Oral iron is the cornerstone of therapy for IDA, and an effective first line strategy for most patients provided the dose and duration are adequate.
Adequate doses of oral iron (100 to 200 mg of elemental iron per day in adults) can raise the haemoglobin level by around 20 g/L in a few weeks. This is equivalent to 2 units of red cells.
Iron therapy should be continued for 3 months after normalisation of haemoglobin to adequately replenish iron stores.
There are more than 100 iron containing preparations available over the counter in Australia but few contain a therapeutic dose for the treatment IDA.
Multivitamin-mineral supplements should be avoided because the elemental iron content is low (frequently 5 mg or less) and they may contain other ingredients that limit absorption.
To avoid confusion, write the name of the preparation down for the patient to take to the pharmacy.
Oral Preparations for the Treatment of Iron Deficiency Anaemia in Australia
|Name (Manufacturer)||Tablet||Formulation||Elemental iron content||Other active ingredients||*RELATIVE COST (2010 MIMS/PBS)|
|FERRO-GRADUMET (Abbott)||325 mg Ferrous sulphate Controlled-release tablets||105 mg||Nil||$6.56 (30 tablets)|
|FERROGRAD C (Abbott)||325 mg Ferrous sulphate Controlled-release tablets||105 mg||Ascorbic acid (500 mg)||$8.16 (30 tablets)|
|FGF (Abbott)||250 mg Ferrous sulphate Controlled-release tablets||80 mg||Folic acid (300 mcg)||$3.92 (30 tablets)|
|FEFOL Iron and Folate Supplement (Pharm-a-care)||270 mg Ferrous sulphate Controlled-release capsules||87.4 mg||Folic acid (300 mcg)||$9.95 (30 tablets)|
|Ferro-f-tab (AFT pharmaceuticals)||310 mg Ferrous fumarate Non-controlled − release tablets||100 mg||Folic acid (350 mcg)||$9.47 (60 tablets)PBS listed ($12.79)†|
|Ferro-tab (AFT pharmaceuticals)||200 mg Ferrous fumarate Non-controlled − release tablets||65.7 mg||Nil||$9.47 (60 tablets) PBS listed ($12.79)†|
|FERRO-LIQUID (AFT pharmaceuticals)||250 mL bottle Ferrous sulphate Oral liquid||30 mg / 5 mL||Nil||$19.35 (250 mL bottle) PBS listed|
Notes: The usual ADULT dose for IDA is around 100–200 mg elemental iron daily in divided doses (1–2 tablets per day of the above preparations, taken 1 hr before or 2 hrs after food). GI upset may be reduced by taking the tablet with food or at night & increasing the dose gradually. When a rapid increase in Hb is not required, intermittent dosing (1 tablet 2–3 times per week) or lower daily doses of iron (eg, 30 mg of elemental iron given as syrup, increasing to bd or tds as tolerated) may reduce GI upset. Multivitamin-mineral supplements should not be used to treat IDA as iron content is low & absorption may be reduced. *Intended to indicate relative cost not price to the consumer (actual cost of OTC medicines may vary).
- BloodSafe. Oral preparations for the treatment of Iron Deficiency Anaemia in Australia. South Australia, 2011.