Iron + Folic Acid + Vitamin B + Vitamin C
Indications
Iron + Folic Acid + Vitamin B + Vitamin C is used for:
Nutritional deficiency in pregnancy & lactation.
Adult Dose
One capsule daily. In more severe cases, 2 capsules a day may be required.
Child Dose
Renal Dose
Administration
For maximum absorption take on empty stomach, but may take with or after meals to minimize GI irritation
Contra Indications
Patients with a known hypersensitivity to any of the ingredients, haemolytic anemia.
Precautions
Care should be taken in patients who may develop iron overload, such as those with haemochromatosis, haemolytic anemia or red cell aplasia. Iron chelates with tetracycline and absorption may be impaired.
Folic acid may mask the symptoms of pernicious anemia in that hematologic remission may occur while neurologic manifestations remain progressive. Administering folic acid may obscure pernicious anemia. Recommended doses are insufficient to correct severe vitamin deficiency states and may be insufficient in patients with markedly increased vitamin requirements.
Daily vitamin requirements must be calculated to avoid over dosage and toxic effects, particularly in pediatric patients.
Lactation: Present in breast milk, use caution
Pregnancy-Lactation
Interactions
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.
Vit C: Deferroxamine, hormonal contraceptives, flufenazine, warfarin, elemental iron, salicylates, warfarin, fluphenazine, disulfiram, mexiletine, vitamin B12.
Adverse Effects
Side effects of Iron + Folic Acid + Vitamin B + Vitamin C :
Allergic sensitization has been reported following oral administration. May cause nausea, vomiting, constipation or diarrhoea.
Mechanism of Action
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.
Vitamin B: Plays a role in the synthesis and maintenance of coenzyme A. Necessary for lipid metabolism, carbohydrate metabolism, tissue respiration, glycogenolysis, inhibition of very low-density lipoprotein (VLDL) synthesis. May increaase chylomicron triglyceride removal from plasma.
Vitamin C is necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in conversion of folic acid to folinic acid.