Iron supplements Prepared by: AbdulRahman I. Bin Muhanna

Oral Ferrous Sulfate ( Elixir,syrup,enteric coated) 325mg tid between meals. start with one tablet daily to prevent gastric irritation & inc. by one tablet Q2-3 days till full dose. Ferrous Gluconate (contain less iron than sulfate

Cont. oral  reticulocyte count inc. within 3-4 days. Peaks within 7-10 days, Hgb inc. by 2 g/dl within one month.  Duration of therapy for 3 to 6 months after normalization of CBC to replace Iron store. - Symptoms resolve in one to 3 months. - Give a stool softener (docusate) to dec. constipation.

Parental iron therapy  indicated in the failure to respond to oral iron therapy duo to noncompliance or malabsorption; intolerance to oral therapy; significant blood loss in patient refusing transfusion.  Iron dextran is FDA approved for I.M. injection at max. dose of 100 mg/day.

Parental iron therapy  Iron dextran for IV infusion of total dose over 2 to 4 hours ( no> 50 mg/min). the dose can be calculated by: dose (ml) = x (desired Hgb- measured Hgb) x IBW + (0.26 X IBW)

Parental iron therapy  Give diluted 25 mg IV test dose (over 10 min) observe for 1 hour for adverse reactions such as allergic or anaphylaxis, then give the rest of the dose over 3 hr.