Microfer (Dried Ferrous Sulfate)

Microfer, an oral iron supplement, is indicated for conditions related to iron deficiency.

• Iron deficiency anemia: restores hemoglobin levels and improves symptoms of fatigue and weakness.
• Prevention of iron deficiency: maintains adequate iron stores in individuals at risk, such as during pregnancy or rapid growth.
• Iron deficiency due to chronic blood loss: supports replenishment of iron lost from gastrointestinal bleeding or menstruation.

• Ferrous sulfate dissociates in the gastrointestinal tract, releasing ferrous (Fe2+) ions that are absorbed primarily in the duodenum and upper jejunum via divalent metal transporter‑1 (DMT‑1). The absorbed iron binds to transferrin in the bloodstream and is delivered to the bone marrow for incorporation into heme, facilitating hemoglobin synthesis and restoring depleted iron reserves.

Oral ferrous sulfate may cause a range of adverse reactions, most of which are related to gastrointestinal irritation.

Common Side Effects

• Nausea: mild to moderate feeling of sickness.
• Abdominal discomfort: cramping or pain in the stomach area.
• Constipation: hard stools and difficulty passing them.
• Diarrhea: loose, watery stools.
• Darkened stools: black or tarry coloration without health concern.

Serious or Rare Side Effects

• Severe allergic reaction: rash, itching, swelling, or difficulty breathing.
• Iron overload: signs include joint pain, fatigue, and organ dysfunction.
• Persistent vomiting: may lead to dehydration.
• Hemochromatosis exacerbation: worsening of iron accumulation disorders.

When using Microfer, certain precautions should be observed to ensure safety and effectiveness.

• Assess iron status: confirm deficiency before initiating therapy.
• Monitor hemoglobin: periodic blood tests to evaluate response.
• Avoid excess: do not exceed recommended dose to prevent toxicity.
• Caution in gastrointestinal disorders: patients with ulcer disease may experience irritation.
• Use with food if needed: taking with meals can reduce stomach upset.
• Store at ambient temperature: keep below 25 °C in the original container, protected from moisture and light.

Ferrous sulfate can interact with several medicines and nutrients, affecting absorption or increasing adverse effects.

Major Interactions (Avoid)

• Tetracycline antibiotics: chelation reduces antibiotic absorption.
• Fluoroquinolones: decreased antibiotic bioavailability.
• Levothyroxine: iron impairs thyroid hormone absorption.

Moderate Interactions (Monitor Closely)

• Proton pump inhibitors: reduced gastric acidity may lower iron absorption.
• Calcium supplements or antacids: compete for absorption sites.
• Vitamin C: can increase iron absorption, potentially leading to excess if high doses.