Ferrous sulfate

Pronunciation: FER-us SUL-fate.

Generic name
ferrous sulfate
Drug class
Iron salt (oral iron supplement / haematinic)
Form
Tablet (200 mg, 325 mg, or prolonged-release 325 mg) or oral liquid/solution
Route
Oral
Legal status
Available over-the-counter in most markets; also supplied on prescription at higher strengths

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: FERRO-GRAD; FERRO-GRAD C; FERRO-GRAD F; FERRO-LIQUID (5) · Full directory

What ferrous sulfate is and how it works

Ferrous sulfate is an iron supplement used to treat and prevent iron-deficiency anaemia (low iron levels in the blood). It replaces iron the body needs to make healthy red blood cells. (1) (2)

Take ferrous sulfate exactly as directed on the pack or by your prescriber. This medicine contains iron, and accidental overdose in young children is a leading cause of fatal poisoning -- always store it out of the sight and reach of children, and seek emergency help immediately if a child may have swallowed any.

Mechanism of action: how ferrous sulfate works

Ferrous sulfate supplies ferrous (Fe2+) iron, which is absorbed in the duodenum and upper jejunum and incorporated into haemoglobin, myoglobin, and other iron-dependent enzymes, correcting the iron deficit that underlies iron-deficiency anaemia. (2)

What ferrous sulfate is used for

Iron-deficiency anaemia

Used to treat iron-deficiency anaemia and to prevent it in people at higher risk of low iron levels, such as during pregnancy. (1) (2)

Before taking ferrous sulfate

Do not take / not appropriate for

  • Do not take ferrous sulfate if you have haemochromatosis, haemosiderosis, or another condition involving iron overload. (all countries) (2)
  • Do not take ferrous sulfate if you have haemolytic anaemia (a condition where red blood cells are destroyed faster than normal) or paroxysmal nocturnal haemoglobinuria. (all countries) (2)
  • Do not take ferrous sulfate if you have an active peptic (stomach) ulcer, or have had repeated blood transfusions, unless your prescriber has advised otherwise. (United Kingdom) (2)

Tell your clinician about

  • Whether you have any condition that affects how your body handles iron, or a history of iron overload.
  • All other medicines you take, especially antibiotics (tetracyclines or fluoroquinolones/quinolones) and levothyroxine (thyroid medicine), since timing needs to be spaced apart.
  • Pregnancy, plans for pregnancy, or breastfeeding.
  • Any children in the household, so you can plan safe storage.
(1) (2)

How to take ferrous sulfate

  • Swallow tablets whole with water -- do not chew, crush, or suck them, as this can irritate or ulcerate the mouth.
  • Take with food if it upsets your stomach, though taking on an empty stomach can improve absorption if tolerated.
  • Space this medicine at least 2 hours apart from tetracycline or fluoroquinolone antibiotics, levothyroxine, and antacids or calcium/magnesium supplements, since iron can reduce their absorption (or theirs can reduce iron's).
  • Always store ferrous sulfate out of the sight and reach of children, in a container with a child-resistant closure where available -- accidental overdose in young children is a leading cause of fatal poisoning.
(1) (2)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

If you miss a dose, take it as soon as you remember unless it is nearly time for your next dose -- do not double up. If you are giving this to a child and miss a dose, check with your pharmacist or prescriber.

Overdose

Iron overdose can be fatal, especially in young children. If you suspect any child has swallowed this medicine, or if an adult has taken more than directed, call a doctor or your local Poison Control Center right away, or seek emergency medical help immediately -- do not wait for symptoms to appear. (1) (2)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Constipation.

What to notice: Constipation.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Dark or black-coloured stools (this is expected and not usually a cause for concern).

What to notice: Dark or black-coloured stools (this is expected and not usually a cause for concern).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Nausea and abdominal pain.

What to notice: Nausea and abdominal pain.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Diarrhoea.

What to notice: Diarrhoea.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Serious warnings

Suspected iron overdose, especially in a young child — emergency

Symptoms: In children: vomiting, diarrhoea (sometimes bloody), stomach pain, or lethargy in the hours after ingestion, which can progress to more severe effects. In adults: significant nausea, vomiting, abdominal pain, or dizziness after taking much more than directed.

Action: Seek emergency medical help immediately, or call your local Poison Control Center, for any suspected iron overdose in a child, even if the child seems well at first -- iron poisoning can be fatal and symptoms can be delayed. Always keep this medicine out of the sight and reach of children. (1) (2)

Signs of a serious allergic reaction — emergency

Symptoms: Swelling of the face, lips, tongue, or throat; difficulty breathing; widespread rash or hives.

Action: Seek emergency medical help immediately. (2)

Interactions

  • Tetracycline antibiotics: take iron and tetracyclines at least 2-3 hours apart, since each can reduce the absorption of the other. (2)
  • Fluoroquinolone (quinolone) antibiotics: take iron and these antibiotics at least 2 hours apart, as iron can reduce their absorption. (2)
  • Levothyroxine (thyroid medicine): take iron and levothyroxine at least 2 hours apart, as iron can reduce levothyroxine absorption. (2)
  • Antacids, and calcium or magnesium supplements: take at least 2 hours apart from iron, as they can reduce iron absorption. (2)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Iron supplementation is commonly recommended during pregnancy when a deficiency is confirmed or a higher iron requirement is expected, particularly beyond the first trimester. Discuss the right product and dose with your prescriber. (1) (2) (3) (4) (5) (6)

Breastfeeding

Iron supplements are generally considered compatible with breastfeeding when needed for iron deficiency -- discuss with your prescriber. (1) (2) (3) (4) (5) (6)

Children

Iron supplements are used in children with confirmed iron deficiency, but the dose must be individually calculated by a doctor or pharmacist based on the child's weight -- never estimate a child's dose from an adult product. (1) (2) (3) (4) (5) (6)

Elderly

No specific age-based dose adjustment is described in the sources reviewed, though absorption and tolerance can vary -- follow your prescriber's guidance. (1) (2) (3) (4) (5) (6)

Hepatic Impairment

Not specifically addressed in the sources reviewed for this dossier. (1) (2) (3) (4) (5) (6)

Renal Impairment

Not specifically addressed in the sources reviewed for this dossier. (1) (2) (3) (4) (5) (6)

Monitoring

Before starting

  • Confirmation of iron-deficiency anaemia (blood tests) rather than assuming iron is needed.
  • Review for contraindications such as haemochromatosis or haemolytic anaemia.

During treatment

  • Periodic blood tests to check haemoglobin and iron levels and confirm the treatment is working.
  • Watching for gastrointestinal side effects such as constipation.
  • Safe storage checks, especially in households with young children.
(2)

Storage

Store at room temperature in a cool, dry place, tightly closed, in the original container with a child-resistant closure where available. Keep out of the sight and reach of children at all times -- accidental overdose of iron products is a leading cause of fatal poisoning in young children.

Professional information

Clinician-facing context only, sourced from the current US FDA OTC drug facts label and UK SmPC; verify against the current full label before prescribing or recommending.

United States

Indication: Iron-deficiency anaemia (treatment and prevention)

Dose summary: Adults and children 12 years and over: 1 tablet (325 mg ferrous sulfate, 65 mg elemental iron) daily, preferably with a meal, or as directed. Children under 12: consult a doctor.

Renal context: Not addressed in the source reviewed for this dossier. (1)

United Kingdom

Indication: Iron-deficiency anaemia (treatment and prevention)

Dose summary: Prophylaxis: one 200 mg tablet daily. Treatment: one 200 mg tablet two to three times daily. Tablets swallowed whole, not chewed.

Renal context: Not addressed in the source reviewed for this dossier. (2)

Mechanism of action

Hepatic guidance

Not specifically addressed in the sources reviewed for this dossier.

Overdose note

Iron overdose can cause severe gastrointestinal corrosive injury, followed by a period of apparent improvement, then systemic toxicity including metabolic acidosis, coagulopathy, hepatic necrosis, cardiovascular collapse, and (in severe cases) death; management includes urgent supportive care and chelation therapy (e.g. deferoxamine) as directed by a poison control centre or toxicologist. (2)

Frequently asked questions

Is ferrous sulfate available in the US, UK, Europe, Canada, Australia, and New Zealand?

It is currently authorised and available in the United States, United Kingdom, European Union (for example as Fero Gradumet in the Netherlands), Canada (for example as Fer-In-Sol), and Australia (for example as Ferro-Grad). In New Zealand, the branded product Ferrograd is undergoing a supply and funding discontinuation, with ferrous fumarate recommended as the alternative iron supplement. (1) (3) (2) (4) (5) (6)

What should I do if my child swallows some of my iron tablets?

Seek emergency medical help immediately or call your local Poison Control Center, even if your child seems fine at first. Accidental overdose of iron-containing products is a leading cause of fatal poisoning in young children, and symptoms can be delayed. Always store iron tablets out of the sight and reach of children. (1) (2)

Can I take ferrous sulfate with an antibiotic?

Oral iron products can interfere with the absorption of certain antibiotics, so ferrous sulfate should not be taken within about two hours of these medicines. Ask your pharmacist about spacing your specific antibiotic away from your iron tablet. (1)

What is the mechanism of action of ferrous sulfate?

Ferrous sulfate supplies ferrous (Fe2+) iron, which is absorbed in the duodenum and upper jejunum and incorporated into haemoglobin, myoglobin, and other iron-dependent enzymes, correcting the iron deficit that underlies iron-deficiency anaemia. (2)

What is the generic name of Ferrous sulfate?

The generic name is ferrous sulfate. (1) (2)

What class of drug is ferrous sulfate?

Ferrous sulfate is classed as: Iron salt (oral iron supplement / haematinic). (1) (2)

References

  1. Ferrous Sulfate 325 mg tablets, film coated -- Drug Facts labelU.S. Food and Drug Administration / DailyMed (NIH), OTC drug facts label · United States · accessed 2026-07-29 · source 1
  2. Ferrous Sulfate Tablets 200 mg -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-29 · source 2
  3. Fero Gradumet, controlled-release tablets 105 mg Fe (ferrous sulfate) -- Netherlands marketing authorisation (RVG 05752)College ter Beoordeling van Geneesmiddelen (Netherlands Medicines Evaluation Board) -- national marketing authorisation within the EU regulatory framework · European Union · accessed 2026-07-29 · source 3
  4. Fer-In-Sol (ferrous sulfate) oral liquid -- Health Canada DIN 00762954Health Canada Drug Product Database (DIN registration) · Canada · accessed 2026-07-29 · source 4
  5. FERRO-GRAD (ferrous sulfate) tablets and FERRO-LIQUID oral solution -- ARTG registrationsTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-29 · source 5
  6. Discontinuation of ferrous sulfate tablets (Ferrograd) in New ZealandPharmac | Te Pataka Whaioranga (New Zealand government medicines funding agency) · New Zealand · accessed 2026-07-29 · source 6

Brand names by country

Single-ingredient ferrous sulfate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Ferrum sulphuricum500 [hp_C], 30 [hp_C]/30[hp_C], 30 [hp_C], 6 [hp_C], 200 [hp_C], 1 [hp_Q], 12 [hp_C], 1 [hp_M] · hahnemann laboratories, inc.
  • Schuessler Tissue Salts Ferr Phos First Aid 46 [hp_X]/30mL, 6 [hp_X] · martin & pleasance pty ltd
  • Ferrum Carbonicum6 [hp_X]/23g · true botanica, llc
  • Ferrum iodatum30 [hp_C]/30[hp_C] · boiron

United Kingdom

  • Ferrous Sulfate Tablets; Ferrograd (2)MHRA licensed emc smpc confirmed · 200 mg, 325 mg (Ferrograd, prolonged release) · multiple manufacturers including Wockhardt UK, Sandoz, TEOFARMA

Canada

  • Fer-In-Sol; Slow Fe; Palafer (4)Health Canada DIN registered confirmed · 75 mg/mL (15 mg elemental iron/mL, Fer-In-Sol oral liquid) · multiple manufacturers

Australia

  • FERRO-GRAD; FERRO-GRAD C; FERRO-GRAD F; FERRO-LIQUID (5)TGA ARTG registered confirmed · 325 mg tablet, 30 mg/mL oral liquid (heptahydrate) · Arrotex Pharmaceuticals Pty Ltd

New Zealand

  • Ferrograd (ferrous sulfate) -- undergoing supply/funding discontinuation; no new patients since 1 September 2025, full delisting from the Pharmaceutical Schedule from 1 March 2026; ferrous fumarate (Ferro-tab) is the recommended alternative (6)supply and funding discontinuation confirmed via pharmac not confirmed as medsafe deregistration · 325 mg (105 mg elemental iron), historical · not fully specified in the source reviewed
View brands in additional countries.

European Union

Fero Gradumet; Tardyferon; Tardyneo; Tardysol (3)

This page provides general reference information about ferrous sulfate and is not a substitute for advice from the prescriber or pharmacist managing your treatment. All dosing decisions, especially for children, should be made with your prescriber or pharmacist.

Related medicines

Related conditions