Ferrous sulfate in the treatment of iron deficiency anemia: The positions continue

Dvoretsky L.I.

doi:https://doi.org/10.17116/terarkh20178910108-112

Close metadata

Recommended articles:

Arterial hypertension is an oxidative stress, as a pathogenetic target for the treatment of chronic cerebrovascular insufficiency. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(1):84-90

Psoriasis: analysis of comorbid pathology. Russian Journal of Clinical Dermatology and Venereology. 2025;(1):16-21

Sleep deprivation and the development of oxidative stress in animal models. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(3):124-129

Iron supplements and erythropoiesis-stimulating agents in intensive care of postpartum hemorrhage: a Bayesian network meta-analysis. Russian Journal of Anesthesiology and Reanimatology. 2025;(2):59-67

The main mechanisms of development of cognitive impairment. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(4-2):13-18

Therapeutic potential of quercetin and its derivatives against COVID-19. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(5):44-50

Relationship between oxidative stress patterns and proinflammatory cytokines in patients with polypous rhinosinusitis under the course of therapeutic physical factors. Regenerative Biotechnologies, Preventive, Digital and Predictive Medicine. 2025;(2):42-49

Associations of genetic polymorphisms in key inflammatory response genes with the risk of chronic apical periodontitis development. Russian Journal of Stomatology. 2025;(2):52-56

Erythrocyte indices — markers for the diagnosis of blood iron deficiency in donors. Russian Journal of Preventive Medicine. 2025;(6):88-91

Effect of uric acid on the progression of Parkinson’s disease: Myth or reality?. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(7):7-14

Abstract:

The paper discusses treatment strategy and tactics for iron deficiency anemia. It gives data on the comparative efficacy of different iron sulfate drugs, their bioavailability, effects on peroxidation processes, and side effects. The paper also considers the clinical significance of a dosage form of iron-containing drugs with a sustained iron release, as well as ways to reduce the frequency and magnitude of side effects when ferrous sulfate is used.

Keywords:

iron deficiency anemia

iron preparations

iron sulfate

oxidative stress

Authors:

Dvoretsky L.I.

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia

Close metadata

References:

WHO. Iron deficiency anemia; assesment, prevention and control. A guide for programme managers. Geneva: World Health Organization, 2001:1-114
Rumyantsev AG, Maschan AA. Federal’nye klinicheskie rekomendatsii po diagnostike i lecheniyu zhelezodefitsitnoi anemii. M., 2014 (In Russ.)
Auerbach M, Adamson J. How we diagnose and treat iron deficiency anemia. Am J Hematol. 2016;91(1):31-38. https://doi.org/10.1002/ajh.24201
Dvoretsky L, Zaspa E. Algoritms of diagnostic and treatment of iron deficiency anemia. Pharmateca. 2006;5(120):117-120 (In Russ.)
Dvoretsky L, Kolendo S. Sorbifer-Durules in treatment of iron deficiency anemia. International medical journal. 1999;3-4. (In Russ.)
Gorodetski V, Goduljan O, Vertkin A. Comparative efficacy of iron-containing preparations in patients with iron-defficiency anemia. Russkii meditsinskii zhurnal 2004;5:309-315. (In Russ.)
Стуклов Н.И. Железодефицитная анемия в практике гинеколога. Алгоритмы диагностики, профилактики и лечения. Акушерство и гинекология. 2016;7:99-104. https://doi.org/10.18565/aig
Dvoretsky L, Ivleva O. Key issues in the treatment of iron deficiency anemia Vrach. 2017;2:68-73. (In Russ.)
Okam M, Koch A, Tran M. Iron deficiency anemia treatment response to oral iron therapy: a pooled analysis of five randomized controlled trials. Haematologica. 2015;100:xxx. https://doi.org/10.3324/haematol.2015.129114
Isler M, Delibas N, Guclu M, Gultekin F, Sutcu R, Bahceci M, Kosar A.Superoxide dismutase and glutathione peroxidase in erytrocytes of patient with iron deficieny anemia: effects of different treatment modalities. Croatian medical journal. 2002;43(1):16-19.
Kurtoglu E, Ugor A, Baltaci A, Undar L. Effect of iron supplementation on oxidative stress and antioxidant status in iron deficiency anemia. Biol Trace Elem Res. 2003;96(1-3):117-124. https://doi.org/10.1385/bter
Dvoretsky L, Zaspa E, Litvitsky P, Bolevich S, Menshova N. Free radical processes in patients with iron deficiency anemia on iron medication. Terapevticheskii Arkhiv. 2006;78(1):52-57. (In Russ.)
Aly S, Fayed M, Ahmed S, Abdella A, Tamam A, Mohmmed N. Effects of oral iron (ferrous versus ferric) supplementation on oxidative stress and antioxidant status in pregnant women with iron deficiency: controlled trial. Egypt J Haematol. 2016;41(2):31-41. https://doi.org/10.4103/1110-1067.186392
Tiwari A, Mahdi A, Chandyan S, Zahra F, Godbole M, Jaiswar S, Srivastava V, Negi M. Oral iron supplementation leads to oxidative imbalance in anemic women: a prospective study. Clin Nutr. 2011;30(2):188-193. https://doi.org/10.1016/j.clnu.2010.08.001
Tolkien Z, Stecher L, Mander A, Pereira D, Powell J. Ferrous sulfate supplementation causes significant gastrointestina side-effects in adults: a systematic review and meta-analysis. PLoS One. 2015;10(2): e0117383. https://doi.org/10.1371/journal.pone.0117383
Gromova O, Torshin Yu, Hadzhidis A. Adverse effects of iron sulfate in obstetrics, pediatrics and therapeutics. Zemskij vrach. 2010;2:1-8. (In Russ.)
Cheney K, Gumbiner C, Benson B, Tenenbein M.Survival after a severe iron poisoning treated with intermittent infusions of deferoxamine. J Toxicol Clin Toxicol. 1995;33(1):61-66. https://doi.org/10.3109/15563659509020217
Nazarenko O, Gromova O, Demidov V, Torshin I, Tomilova I, Aleksakhina Y. Comparative evaluation of chronic iron overload in the application of iron preparations in the sub-toxic doses. Pharmateka. 2016;18:40-44. (In Russ.)
Geisser P, Burckhardt S. The Pharmacokinetics and Pharmacodynamics of Iron Preparations. Pharmaceutics. 2011;3(1):12-33. https://doi.org/10.3390/pharmaceutics3010012
Kaye P, Abdulla K, Wood J, James P, Foley S, Ragunath K, Atherton J. Iron-induced mucosal pathology of the upper gastrointestinal tract: a common finding in patients on oral iron therapy. Histopathology. 2008;53(3):311-317. https://doi.org/10.1111/j.1365-2559.2008.03081.x
Marginean E, Bennick M, Cyczk J, Robert M, Jain D. Gastric siderosis: patterns and significance. Am J Surg Pathol. 2006;30(4):514-520. https://doi.org/10.1097/00000478-200604000-00013
Hallberg L, Ryttinger L, Sölvell L.Side-effects of oral iron therapy. A double-blind study of different iron compounds in tablet form. Acta Med Scand Suppl. 1966;180(S459):3-10. https://doi.org/10.1111/j.0954-6820.1966.tb19403.x
Cancelo-Hidalgo M, Castelo-Branco C, Palacios S, Haya-Palazuelos J, Ciria-Recasens M, Manasanch J, Pérez-Edo L.Tolerability of different oral iron supplements: a systematic review. Curr Med Res Opin. 2013;29(4):291-303. https://doi.org/10.1185/03007995.2012.761599
McDiarmid T, Johnson Diane E. Are any oral iron formulations better tolerated than ferrous sulfate? J Fam Pract. 2002;51(6):575-577.
Rybo G, Sölvell L. Side-effect studies on a new sustained release iron preparation. Scandinavian Journal of Haematology. 1971;8(4):257-264. https://doi.org/10.1111/j.1600-0609.1971.tb00873.x
Elwood P, Williams G. Comparative trial of slow-release and conventional iron preparations. Practitioner. 1970;204(224):812-815.
Brock C, Curry H, Hanna C. Adverse effects of iron supplementation: a comparative trial of a wax-matrix iron preparation and conventional ferrous sulfate tablets. Clinical Therapeutics. 1985; 7(5):568-573.
Manasanch J, Castelo-Branco C, Cancelo-Hidalgo M. Tolerability of different oral iron supplements: a systematic review. In: Proceedings of the 16th Wonca European Conference; 2010.
Stuklov N, Semenova Y. Treatment of iron defciency anemia. Which is more important: effciency or tolerance? Is there an optimal decision? Journal of international medicine. 2013;1(2):47-55. (In Russ.)
Low M, Speedy J, Styles C, De-Regil L, Pasricha S.. Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database Syst Rev. 2016; 18;4:CD009747. https://doi.org/10.1002/14651858.CD009747.pub2
Schrier S. So you know how to treat iron deficiency anemia. Blood. 2015;126(17):1971-1971. https://doi.org/10.1182/blood-2015-09-666511
Moretti D, Goede J, Zeder C. et al. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women Blood. 2015;126 (17):1981-1989. https://doi.org/10.1182/blood-2015-05-642223
Rüegg P. When less is really more ETH Zurich 2015; /https://www.ethz.ch/en/news.../iron-supplementation.htm).
Rimon E, Kagansky N, Kagansky M, Mechnick L, Mashiah T, Namir M, Levy S.Are we giving too much iron? Low-dose iron therapy is effective in octogenarians. Am J Med. 2005;118 (10):1142-1147. https://doi.org/10.1016/j.amjmed.2005.01.065
Brise H. Influence of meals on iron absorption in oral iron therapy. Acta Med Scanda Suppl. 1962;171(S376):39-45. https://doi.org/10.1111/j.0954-6820.1962.tb18681.x
Rossiiskii farmatsevticheskii rynok: itogi i prognozy. Remedium. Itogi 2016 goda. 2017:145.
Santiago P. Ferrous versus ferric oral iron formulations for the treatment of iron deficiency: a clinical overview. Scientific World Journal. 2012;2012:846824. https://doi.org/10.1100/2012/846824
Stuklov N, Semenova E. Iron Deficiency Anemia. Modern Diagnostic And Treatment Strategy. Criteria For Therapeutic Efficacy Klinicheskaja medicina 2013;12:61-67. (In Russ.)