Iron supplement side effects

[Girlsmumma2618]

My 4 year old daughter was prescribed sodium feredetate due to low iron levels. She’s had really bad diarrhoea. Has anyone else’s little ones experienced this?

As an adult - yes. It can be very irritating to the stomach, it gave me those symptoms too. The BNF page says in adults you can reduce the dose to every other day if the side effects are too bad.

I found taking it right before bed helped, but you have to avoid milk for an hour or so either side (just in case you little one likes a glass at bed time).

Children's BNF says you can give every other day https://bnfc.nice.org.uk/drugs/sodium-feredetate/

Thank you so much for your reply. I really
appreciate it. Silly question, why avoid milk?

Thanks for sending me this. I find it interesting that it says up to 4 year old the dose is less than what they have prescribed. She’s taking 7.5ml x3 a day!

The milk thing is partly because calcium and iron compete to be absorbed in the gut, and so if you take them together, you get a lot less iron absorbed. Whereas orange juice does the opposite - vitamin C improves iron uptake.

On the high dose from the GP thing... Guidelines for adults have recently changed after a big clinical trial showed (essentially) that less is more when it comes to iron supplements for anaemia - you can get the same improvement in haemoglobin and iron stores by giving a lower dose once per day or even every other day, compared to several doses per day. GPs have a lot to keep track of and often haven't noticed the change in recommended iron dose - I looked it all up for myself while I was pregnant because I was sick of the stomach ache from the iron tablets!

If your daughter is struggling with the side effects, I would consider dropping a note to your GP with a link to that BNF for children page, or I would go and chat to a pharmacist and show them that link. Maybe the GP thinks your daughter needs to up her iron very quickly and that's while they put her on a high dose - but I would guess that actually, the GP just doesn't know the most up to date dosing guidelines for her age. Highly likely it's fine to reduce the dose AND go to every other day and that will make the side effects so much better. But I'm not a medical professional. Pharmacist probably the quickest place for advice.