Ferrous Sulfate (DB13257): A Comprehensive Pharmacological and Clinical Monograph

1.0 Executive Summary

Ferrous sulfate is a small molecule inorganic salt that has served as the cornerstone of oral iron repletion therapy for decades. Identified by DrugBank ID DB13257 and CAS Number 7720-78-7, it is widely regarded as the "gold standard" for the treatment and prevention of iron deficiency anemia (IDA), a condition with significant global public health impact.[1] The therapeutic action of ferrous sulfate is rooted in its ability to supply the body with ferrous iron (

Fe2+), an essential mineral component for the synthesis of hemoglobin in red blood cells and myoglobin in muscle tissue, thereby facilitating systemic oxygen transport.[4]

The pharmacokinetics of ferrous sulfate are characterized by a tightly regulated absorption process in the proximal small intestine, which is significantly enhanced in iron-deficient states but can be inhibited by food and certain medications.[4] This creates a fundamental clinical challenge: the conditions that maximize bioavailability—administration on an empty stomach—are precisely those that precipitate the most common adverse effects.[8] The predominant adverse events are gastrointestinal in nature, including nausea, abdominal pain, and constipation, which are a primary driver of patient non-adherence and subsequent treatment failure.[3]