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Ferrous Sulfate
Haematinic — Iron SupplementNigerian brand names:FerosulFerobinCoscopin IronIberetFesolate
Reviewed by the PMC Medical Team · Promise Medical Centre
Overview
Ferrous sulfate is an iron supplement used to prevent and treat iron-deficiency anaemia — the most common nutritional deficiency in Nigeria and worldwide. Iron is essential for the production of haemoglobin, the protein in red blood cells that carries oxygen. When iron stores are depleted, the body cannot make enough healthy red blood cells, causing fatigue, weakness, and pallor. Ferrous sulfate is the most commonly used and cost-effective oral iron supplement in Nigeria.
Uses
Ferrous sulfate is used to:
- Treat iron-deficiency anaemia (low haemoglobin caused by insufficient iron)
- Prevent iron deficiency in high-risk groups: pregnant women, breastfeeding mothers, infants and young children, people with heavy menstrual bleeding, vegetarians/vegans, people with chronic blood loss (e.g., peptic ulcer, hookworm infection)
- Supplement iron during pregnancy to support foetal development and prevent maternal anaemia
How to Use
Take ferrous sulfate exactly as directed.
Standard adult dosage for treatment: 200 mg tablet (containing 65 mg elemental iron) two to three times daily.
Prevention/supplementation: 200 mg once daily, or as prescribed.
For best absorption:
- Take on an empty stomach, 30–60 minutes before a meal or 2 hours after eating
- Take with a glass of orange juice or vitamin C — ascorbic acid significantly improves iron absorption
- Do not take with tea, coffee, milk, dairy products, or calcium supplements — these reduce iron absorption
If stomach upset is a problem:
- Take with food (absorption is lower but tolerated better)
- Start with a lower dose and increase gradually
Duration: Usually 3–6 months to replenish iron stores, even after haemoglobin returns to normal. Follow your doctor's instructions on how long to continue.
Side Effects
Common side effects:
- Nausea, stomach upset, or heartburn
- Constipation — increase water and fibre intake; a stool softener may be prescribed
- Diarrhoea (less common)
- Dark/black stools — this is harmless and expected; do not be alarmed
- Abdominal cramps
These side effects are dose-dependent — taking with food or starting with a lower dose can help.
Rare but serious:
- Accidental overdose in children: Iron overdose is a medical emergency. Keep tablets out of reach of children — severe poisoning can be fatal
- Very dark or tarry stools from GI bleeding (different from the harmless black stools of iron) — seek medical advice if concerned
Warnings & Precautions
Precautions and contraindications:
- Do not take if you have haemochromatosis (iron overload), thalassaemia (unless confirmed iron deficient), repeated blood transfusions, or non-iron-deficiency anaemia — excess iron can cause organ damage
- CRITICAL: Keep all iron tablets locked away from children — iron overdose is a leading cause of accidental poisoning death in young children. Signs of overdose: vomiting blood, stomach pain, green or black stools, dizziness, seizures — call emergency services immediately
Pregnancy: Iron supplementation is recommended for pregnant women in Nigeria (high rates of anaemia); however, the correct dose and duration should be guided by your doctor or midwife.
Allergies: Rare but possible — stop and report any rash, swelling, or breathing difficulty.
Anaemia diagnosis: Not all anaemia is caused by iron deficiency. Confirm diagnosis with blood tests (serum ferritin, haemoglobin, blood film) before starting iron. Taking iron when you do not need it is not beneficial and can cause harm.
Drug Interactions
Important interactions:
- Antacids (e.g., aluminium hydroxide, magnesium hydroxide): Significantly reduce iron absorption — take iron at least 2 hours apart from antacids
- Calcium supplements and dairy products: Reduce iron absorption — space them 2 hours apart
- Tetracycline and doxycycline antibiotics: Iron chelates these antibiotics, reducing both iron and antibiotic absorption — take 2–3 hours apart
- Fluoroquinolones (ciprofloxacin, levofloxacin): Iron reduces antibiotic absorption — take 2 hours apart
- Levodopa (for Parkinson's disease): Iron reduces absorption
- Levothyroxine (thyroid medication): Iron reduces absorption — take 4 hours apart
- Proton pump inhibitors (omeprazole): Reduce stomach acid needed to dissolve iron — may reduce absorption
- Tea and coffee: Tannins bind iron and reduce absorption — avoid drinking with iron supplements
Storage
Store at room temperature (below 25°C), in a dry place away from moisture. Keep tightly sealed. Keep out of reach of children — iron poisoning in children is a medical emergency.
Buy only NAFDAC-registered medications
Nigeria has a significant problem with counterfeit and substandard drugs. Always purchase medications from a licensed pharmacy and check the NAFDAC registration number on the package — verify at nafdac.gov.ng.