Obstetrics and Gynaecology  |  Menorrhagia Pathway - Treatment of Iron Deficiency

Obstetrics and Gynaecology

Menorrhagia Pathway - Treatment of Iron Deficiency

Subsidised Oral Iron preparations



Ferrous fumarate Tab 200 mg (65 mg elemental) Ferro-tab

TREATMENT - one tablet three times daily

PROPHYLAXIS - one tablet once or twice daily

Ferrous fumarate with folic acid Tab 310 mg (100 mg elemental) with folic acid 350 mcg Ferro-F tab

One tablet once daily.

Ferrous sulphate Tab long-acting 325 mg (105 mg elemental)   Ferrograd

One tablet once daily

Ferrous Sulphate Oral liq 30 mg per 1 ml (6 mg elemental per 1 ml) Ferodan

Adults: 15-30ml daily in 3 divided doses

The oral dose of elemental iron for iron deficiency should be 100 to 200 mg daily.

Although iron preparations are best absorbed on an empty stomach they can be taken after food to reduce gastro-intestinal adverse effects; they may discolour stools. The incidence of adverse effects due to ferrous sulfate is no greater than with other iron salts when compared on the basis of equivalent amounts of elemental iron.

Parenteral iron does not produce a faster haemoglobin response than oral iron provided that the oral iron preparation is taken reliably and is absorbed adequately (with the exception of patients with severe renal failure receiving haemodialysis).

Partially-Subsidised/Non-subsidised Oral Iron preparations



Ferrous sulphate with folic acid Tab long-acting 325 mg (105 mg elemental) with folic acid 350 mcg Ferrograd F ($ Part charge - approx $9.50/month + Rx fee)

One tablet once daily


Ferrous sulphate with ascorbic acid. Tab long-acting 325 mg (105 mg elemental) with sodium ascorbate 562.4 mg  Ferrograd C NOT SUBSIDISED at all

One tablet once daily


Subsidised Parenteral Iron Preparations

Parenteral iron is generally reserved for use when oral therapy is unsuccessful because the patient cannot tolerate oral iron, or does not take it reliably, or if there is continuing blood loss, or in malabsorption. 

Hypersensitivity can occur with parenteral iron and facilities for cardiopulmonary resuscitation should ideally be available-risk of allergic reactions increased in immune or inflammatory conditions.

Oral iron should not be given until 7 days after last injection.

Parenteral Dose

Calculation of Required Parenteral Iron Dose (GANZONI (Schweiz. Med. Wschr. 100, 301-303, 1970):

 Iron dose (mg) = Body weight (kg) x (Target Hb - Actual Hb in g/L) x 0.24 + Iron depot.

 Over 34 kg body weight: target Hb = 150 g/L, iron depot = 500 mg.



Iron polymaltose Inj 50 mg per ml, 2 ml Ferrum H 


Injection (only method listed in NZ FerrumH datasheet)

The technique of injection is of crucial importance. Avoid arm or other exposed areas. The wrong injection technique may result in pain and persistent discolouration of the skin.

Administer 2 mL by intramuscular injection every second day until the total dose is attained or administer 4 mL at longer intervals

Medsafe datasheet on Ferrum H


When the haemoglobin is in the reference range, treatment should be continued for a further 3 months to replenish the iron stores.

Last updated : Friday, August 21, 2015
Next review date : Saturday, August 20,2016

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