BNF for Children 2011-2012

444 9.1.1 Iron-deficiency anaemias BNFC 2011–20129 Nutrition and bloodFersamal c (Goldshield)Tablets, brown, ferrous fumarate 210 mg (68 mg iron),net price 100 = £1.44DoseChild 12–18 years prophylactic, 1 tablet 1–2 times daily;therapeutic, 1 tablet 2–3 times dailySyrup, brown, ferrous fumarate approx. 140 mg(45 mg iron)/5 mL. Net price 200 mL = £3.11DosePreterm neonate see notes aboveNeonate see notes aboveChild 1 month–12 years see notes aboveChild 12–18 years prophylactic, 5 mL twice daily;therapeutic, 10 mL twice dailyGalfer c (Thornton & Ross)Capsules, red/green, ferrous fumarate 305 mg(100 mg iron), net price 100 = £2.00DoseChild 12–18 years prophylactic, 1 capsule daily; therapeutic,1 capsule twice dailySyrup, brown, sugar-free ferrous fumarate 140 mg(45 mg iron)/5 mL. Net price 300 mL = £5.33DosePreterm neonate and body-weight up to 3 kg prophylactic,0.5 mL daily, see notes aboveNeonate prophylactic and therapeutic, 0.25 mL/kg twicedaily (total daily dose may alternatively be given in 3divided doses), see notes aboveChild 1 month–12 years prophylactic and therapeutic,0.25 mL/kg twice daily (total daily dose may alternativelybe given in 3 divided doses); max 20 mL daily, see notesaboveChild 12–18 years prophylactic, 10 mL once daily;therapeutic, 10 mL 1–2 times dailyFERROUS GLUCONATECautions interactions: Appendix 1 (iron)Side-effects see notes aboveIndication and doseIron-deficiency anaemia see notes above andpreparationpack = £6.06; D 1 30-mL dropper bottle for paediatricuse = £2.16. Counselling, use of dropperDoseNeonate (from dropper bottle) 1 drop (approx. 500 microgramsiron) per 450 g body-weight 3 times daily, seenotes aboveChild 1 month–2 years (from dropper bottle) 1 drop(approx. 500 micrograms iron) per 450 g body-weight 3times daily, see notes aboveChild 2–6 years therapeutic, 2.5 mL dailyChild 6–12 years therapeutic, 5 mL dailyChild 12–18 years prophylactic, 2.5 mL daily; therapeutic,5 mL 1–2 times daily (5 mL once daily if requiredduring second and third trimester of pregnancy)1. except 30 mL paediatric dropper bottle for prophylaxis andtreatment of iron deficiency in infants born prematurely;endorse prescription ‘SLS’SODIUM FEREDETATE(Sodium ironedetate)Cautions interactions: Appendix 1 (iron)Side-effects see notes aboveLicensed use not licensed for prophylaxis of irondeficiencyIndication and doseIron-deficiency anaemia, prophylaxis of irondeficiency see notes above and preparationSytron c (Archimedes)Elixir, sugar-free, sodium feredetate 190 mg equivalentto 27.5 mg of iron/5 mL. Net price 100 mL =£1.07DoseNeonate prophylactic, 1 mL daily, see notes above; therapeutic,up to 2.5 mL twice daily (smaller doses should beused initially), see notes aboveChild 1 month–1 year prophylactic, 1 mL daily, seenotes above; therapeutic, up to 2.5 mL twice daily(smaller doses should be used initially), see notes aboveChild 1–5 years therapeutic, 2.5 mL 3 times dailyChild 5–12 years therapeutic, 5 mL 3 times dailyChild 12–18 years therapeutic, 5 mL increasing graduallyto 10 mL 3 times dailyFerrous Gluconate (Non-proprietary)Tablets, red, coated, ferrous gluconate 300 mg (35 mgiron), net price 28 = £2.95DoseChild 6–12 years prophylactic and therapeutic, 1–3tablets dailyChild 12–18 years prophylactic, 2 tablets daily; therapeutic,4–6 tablets daily in divided dosesPOLYSACCHARIDE-IRON COMPLEXCautions interactions: Appendix 1 (iron)Side-effects see notes aboveIndication and doseIron-deficiency anaemia, prophylaxis of irondeficiency see notes above and preparationNiferex c (Tillomed)Elixir, brown, sugar-free, polysaccharide-iron complexequivalent to 100 mg of iron/5 mL. Net price 240-mL9.1.1.2 Parenteral ironIron can be administered parenterally as iron dextran,iron sucrose, or ferric carboxymaltose. Parenteral ironis generally reserved for use when oral therapy isunsuccessful because the child cannot tolerate oraliron, or does not take it reliably, or if there is continuingblood loss, or in malabsorption.Many children with chronic renal failure who are receivinghaemodialysis (and some who are receiving peritonealdialysis) also require iron by the intravenous routeon a regular basis (see also Erythropoietins, section9.1.3).With the exception of children with severe renal failurereceiving haemodialysis, parenteral iron does not producea faster haemoglobin response than oral ironprovided that the oral iron preparation is taken reliablyand is absorbed adequately.