FERROUS SULFATE

Absorption

Approximately 5 – 10% of dietary iron is absorbed, and this absorption rate increases to up to 30% in iron deficiency states. Oral iron supplements are absorbed up to 60% via active and passive transport processes. Gastrointestinal absorption of iron occurs via strict regulation by the enterocyte and duodenal cytochrome and ferric reductase enzymes. The hormone hepcidin heavily regulates iron absorption and distribution throughout the body.
The median time to maximum serum concentration (Tmax) is generally 4 hours after administration. Between 2-8 hours post administration, average serum iron concentrations fluctuate by 20%, according to one study. Bioavailability of iron depends on whether it is administered in a film coated tablet or enteric coated tablet. One pharmacokinetic study in healthy volunteers revealed a 30% bioavailability for enteric coated tablets. The AUC of enteric coated tablets varied between a lower limit of -46.93 to 5.25 μmolxh/l. Cmax is higher for film coated tablets, ranging from 3.4 to 22.1 μmol/h/l.
It is advisable to take ferrous sulfate with ascorbic acid, as this practice may increase absorption. Avoid antacids, tea, coffee,tea, dairy products, eggs, and whole-grain bread for at least an hour after taking ferrous sulfate. Calcium can decrease iron absorption by 33% if taken concomitantly.

Toxicity

The toxicity of ferrous sulfate in humans depends on the amount of iron ingested. Up to 20 mg/kg of elemental iron is not toxic, 20-60 mg/kg has mild toxicity, and more than 60 mg/kg can lead to severe symptoms and morbidity.
Overdose information
Iron containing products are the primary cause of drug overdose in children under 6 years of age. Iron is toxic to the gastrointestinal system, cardiovascular system, in addition to central nervous system. The most early reported effects following the excess ingestion of iron include nausea, flatulence, abdominal pain, diarrhea, constipation, and black/tarry stools. Symptoms of overdose in the later stages include bluish lips, fingernails, and palms, drowsiness, tachycardia, seizures, metabolic acidosis, hepatic injury, and cardiovascular dysfunction. Sequelae of iron sulfate overdose include intestinal obstruction, pyloric stenosis, and gastric scarring. If the patient is comatose or seizing, gastric lavage with sodium bicarbonate should be performed. Deferoxamine is the antidote for iron poisoning. Other supportive treatments to support fluid and electrolyte balance and correct metabolic acidosis are also advised. Hospitalization should continue for 24 h after the patient becomes asymptomatic to monitor for delayed onset of shock/gastrointestinal bleeding.

Description

Green vitriol, FeSO4.7H20, has been known since the thirteenth century ; it crystallizes from solutions of iron or iron bases in dilute sulphuric acid. The heptahydrate forms green monoclinic crystals of density 1·88, very soluble in water (296 g litre^-1 FeS04 at 25°C). By precipitating the aqueous solution with ethanol, heating the heptahydrate to 140° in vacuo or by crystallizing it from 50 % sulphuric acid, the white monohydrate is obtained. This can be further dehydrated to the white, amorphous FeSO4 by heating to 300° in a current of hydrogen. At red heat the sulphate decomposes : 2FeS04 -> Fe203+S02+S03 A tetrahydrate, FeS04.4H20, crystallizes from aqueous solutions above 56°.

The Uses of FERROUS SULFATE

Ferrous Sulfate is a nutrient and dietary supplement that is a source of iron. it is a white to grayish odorless powder. ferrous sulfate hep- tahydrate contains approximately 20% iron, while ferrous sulfate dried contains approximately 32% iron. it dissolves slowly in water and has high bioavailability. it can cause discoloration and rancidity. it is used for fortification of baking mixes. in the encapsulated form it does not react with lipids in cereal flours. it is used in infant foods, cereals, and pasta products.

Background

Iron deficiency anemia is a large public health concern worldwide, especially in young children, infants, and women of childbearing age. This type of anemia occurs when iron intake, iron stores, and iron loss do not adequately support the formation of erythrocytes, also known as red blood cells.
Ferrous sulfate is a synthetic agent used in the treatment of iron deficiency. It is the gold standard of oral iron therapy in the UK and many other countries.

Indications

Ferrous sulfate is used for the prevention and treatment of iron deficiency anemia in adults and children.

Pharmacokinetics

Ferrous sulfate replenishes iron, an essential component in hemoglobin, myoglobin, and various enzymes. It replaces the iron that is usually found in hemoglobin and myoglobin. Iron participates in oxygen transport and storage, electron transport and energy metabolism, antioxidant and beneficial pro-oxidant functions, oxygen sensing, tissue proliferation and growth, as well as DNA replication and repair.

Metabolism

The metabolism of iron is complex. Normally, iron exists in the ferrous (Fe2+) or ferric (Fe3+) state, but since Fe2+ is oxidized to Fe3+, which hydrolyzes to insoluble iron(III)hydroxides in neutral aqueous solutions, iron binds to plasma proteins and is either transported or stored throughout the body.
There are three proteins that serve to regulate the storage and transport of ingested iron. The first protein , transferrin, transports iron in both the plasma and extracellular fluid. Ceruloplasmin in the plasma and hephaestin on the enterocyte participate in the oxidation and binding of iron to transferrin. The main role of transferrin is the chelation of iron to prevent the production of reactive oxygen species, while facilitating its transport into cells. The transferrin receptor, located on many cells that require iron, binds the transferrin complex and internalizes this complex. Ferritin is a protein that stores iron, making it readily available for body requirements.