Maxaron

Indications

Ferrous sulphate is an iron supplement. It is used to:

• Treat iron deficiency anaemia (low haemoglobin caused by too little iron), which causes tiredness, weakness, pale skin and shortness of breath.
• Prevent iron deficiency when needs are high, such as in pregnancy, after blood loss, with heavy periods and in some people with poor diet.

How It Works

Iron is needed to make haemoglobin, the part of red blood cells that carries oxygen around the body. Ferrous sulphate replaces the missing iron so the body can make healthy red blood cells and refill its iron stores.

Dosage and Administration

• Adults, treatment: usually one 200 mg tablet (about 65 mg of iron) once or twice a day, or as prescribed. Many doctors now advise once a day, which works well and causes fewer stomach problems.
• Adults, prevention: usually one 200 mg tablet a day, or as advised.
• Treatment usually continues for about 3 months after the blood count returns to normal, to rebuild iron stores.
• Children: liquid or tablet doses as prescribed.

Iron is absorbed best on an empty stomach (1 hour before food), but it can be taken with food if it upsets the stomach. Taking it with orange juice or vitamin C helps absorption. Avoid tea, coffee, milk and antacids for 1 to 2 hours before and after each dose. Swallow tablets whole with water.

Interactions

• Antacids, calcium, zinc, Omeprazole and other stomach acid medicines reduce iron absorption.
• Iron reduces the absorption of Tetracycline, Doxycycline, Ciprofloxacin, Levofloxacin, Levothyroxine, Levodopa, Methyldopa, Penicillamine and bisphosphonates such as Alendronate. Separate these from iron by at least 2 hours (Levothyroxine by at least 4 hours).
• Tea, coffee, milk, eggs and whole grains also reduce iron absorption.

Contraindications

• Anaemia not caused by iron deficiency, unless iron deficiency is also present.
• Iron overload, such as haemochromatosis or haemosiderosis, or frequent blood transfusions (for example in thalassaemia) unless a doctor advises iron.
• Allergy to ferrous sulphate or any ingredient of the product.

Side Effects

Common: dark or black stools (harmless), constipation, nausea, stomach pain, heartburn and diarrhoea. Liquid iron can stain teeth; drink it through a straw and rinse the mouth. Get urgent medical help if you have severe stomach pain, vomiting blood or material like coffee grounds, red blood in the stools, or signs of a serious allergic reaction such as swelling of the face or difficulty breathing.

Pregnancy and Lactation

Iron is commonly prescribed in pregnancy to prevent and treat anaemia. It is safe during breastfeeding. Take the dose your doctor advises.

Precautions and Warnings

Do not take iron unless iron deficiency has been confirmed or a doctor advises it, as excess iron builds up in the body. Tell the doctor if you have a stomach ulcer, inflammatory bowel disease, or a blood disorder. Black stools are expected, but black, tarry stools with stomach pain or weakness need checking. Keep iron tablets locked away from children, as they look like sweets.

Overdose

Iron overdose is dangerous, especially for young children, and can be fatal. Symptoms include vomiting, diarrhoea, stomach pain and drowsiness; a person may seem better for a while before becoming seriously ill. Go to hospital immediately even if there are no symptoms, and take the pack with you.

Therapeutic Class

Iron preparation (haematinic, used to treat anaemia).

Storage

Store below 30°C in a dry place, away from light. Keep out of the reach and sight of children, ideally in a locked cupboard.