Iron Dosing for Iron Deficiency Anemia

Age-Specific Dosing Recommendations

Infants and toddlers should be administered 3 mg/kg per day of elemental iron, taken between meals, with hemoglobin rechecked after 4 weeks to confirm diagnosis, and treatment continued for 2 additional months after hemoglobin normalizes, according to the Centers for Disease Control and Prevention 1
School-age children (5-12 years) should take one 60-mg iron tablet daily, combined with dietary counseling about iron-rich foods, as recommended by the Centers for Disease Control and Prevention 2, 3
Adolescent boys (12-18 years) should take two 60-mg iron tablets daily (total 120 mg), as recommended by the Centers for Disease Control and Prevention 2, 3
Adolescent girls and nonpregnant women (12-49 years) should take 60-120 mg elemental iron daily for treatment of anemia, with the dose adjusted based on severity and tolerance, as recommended by the Centers for Disease Control and Prevention 2, 3

Pregnant women should take 30 mg elemental iron daily starting at the first prenatal visit for routine supplementation, as recommended by the American Academy of Family Physicians 3, 4, 5
Pregnant women with anemia should take 60-120 mg elemental iron daily, with higher doses (60-100 mg daily) prescribed for populations at increased risk, and treatment continued throughout pregnancy and 2-3 months postpartum, as recommended by the American Academy of Family Physicians 4, 5, 6

Hemoglobin should be rechecked after 4 weeks of treatment, with an expected response of hemoglobin increase ≥1 g/dL or hematocrit increase ≥3%, as recommended by the Centers for Disease Control and Prevention 1, 2, 6
Treatment should be continued for 2-3 months after hemoglobin normalizes to replenish iron stores, as recommended by the Centers for Disease Control and Prevention 3, 6

Vegetarian patients may require almost twice the iron dose due to poor absorption of non-heme iron from plant sources, and should be considered for prescribing at the higher end of the dosing range (100-120 mg daily), as recommended by the American Academy of Family Physicians 5, 7
Patients with gastrointestinal side effects should reduce to the lower end of the dosing range (60 mg daily) or split the dose, and consider alternate-day dosing, as recommended by the Praxis Medical Insights 7
Intravenous iron should be used when oral therapy fails despite compliance, or in cases of severe anemia requiring rapid correction, intestinal malabsorption, or specific conditions such as dialysis-dependent renal insufficiency, heart failure, or active inflammatory bowel disease, as recommended by the Praxis Medical Insights 6