# Anaemia of Chronic Disease (Inflammation) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: BSH Guidelines for the Management of Anemia of Chronic Disease 2017 - Verified date: 2026-08 ## Verified against - BSH Guidelines for the Management of Anemia of Chronic Disease 2017 ## Treatment metadata - Ferrous fumarate — 200 mg — oral.solid ## Complete treatment card ```text ANAEMIA OF CHRONIC DISEASE (INFLAMMATION) Sources: BSH Guidelines for the Management of Anemia of Chronic Disease 2017 Review status: REVIEWED against the source listed above (2026-08) 1. FERROUS FUMARATE [1st line] Adult 200 mg once daily (or on alternate days) ONLY if co-existing true iron deficiency confirmed (ferritin <100 mcg/L with TSAT <20%) x 2-3 months Peds 3-6 mg/kg/day [child max 180 mg] (3-6 mg/kg/day elemental iron in 1-2 divided doses only if co- existing iron deficiency documented. Ceiling of 180 mg is the formulary maximum for a child: 20 mL/day of the 140 mg/5 mL syrup, which is 45 mg elemental iron per 5 mL. This is deliberately above the 130 mg an adult gets here: a growing child needs more elemental iron per kilogram, and modern adult practice is lower and less frequent dosing than the formulary allows. It is not an inversion to correct.) 3kg -> 9-18 mg/day 4kg -> 12-24 mg/day 5kg -> 15-30 mg/day 6kg -> 18-36 mg/day 7kg -> 21-42 mg/day 8kg -> 24-48 mg/day 9kg -> 27-54 mg/day 10kg -> 30-60 mg/day 11kg -> 33-66 mg/day 12kg -> 36-72 mg/day 13kg -> 39-78 mg/day 14kg -> 42-84 mg/day 15kg -> 45-90 mg/day 16kg -> 48-96 mg/day 17kg -> 51-102 mg/day 18kg -> 54-108 mg/day 19kg -> 57-114 mg/day 20kg -> 60-120 mg/day 21kg -> 63-126 mg/day 22kg -> 66-132 mg/day 23kg -> 69-138 mg/day 24kg -> 72-144 mg/day 25kg -> 75-150 mg/day 26kg -> 78-156 mg/day 27kg -> 81-162 mg/day 28kg -> 84-168 mg/day 29kg -> 87-174 mg/day 30kg -> 90-180 mg/day 31kg -> 93-180 mg/day (upper capped) 32kg -> 96-180 mg/day (upper capped) 33kg -> 99-180 mg/day (upper capped) 34kg -> 102-180 mg/day (upper capped) 35kg -> 105-180 mg/day (upper capped) 36kg -> 108-180 mg/day (upper capped) 37kg -> 111-180 mg/day (upper capped) 38kg -> 114-180 mg/day (upper capped) 39kg -> 117-180 mg/day (upper capped) 40kg -> 120-180 mg/day (upper capped) 41kg -> 123-180 mg/day (upper capped) 42kg -> 126-180 mg/day (upper capped) 43kg -> 129-180 mg/day (upper capped) 44kg -> 132-180 mg/day (upper capped) 45kg -> 135-180 mg/day (upper capped) 46kg -> 138-180 mg/day (upper capped) 47kg -> 141-180 mg/day (upper capped) 48kg -> 144-180 mg/day (upper capped) 49kg -> 147-180 mg/day (upper capped) 50kg -> 150-180 mg/day (upper capped) Source BSH Guidelines for the Management of Anemia of Chronic Disease 2017 Why Iron therapy is ineffective and potentially harmful in pure anaemia of chronic disease without absolute iron deficiency - the ferritin and TSAT thresholds in the dose above are the gate, not a formality. Where it is indicated, Egypt's oral iron is ferrous fumarate; 200 mg is 65.57 mg elemental. Caution DO NOT ROUTINELY PRESCRIBE ORAL IRON FOR PURE ACD: High hepcidin levels block intestinal iron absorption and trap iron in macrophages. Definitive management is treating the underlying inflammatory, infectious, or malignant condition. Differentiate ACD from iron deficiency anaemia: ACD typically shows low serum iron, low TIBC, normal/high ferritin, and low transferrin saturation. Most iron tablets in Egypt come with folic acid in them, though not all - check the pack. Folate corrects the blood picture of B12 deficiency while the neurological damage carries on - check B12 before starting if the anaemia is macrocytic, mixed, or unexplained. The guideline says ferrous sulphate. The Egyptian formulary has no ferrous sulphate monograph; its oral iron is ferrous fumarate, 200 mg tablet = 65.57 mg elemental. Substitute on elemental iron, not on tablet weight. The pack a pharmacy hands over is a combination rather than plain iron - besides folic acid, many Egyptian iron products add vitamin C, and some add zinc or B vitamins. A combination is an acceptable way to give oral iron: the formulary's ferrous fumarate monograph lists the dosage forms as a 200 mg tablet and a 140 mg/5 mL syrup, then adds combination products to that list, and states the adult dose in elemental iron (100 to 200 mg elemental iron daily). The vitamin C is wanted rather than merely tolerated - 200 to 500 mg alongside oral iron is recommended to enhance its absorption. Dose by the elemental iron the pack states, not by tablet weight and not by the other ingredients. The Egyptian register does not record elemental iron content for most of these products, so the carton has to be read. Egypt FERROL 10 F.C. TABLET AMOUN 2.00 EGP (0.20/unit) -> ! also contains folic acid FOLIFER 30 TAB. MISR 7.20 EGP (0.24/unit) -> ! also contains folic acid FERROZINC-C 24 CAPS. SAFE PHARMA >... 7.50 EGP (0.31/unit) -> ! also contains vitamin c, zinc IROFOL 30 CAPS. MULTICARE 40.50 EGP (1.35/unit) -> ! also contains copper, folic acid, pyridoxine, vitamin b12, zinc HAEMACTIN 30 CAPS. DELTA GRAND P... 150.00 EGP (5.00/unit) -> ! also contains folic acid, vitamin b12 TESLAGLOBIN 20 CAP DAWA EGYPT IN... 140.00 EGP (7.00/unit) -> ! also contains b12, b6, copper, folic acid, zinc CHEMARED CAPSULE PHARMA ZAD > ... 195.00 EGP -> ! also contains calcium, methyl cobolamine, pyridoxine FERRONIL 125MG/5ML SYRUP 120 ML EL NILE. 4.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)