Cyanocobalamin + Elemental Iron + Folic Acid
Indications
Cyanocobalamin + Elemental Iron + Folic Acid is used for:
Iron deficiency anemia, Megaloblastic anemias
Adult Dose
Adults: 1-2 capsules daily.
Child Dose
Child: 1 capsule daily.
Renal Dose
Administration
Contra Indications
Hypersensitivity to folic acid, cyanocobalamin, pyridoxine, or any component of the formulation
Precautions
Iron chelates with antacid and tetra cycline, so there absorption may be impaired if use concurrently.
Pregnancy-Lactation
Interactions
Cyanocobalamin: Absorption reduced by antibiotics, aminosalicylic acid, anticonvulsants, biguanides, cholestyramine, cimetidine, colchicine, K salts, methyldopa.
Elemental iron: Antacids may decrease the absorption of carbonyl iron.
Folic acid: Antiepileptics, oral contraceptives, anti-TB drugs, alcohol, aminopterin, methotrexate, pyrimethamine, trimethoprim and sulphonamides may result to decrease in serum folate contrations. Decreases serum phenytoin concentrations.
Adverse Effects
Side effects of Cyanocobalamin + Elemental Iron + Folic Acid :
Iron: Constipation, diarrhea, nausea, vomiting, dark stools, and abdominal pain
Folic acid: Allergic sensitization
Bronchospasm, Flushing, Malaise, Erythema, Rash, Diarrhea, Nausea, Pruritus, Urticaria
Mechanism of Action
Vitamin B12 (cyanocobalamin): Required for the maintenance of normal erthropoiesis, nucleprotein and myelin synthesis, cell reproduction and normal growth; Coenzyme; metabolic functions include protein synthesis and carbohydrate metabolism. Plays role in cell replication and hematopoiesis.
Iron: Essential component in the formation of hemoglobin; adequate amounts of iron are necessary for effective erythropoiesis; also serves as a cofactor of several essential enzymes, including cytochromes that are involved in electron transport. Replacement of iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin.
Folic acid: Required for nucleoprotein synthesis and the maintenance of normal erythropoiesis; folic acid is converted in the liver and plasma to its metabolically active form, tetrahydrofolic acid, by dihydrofolate reductase; prevents neural tube defects in women of childbearing potential and higher doses required during pregnancy.