The most commonly used iron preparations are ferrous sulfate, ferrous gluconate, and ferrous fumorate. Some other preparations are ferrous succinate, controlled release iron preparations, polysaccharide-iron complex and carbonyl iron.

It should be noted that: 1) The absorption of ferrous form of iron is better than ferric form. 2) Iron absorption is better, but its side effects are more when iron is taken on an empty stomach than when it’s taken with meal. 3) Absorption of iron is best in proximal jejunum. 4) Different iron preparations have different content of elemental iron.

The elemental iron content of one tablet of different preparations is as follows: ferrous sulfate (325 mg tablet): 65 mg, ferrous fumarate (300 mg tablet ): 99 mg, ferrous gluconate (325 mg tablet): 35 mg, slow FE (control-release 160 mg tablet): 50 mg.

In a randomized, double blind, placebo controlled study in 1,496 subjects there was no significant difference in gastrointestinal (GI) symptoms when equal dosage of ferrous sulfate, gluconate or fumarate were taken on an empty stomach. Side effects were reported in 23% of those taking ferrous sulfate and 14% of those taking placebo! Control-release preparations have a little less side effects but their absorption rate is lower than those of regular generic iron salt tablets (J Fam Pract 2002;51:576-8).

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