In this section
Aim for iron supplementation at 2 - 6mg/kg/day
of elemental iron.
2mg/kg/day is the preventative dose for iron
deficiency and also effective in mild-moderate deficiency.
The higher range doses are usually only
necessary for severe deficiency, and iron studies should be
monitored carefully to prevent overload.
Higher doses should be divided (up to tds) to
reduce gastric irritation.
Ferrous sulphate mixture (Ferro-Liquid) is
usually available and contains 6mg/ml elemental iron. There is a
shortage of this sometimes
Ferrous sulphate spansules contain beads
(Fefol; also contains folate and sucrose). Each spansule contains
87.4mg of elemental iron. The spansule can be opened and the beads
sprinkled on food to give lower doses, but the beads shouldn't be
crushed or chewed.
Ferro-Gradumet slow release tablets are
suitable for older children who can swallow them whole.
Iron is better absorbed if given with an
acidic substance (eg orange juice, Vitamin C etc).
Check reticulocyte response and ferritin at 4 weeks. Continue
supplements for minimum of 3 mths usually (to replenish
Monitor response as there is a risk of iron overload with
excessive doses over long periods, particularly in susceptible
Note: doses in patients > 40kg are usually limited to one
spansule / tablet per day unless inadequate response.
These are the total daily dose. The liquid can be split into BD
or TDS amounts for the larger doses to avoid gastric
Ferro-Gradumet slow release
3mls per day
half a spansule every second day
6mls per day
half a spansule daily
9mls per day
whole & half spansule alternate days
12mls per day
whole spansule daily
1 tablet daily