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BLOOD AND BLOOD FORMING ORGANS › ANTIANEMIC PREPARATIONS › IRON PREPARATIONS › Iron in combination with folic acid
ferrous sulfate and folic acid
B03AD03
Forms & Strengths
- Tablet: 325 mg ferrous sulfate (65 mg elemental iron) + 0.25 mg folic acid
- Tablet: 325 mg ferrous sulfate (65 mg elemental iron) + 0.8 mg folic acid
- Tablet (Extended-Release): 250 mg ferrous sulfate + 0.5 mg folic acid
- Elixir: 220 mg/5 mL ferrous sulfate + 1 mg/5 mL folic acid
Adult Dosing
- Iron deficiency anemia during pregnancy: 1 tablet daily or as directed by clinician
- Prevention of iron and folate deficiency: 1 tablet daily
Pediatric Dosing
- Pediatric dosing is age- and weight-dependent; typically calculated based on elemental iron and folic acid requirements
- Refer to specific pediatric guidelines for treatment of documented iron and folate deficiency anemias
Indications
- Prevention and treatment of iron deficiency anemia and concomitant folic acid deficiency
- Prophylaxis of iron and folate deficiencies during pregnancy and lactation
Mechanism of Action
- Ferrous sulfate provides elemental iron, which is absorbed and incorporated into hemoglobin, myoglobin, and enzymes, correcting iron deficiency
- Folic acid is reduced to tetrahydrofolate, acting as a coenzyme for synthesis of thymidylate, purines, and methionine, essential for erythropoiesis
Contraindications
- Hemochromatosis and hemosiderosis
- Pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient
- Active peptic ulcer disease or regional enteritis
- Hypersensitivity to iron salts, folic acid, or any component of the formulation
Adverse Reactions
- Constipation, diarrhea, nausea, epigastric pain, and black stools
- Discoloration of urine
- Allergic reactions (rare with folic acid)
Drug Interactions
- Antacids, calcium supplements, and proton pump inhibitors decrease iron absorption
- Iron decreases absorption of fluoroquinolones, tetracyclines, levodopa, and levothyroxine
- Chloramphenicol may antagonize the hematopoietic response to folic acid
- Anticonvulsants (e.g., phenytoin, phenobarbital) may have decreased serum concentrations when coadministered with folic acid
Curated Content: Needs Vetting Before Put to Clinical Use