Ferium Mechanism of Action

Pharmacology: Pharmacodynamics: Mechanism of action: In the IPC, the polynuclear iron (III) hydroxide core is superficially surrounded by a number of non-covalently bound polymaltose molecules, which leads to an average total molecular weight of approximately 50kDa. IPC is a stable complex and does not release large amounts of iron under physiological conditions. The polynuclear iron core of the IPC has a structure similar to the physiological iron storage protein ferritin. Because of its size, the extent of diffusion of IPC through the membrane of the mucosa is about 40 times less than in most water-soluble iron (II) salts, existing in aqueous solution as hexaqua-iron (II) ion complex. Iron from IPC is taken up in the gut via an active mechanism.
Folic acid (folate) belongs to the group of B vitamins. It is a precursor to tetrahydrofolate, a coenzyme that is involved in various metabolic processes, including the biosynthesis of purines and thymidylates of nucleic acids. Folic acid is required for nucleoprotein synthesis and to maintain normal erythropoiesis.
The absorbed iron is bound to transferrin and used for Hb synthesis in the bone marrow or stored, primarily in the liver, bound to ferritin.
Folic acid is the precursor of tetrahydrofolic acid which is active and acts as a co-factor for 1-carbon transfer reactions in the biosynthesis of purines and thymidylates of nucleic acids.
Pharmacokinetics: Studies with radiolabeled IPC show a good correlation between iron absorption and the iron incorporation into hemoglobin. The relative amount of absorbed iron correlates with the extent of iron deficiency (i.e. the higher the iron deficiency, the better the iron absorption). In contrast to iron (II) salts, no negative impact of food on the bioavailability of iron from IPC was found: A significantly increased bioavailability of iron with concomitant food intake was demonstrated in one clinical study, while three further studies showed a positive trend but no clinically relevant effects.
Approximately 80% of folic acid is absorbed in the small intestine, with an absorption maximum after 30-60 minutes.
Unabsorbed iron is excreted through the faeces. Folic acid is mainly excreted in the urine.