In vivo effectiveness of oral complexation agents in the management of iron poisoning.

The accidental ingestion of iron-containing preparations is relatively common in children, as are intentional overdoses with iron in adults. One of the most commonly used treatment modalities is the use of orally administered sodium bicarbonate or sodium hydrogen phosphate, which is thought to render iron less soluble and bioavailable by converting it to ferrous carbonate or ferrous phosphate. An in vivo parallel study utilizing 3 groups of 50 male Sprague-Dawley rats was designed to evaluate the effectiveness of oral complexation agents at five distinct time points. Each animal group was dosed with 300 mg/kg ferrous sulfate (60 mg/kg elemental iron), followed by a 5% solution of either sodium bicarbonate, sodium dihydrogen phosphate, or a control of distilled water. The animals were anesthetized in each group at separate time points of 0, 1, 2, 4, and 6 hours post iron load, and blood samples were taken to determine serum iron levels. There were no differences in serum iron levels between the control group and either complexing agent. This suggests that oral complexation in iron poisoning may be ineffective.