ToxicologyEmergencyPaediatrics
Iron overdose
Risk-stratification by elemental iron dose, role of whole-bowel irrigation, and desferrioxamine for severe poisoning.
Source: TOXBASE/NPIS; AACT/EAPCCT; BNF
Step 1 of ~7
action
Estimate elemental iron dose
Iron toxicity is dose-related. Calculate elemental iron (mg/kg) — varies by salt:
• Ferrous sulfate 200 mg = 65 mg elemental Fe
• Ferrous fumarate 200 mg = 65 mg
• Ferrous gluconate 300 mg = 35 mg
• Sodium feredetate 190 mg = 27 mg
ABCDE; bloods: iron level (4–6 h post-ingestion, peak earlier for liquid), VBG, glucose, U&E, LFTs, INR, lactate, paracetamol/salicylate. Abdominal X-ray (radiopaque tablets — useful in children).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
Same class
- Desferrioxamine mesilate · Iron chelator (parenteral)
- Dopamine (ICU — Vasopressor/Inotrope) · Catecholamine (Dose-Dependent Vasopressor/Inotrope)
- Acetylcysteine (N-acetylcysteine — Paracetamol Overdose) · Mucolytic / Hepatoprotective Antidote
- Hydroxocobalamin (High-Dose — Cyanide Antidote) · Cyanide Antidote (Vitamin B12 Precursor at High Dose)
- Dopamine hydrochloride · Inotrope / vasopressor (dose-dependent)
Pathways
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014); BNF
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
- Opioid overdose · TOXBASE/NPIS; Resuscitation Council UK; BNF
- Anticholinergic toxidrome · TOXBASE/NPIS; AACT/EAPCCT; BNF
- Benzodiazepine overdose · TOXBASE/NPIS; AACT/EAPCCT; BNF
- β-blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC; BNF
Decision support only. Always apply local guidelines and clinical judgement.