Ferrous sulfate Other names: Melanterite Szomolnokite Iron vitriol Iron(II) sulfate Ferrous sulfate Green vitriol

The absorption of iron salts is also decreased in the presence of antacids, preparations containing zinc, calcium, phosphorus, trientine or when taken with tea, coffee, milk, eggs and whole grains.

Concurrent administration of iron with tetracyclines may impair absorption of both agents.

In coadministration of iron with allopurinol, iron deposition in the liver (especially in hepatic cirrhosis) may be increased.

Chloramphenicol, irrespective of its route of administration, interferes with erythropoiesis by delaying iron clearance from plasma and its incorporation into red blood cells.

Cholestyramine may bind iron to the gastrointestinal tract, thus preventing its absorption.

The absorption of ciprofloxacin, norfloxacin and ofloxacin and bisphosphonates is reduced by oral iron.

Avoid the concomitant use of iron with dimercaprol.

The absorption of levodopa and penicillamine may be reduced in coadministration with iron salts.

Oral iron reduces the absorption of levothyroxine (thyroxine) thus should be given at least 2 hours apart.

Iron salts may reduce the bioavailability of methyldopa.

Concomitant administration of iron with vitamin C by mouth increases its absorption.

Ferrous salts are recommended for use in pregnancy, and no contraindications to such are known.

Ferrous salts are recommended for use in lactation, and no contraindications to such are known.

None known.

Although iron preparations are best absorbed on an empty stomach, they may be taken after food to reduce gastrointestinal side-effects.

Large doses may produce gastro-intestinal irritation, nausea, vomiting, epigastric pain, diarrhoea.

Constipation may be caused by continual administration, particularly in older patients, and may lead to faecal impaction.

Iron supplementation may cause the blackening of stool.

Hypersensitivity reactions have been reported. These range from rashes, sometimes severe, to anaphylaxis.

Bronchial stenosis.

Post-marketing

The following ADRs have been reported during post-marketing surveillance. The frequency of these reactions is considered not known (cannot be estimated from the available data).

Gastrointestinal disorders: mouth ulceration*

* in the context of incorrect administration, when the tablets are chewed, sucked or kept in mouth. Elderly patients and patients with deglutition disorders may also be at risk of oesophageal lesions or of bronchial necrosis, in case of false route.