1 May 2026Oral drugs
Ferrous salts oral
Ferrous salts guidance for prevention of iron deficiency and treatment of iron-deficiency anemia across neonatal, child, and adult ages.
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Antianaemia drug.
Indications
- Prevention of iron-deficiency.
- Treatment of iron-deficiency anaemia.
Forms and strengths
Doses are expressed as elemental iron.
- 140 mg/5 ml syrup of ferrous fumarate containing approximately 45 mg/5 ml of elemental iron.
- 200 mg ferrous fumarate or sulfate tablet containing approximately 65 mg of elemental iron.
Dose
| Age | Weight | Prevention | Treatment | ||
|---|---|---|---|---|---|
| 45 mg/5 ml syrup | 65 mg tablet | 45 mg/5 ml syrup | 65 mg tablet | ||
| < 1 month | < 4 kg | 0.5 ml | - | 0.5 ml x 2 | - |
| 1 month to < 1 year | 4 to < 10 kg | 1 ml | - | 1.5 ml x 2 | - |
| 1 to < 6 years | 10 to < 20 kg | 2.5 ml | - | 2.5 ml x 2 | - |
| 6 to < 12 years | 20 to < 40 kg | 5 ml | - | - | 1 tab x 2 |
| ≥ 12 years and adult | ≥ 40 kg | - | 1 tab | - | 1 tab x 2 or 3 |
Prevention of iron-deficiency
- Neonate: 4.5 mg once daily.
- Child 1 month to < 12 years: 1 to 2 mg/kg once daily, maximum 65 mg daily.
- Child >= 12 years and adult: 65 mg once daily.
Treatment of iron-deficiency anaemia
- Neonate: 1 to 2 mg/kg 2 times daily.
- Child 1 month to < 6 years: 1.5 to 3 mg/kg 2 times daily.
- Child 6 to < 12 years: 65 mg 2 times daily.
- Child >= 12 years and adult: 65 mg 2 to 3 times daily.
- < 1 month and < 4 kg: 0.5 ml daily for prevention or 0.5 ml 2 times daily for treatment.
- 1 month to < 1 year and 4 to < 10 kg: 1 ml daily for prevention or 1.5 ml 2 times daily for treatment.
- 1 to < 6 years and 10 to < 20 kg: 2.5 ml daily for prevention or 2.5 ml 2 times daily for treatment.
- 6 to < 12 years and 20 to < 40 kg: 5 ml daily for prevention or 1 tablet 2 times daily for treatment.
- >= 12 years and adult, >= 40 kg: 1 tablet daily for prevention or 1 tablet 2 or 3 times daily for treatment.
Duration
- Prevention: during the risk period such as pregnancy or malnutrition.
- Treatment: 3 months.
Contra-indications, adverse effects, precautions
- Do not administer to patients with other forms of anaemia.
- May cause abdominal pain, nausea, vomiting, diarrhoea or constipation, and black stools.
- Do not exceed recommended doses in children because of overdose risk.
- Do not give simultaneously with doxycycline, ciprofloxacin, dolutegravir, antacids, levodopa, or zinc sulfate; administer each drug at least 2 hours apart.
- Administration with ascorbic acid increases iron absorption.
- Rinse mouth or drink water after syrup administration because of the risk of tooth staining.
- Pregnancy and breast-feeding: no contra-indication.
- To reduce gastrointestinal disturbances, take during meals and gradually increase dosage.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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