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Iron overdose

Iron is a mineral found in many over-the-counter supplements. Iron overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.

Iron overdose is especially dangerous to children. Children younger than 6 years may eat too many multivitamins. If the child eats too many pediatric multivitamins, the toxic effect is usually minimal. Severe overdose can happen if a child eats adult multivitamins, such as prenatal vitamins.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Alternative Names

Ferrous sulfate overdose; Ferrous gluconate overdose; Ferrous fumarate overdose

Poisonous Ingredient

Iron

Where Found

Iron is an ingredient in many mineral and vitamin supplements. Iron supplements are also sold by themselves. Types include:

  • Ferrous sulfate (Feosol, Slow Fe)
  • Ferrous gluconate (Fergon)
  • Ferrous fumarate (Femiron, Feostat)

Note: This list may not be all-inclusive.

Symptoms

Airways and lungs:

Gastrointestinal system:

Heart and blood:

Nervous system:

  • Chills
  • Coma (decreased level of consciousness and lack of responsiveness, may occur within 1/2 hour to 1 hour after overdose)
  • Convulsions
  • Dizziness
  • Drowsiness
  • Fever
  • Headache
  • Lack of desire to do anything

Skin:

Note: Symptoms may go away in a few hours, then return again after 1 day or later.

Before Calling Emergency

Determine the following information:

  • Patient's age, weight, and condition
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed
  • If the medication was prescribed for the patient

Poison Control

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number

What to Expect at the Emergency Room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate.

The patient may receive:

  • Blood tests, including those to check iron levels
  • Endoscopy -- camera and tube down the throat to see the esophagus and the stomach and remove pills
  • EKG (heart tracing)
  • Fluids through¬†a vein (by IV)
  • Medication to help remove iron from the body (deferoxamine)
  • Tube through mouth into the stomach to empty the stomach (gastric lavage )
  • X-ray to make sure all iron tablets are gone from the stomach

Outlook (Prognosis)

There is a good chance of recovery if you have no symptoms 48 hours after swallowing the iron. However, some people have died up to a week after an iron overdose. The more quickly you receive treatment, the better the chance for survival.

Iron overdose can be extremely severe in children. Children may sometimes eat large amounts of iron pills because they look like candy. Many manufacturers have changed their pills so they no longer look like candy.

References

Liebelt EL. Iron. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 72.

Velez LI, O'Connell EJ. Heavy metals. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 157.

Updated: 1/19/2014

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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