ferrous sulfate

Disclaimer to the Online Edition

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

Indication

  • Prevention of iron deficiency anemia in preterm infants

Dosage Guidelines

  • Start ferrous sulfate in all babies born at 36+6 or earlier when they reach full enteral feeds of expressed breast milk (EBM) and are at least one week of age
  • Standard starting doses based on weight:
    • Less than 1.5 kg: 15 mg (0.2 mL) daily
    • 1.5 kg or greater – 2.5 kg: 22.5 mg (0.3 mL) daily
    • Greater than 2.5 kg: 37.5 mg (0.5 mL) daily
  • Target dosing for anemia prophylaxis is ~ 15 mg/kg/dose (3 mg elemental iron/kg) oral daily

Administration

  • Oral: patient must be feeding full enteral feeds.

Adverse Effects

  • Minimal; mild GI upset, constipation, darkened stools

Comments

  • Give at the beginning of a feed
  • Hold or do not start ferrous sulfate within 10 – 14 days of receiving packed red blood cell transfusion

Supplied As

  • Oral Drops: ferrous sulfate 75 mg/mL (provides 15 mg elemental iron/mL)

References

LexiComp (Pediatric and Neonatal)