Ferrous sulfate

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This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

Ferrous sulfate (Fer-in-Sol®)

Indication

  • To prevent the development of iron deficiency anemia in premature infants

Side Effects

  • Minimal; may cause some GI upset, constipation, diarrhea

Precautions

  • Stools may be coloured dark green or black
  • Give with formula at beginning of a feed
  • Do not give concomitantly with Tri-Vi-Sol or Vitamin E because the Fe may precipitate and not be completely absorbed

Miscellaneous

  • Fer-in-Sol is very acidic and has a normal strong acrid odour which varies between batches and over the shell life of the product. The appearance and taste of Fer-in-Sol also vary somewhat due to the interaction of the ferrous and ferric iron with the sodium bisulfite antioxidant which is required to stabilize the ingredients. The colour change in Fer-in-Sol which has been observed after opening occurs as a result of a small amount of oxidation of ferrous to ferric iron. This does not significantly change the bio-availability or efficacy of the iron.

Dose

  • Present Weight and Daily Oral Volume
    • <1.5 kg = 0.3 mL
    • >1.5 kg = 0.5 mL
  • To be started at 6 weeks of age in preterm infants
  • Infants who are solely on TPN will automatically be supplemented at 6 weeks with elemental iron, as follows: 0.67 mg/L

Supplied As

  • Drops: 1.5 mg elemental iron / 0.1 mL
References
  1. Krogh CME et al (ed): Compendium of Pharmaceuticals and Specialties, Canadian Pharmaceutical Association, 1992.
  2. Personal Communication with Vern Shute, Director, Technical Affairs, Mead Johnson Canada, 15 August 1990 (letter on file).