single morning dose rather than divided doses throughout the day 3
Alternate-day dosing option:
- For patients experiencing gastrointestinal side effects, consider 60-120 mg elemental iron on alternate days rather than daily dosing 3
- This approach may actually increase total iron absorption while reducing side effects, as doses ≥60 mg stimulate hepcidin elevation that persists 24 hours and blocks subsequent iron absorption 3
Monitoring Requirements
Early response assessment:
- Check hemoglobin after 2 weeks of treatment 1, 2
- Absence of hemoglobin rise ≥10 g/L after 2 weeks predicts treatment failure with 90.1% sensitivity 1, 2
- Continue monitoring every 4 weeks until hemoglobin normalizes 1, 2
Treatment duration:
- Continue therapy for 3 months after hemoglobin normalization to replenish iron stores 1, 2, 4
- After treatment completion, monitor blood counts every 6 months to detect recurrent anemia 2
Critical Pitfalls to Avoid
Do not use divided daily dosing:
- Splitting doses throughout the day (e.g., twice or three times daily) is not supported by current evidence and may actually reduce absorption due to hepcidin elevation from the first dose 3
- Morning doses are superior to afternoon/evening doses because the circadian hepcidin increase is augmented by morning iron intake 3
Do not switch between different iron salts for side effects:
- Changing from one ferrous salt to another (e.g., ferrous sulfate to ferrous fumarate) when gastrointestinal side effects occur is not evidence-based 1, 2
- Instead, consider alternate-day dosing or parenteral iron 1
Do not use modified-release preparations:
- Extended-release formulations are less suitable for prescribing due to reduced iron absorption 1
When to Consider Parenteral Iron
Indications for switching to intravenous iron:
- Failure to achieve hemoglobin rise ≥10 g/L after 2 weeks of adequate oral therapy 1, 2
- Significant gastrointestinal intolerance despite alternate-day dosing 1, 2
- Chronic inflammatory conditions where oral iron is less effective 1, 2
- Continuing blood loss or impaired absorption 1
- Malabsorption syndromes 1