Ferrous sulfate, folic acid.
Each tablet contains: Ferrous Sulfate Dried 186 mg (Equivalent to Elemental iron 60 mg), Folic Acid 400 mcg.
Pharmacology: Pharmacokinetics: Iron is irregularly and incompletely absorbed from the gastrointestinal tract, the main sites of absorption being the duodenum and jejunum. Absorption is aided by the acid secretion of the stomach and by some dietary acids (such as ascorbic acid) and is more readily affected when the iron is in the ferrous state or is part of the haem complex (haem-iron). Absorption is increased in conditions of iron deficiency or in the fasting state but is decreased if the body stores are overloaded. Only about 5 to 15 % of the iron ingested in food is normally absorbed. Only small amounts of iron are excreted as the majority released after the destruction of the hemoglobin molecule is re-used. This conservation of body iron, and lack of the excretory mechanism for excess iron, is the reason for the development of iron overload with excessive iron therapy. Folic acid is rapidly absorbed from the gastrointestinal tract, mainly from the duodenum and jejunum. Dietary folates are stated to have about half the bioavailability of crystalline folic acid. The principal storage site of folate is the liver; it is also actively concentrated in the CSF. Folate undergoes enterohepatic circulation. Folic metabolites are eliminated in the urine and folate in excess of body requirements is excreted unchanged in the urine. Folate is distributed into breast milk. Folic acid is removed by hemodialysis.
Used in the treatment and prevention of iron and folate deficiency anemia.
1 tablet daily. Or as prescribed by the physician.
Treatment of Adverse Effects: In treating acute iron poisoning, speed is essential to reduce absorption of iron from the gastrointestinal tract. Lavage should be considered and serum-iron concentrations may be an aid to estimating the severity of poisoning.
Iron: Should not be given to patients receiving repeated blood transfusions or to patients with anemias not produced by iron deficiency unless iron deficiency is also present. Oral iron therapy should not be administered concomitantly with parenteral iron. Care should be taken in patients with iron-storage or iron-absorption diseases such as hemochromatosis, hemoglobinopathies, or existing gastrointestinal diseases such as inflammatory bowel disease, intestinal strictures and diverticulae.
Folic Acid: Should never be given alone or in conjunction with inadequate amounts of vitamin B12 for the treatment of undiagnosed megaloblastic anemia, since folic acid may produce a hematopoietic response in patients with a megaloblastic anemia due to vitamin B12 deficiency without preventing aggravation of neurological symptoms. This masking of the true deficiency state can lead to serious neurological damage, such as subacute combined degeneration of the spinal cord.
The astringent action of iron preparations sometimes produces gastrointestinal irritation and abdominal pain with nausea and vomiting when administered orally. These irritant side-effects are usually related to the amount of elemental iron taken rather than the type of preparation. Other gastrointestinal effects may include either diarrhea or constipation. Side effects may be reduced by administration with or after food (rather than an empty stomach) or by beginning therapy with a small dose and increasing gradually. Folic acid is generally tolerated. Gastrointestinal disturbances and hypersensitivity reactions have been reported rarely.
Iron salts are not well absorbed by mouth, and administration with food may further impair their absorption. Compounds containing calcium and magnesium, including antacids and mineral supplements, and bicarbonates, carbonates, oxalates, or phosphates, may also impair the absorption of iron by the formation of the insoluble complexes. Similarly the absorption of both iron salts and tetracyclines is diminished when they are taken concomitantly by mouth. If treatment with both drugs is required, a time interval of about 2 to 3 hours should be allowed between them. A suitable interval is also advised if an iron supplement is required in patients receiving trientine. Zinc salts may decrease the absorption of iron. Some agents, such as ascorbic acid and citric acid may increase the absorption of iron. The response to iron may be delayed in patients receiving systemic chloramphenicol. Folate deficiency states may be produced by a number of drugs including antiepileptics, oral contraceptives, antituberculous drugs, alcohol, and folic acid antagonists such as aminopterin, methotrexate, pyrimethamine, trimethoprim and sulfonamides. In some instances, such as during methotrexate or antiepileptic therapy, replacement therapy with folinic acid or folic acid may become necessary in order to prevent megaloblastic anemia developing, folate supplementation has reportedly decreased serum-phenytoin concentrations in a few cases and there is a possibility that such an effect could also occur with barbiturate antiepileptics.
Store at temperatures not exceeding 30°C.
B03AD - Iron in combination with folic acid ; Used in the treatment of anemia
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