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Prescribing Iron? Think Small

William H. Crosby, MD
Arch Intern Med. 1978;138(4):616-617. doi:10.1001/archinte.1978.03630280078024.
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Tradition tells us of Naming Day in Eden when God paraded before Adam each of His newly minted creatures, and Adam gave to each of them a name. So must there have been a Dosage Day where he or his pharmacopoeial descendent decided how much of an active ingredient should be incorporated into a pill, which amount thenceforth would be our standard. This primeval wizard had to be careful, since some active ingredients are extremely poisonous; standard pills must not contain a lethal dose. And there was yet another specification. No pill could be so large that the standard human gullet could not swallow it. Thus it came to pass that pharmacopoeia decreed tiny doses for poisonous drugs. But for less toxic medicines, such as aspirin and iron, the size was set at 5 grains, a dose not great enough to kill yet small enough to swallow.1

Iron pills,


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