Ferralet Vs. Ferrous Sulfate: What Is The Difference?

Ferralet-90 is a prescription-only iron product that contains two different types of iron:

• Ferrous gluconate
• Carbonyl iron

Ferrous sulfate is available over the counter and is the most commonly used form for supplementation.

The main points of differentiation between iron products are:

• Percentage of elemental iron
• Absorption rate
• Tolerability
• Cost

Below, I go into more detail regarding the comparison between Ferralet-90 and ferrous sulfate supplements, but as a general summary:

• Ferralet-90 has both immediate-release and extended-release properties while ferrous sulfate is an immediate release product.

• Per dose, Ferralet-90 will provide more iron than most ferrous sulfate products.

• Studies indicate that both ferrous gluconate and carbonyl iron (both in Ferralet-90) may be better tolerated in terms of side effects than ferrous sulfate.

• Ferrous sulfate products are, in most cases, significantly less expensive than Ferralet-90.

• In addition to iron, Ferralet-90 contains additional ingredients, such as vitamin C and docusate (stool softener)

The side effect you mention experiencing (dizziness) typically is not associated with iron supplementation. Most commonly, adverse GI effects (e.g. nausea, vomiting, cramping) are most prevalent.

Dizziness may indicate you are actually not getting enough iron. You should be sure to contact your doctor and discuss the effects you are experiencing so you can be properly evaluated.

Absorption

Ferrous sulfate and ferrous gluconate are considered 'fast absorbing' iron products, but studies indicate that ferrous gluconate generally has slightly slower absorption. This may lend it to being better tolerated.

Nevertheless, the ferrous gluconate contained in Ferralet-90 is the 'fast absorbing' iron in the product.

Carbonyl iron is slow-absorbing as the gastric acid in our stomach must convert it (elemental iron) to the hydrochloride salt prior to absorption in the stomach. Therefore, the absorption rate of carbonyl iron is relatively slow and limited by gastric acid production.

Cost

Ferrous sulfate and ferrous gluconate are most commonly recommended to treat iron-deficient anemia due to the low cost and well-established effectiveness. The cost typically ranges from $0.05-0.10 per day.

The cost of Ferralet-90 will vary depending on whether or not your insurance covers it (it is available by prescription only). Without insurance, it will cost around $70 for a 30 day supply (~$2.30 per day).

Additional Information

In addition to the two different forms on iron contained in Ferralet-90, it also contains:

• Folic acid
• Vitamin C
• Vitamin B12
• Docusate (stool softener)

Vitamin C is added to some products to enhance iron absorption. Studies indicate that vitamin C can increase absorption of 30 mg of elemental iron by about 10%.

The most common side effects of iron supplementation include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Dark stools
• Changes in taste (liquid preparations)

Iron should be initially be taken on an empty stomach to maximize absorption. However, if you are having difficulty tolerating it, food may reduce gastrointestinal discomfort.

If food isn't helping you better tolerate iron, you can consider:

• Trying a product with less elemental iron or slower absorption.

• Taking smaller, less frequent doses.

Going back to the dizziness you are experiencing, it could be from the iron product you are taking (although the prescribing information for Ferralet-90 doesn't list it as a known side effect), but also may be due to other factors (such as low iron levels not properly being treated)

Your best bet is to discuss your therapy with your doctor so you can be evaluated and see whether or not your medication should be adjusted.

If the Ferralet-90 was too expensive, there are certainly other options, but they may have to be dosed in a different way from which you are currently taking it.