Oral ferrous iron
Ferrous fumarate
Brand names: Galfer, Fersaday, Fersamal
Adult dose
Dose: 210mg TDS (≈68mg elemental TDS); prophylaxis 210mg OD
Route: PO
Frequency: OD-TDS
Clinical pearls
- Iron deficiency anaemia — alternate-day dosing (e.g. 200mg every other day) gives equal Hb response with fewer side effects (current evidence)
Contraindications
- Iron overload
- Haemochromatosis
Side effects
- GI upset
- Black stools
- Constipation
- Tooth staining (liquid)
Interactions
- Tetracyclines, quinolones, levothyroxine, bisphosphonates, methyldopa (chelation; separate by ≥2h)
- Antacids reduce absorption
- Vitamin C improves absorption
Monitoring
- Hb
- Ferritin
- TSAT
Reference: BNF; NICE CKS; Stoffel et al 2019 (alternate-day dosing); https://bnf.nice.org.uk/drugs/ferrous-fumarate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- DOAC Score for Selecting Direct Oral Anticoagulant in Non-Valvular AF · Anticoagulation
- Corrected Reticulocyte Count / Reticulocyte Production Index · Anaemia
- Ganzoni Equation for Iron Deficiency · Anaemia
- Transferrin Saturation Calculator · Anaemia / Iron Studies
- Iron Deficiency Anaemia Calculator · Anaemia Assessment
- Ferritin Iron Store Interpretation · Haematological Values
Pathways
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO