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- Pharmacology For Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + Zinc
Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + Zinc Pharmacology
Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + Zinc
About Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AMechanism of Action of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/APharmacokinets of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AOnset of Action for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/ADuration of Action for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AHalf Life of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/ASide Effects of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AContra-indications of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/ASpecial Precautions while taking Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AInteractions for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/ATypical Dosage for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/ASchedule of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AStorage Requirements for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AEffects of Missed Dosage of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AEffects of Overdose of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + ZincN/AIron (Ferric ammonium citrate)
About Iron (Ferric ammonium citrate)An iron-containing salt,oral iron preparation, Antianemic,hematinic.Mechanism of Action of Iron (Ferric ammonium citrate)Ferric Ammonium Citrate contains between 16.5% and 18.5% of iron. It exerts haematinic action by being an essential constituent of haemoglobin. It is necessary for the oxidative process of living tissues. Ferric ammonium citrate is given by mouth as a source of iron for iron-deficiency anaemia.Ferric salts have not been preferred over ferrous salts as the ferric ion first requires reduction to ferrous form in the intestinal lumen. The bio-availability of iron from ferric salts is 3 to 4 times less than that of ferrous form.Ferric ammonium citrate (18% elemental iron) is the most commonly used ferric salts.Pharmacokinets of Iron (Ferric ammonium citrate)Absorption: Ferric is converted into Ferrous form and it is absorbed in ferrous form. It is poorly absorbed in healthy individuals (about 10%) but in patients suffering from iron deficiency anaemia up to 60% dose is absorbed. Distribution: Transported in a transferrin bound form in to bone marrow for incorporation in to haemoglobin. Metabolism: Iron liberated by destruction of haemoglobin is reused by the body. Excretion: Excretion of iron is minimal. Loss usually occurs in nails, faeces, urine, hair, sweat, and bile.Onset of Action for Iron (Ferric ammonium citrate)N/ADuration of Action for Iron (Ferric ammonium citrate)N/AHalf Life of Iron (Ferric ammonium citrate)N/ASide Effects of Iron (Ferric ammonium citrate)1.Nausea
2.Epigasttric distress
3.Vomiting
4.Constipation
5.Diarrhoea
6.Black stools
7.Temporary staining of teeth with liquid formulations.
Contra-indications of Iron (Ferric ammonium citrate)1.Haemolytic anaemia unless iron deficiency anaemia is also present
2.Haemochromatosis
3.Haemosiderosis
4.Peptic ulcer
5.Regional enteritis
6.Ulcerative colitis
7.Those receiving repeated blood transfusions
Special Precautions while taking Iron (Ferric ammonium citrate)1. Prolonged use
2. Minimise gastrointestinal discomfort by taking along with meals and gradually increasing the recommended dosage
3. Discontinue if intolerance occurs
4. Higher doses are required for geriatric patients
Pregnancy Related InformationMay be usedOld Age Related InformationUse with cautionBreast Feeding Related InformationMay be usedChildren Related InformationUse with cautionIndications for Iron (Ferric ammonium citrate)1. Iron deficiency
2. Iron deficiency anaemia
Interactions for Iron (Ferric ammonium citrate)N/ATypical Dosage for Iron (Ferric ammonium citrate)Adult: I capsule or 15ml twice daily after meals.
Children: 5 ml twice daily after meals.
Schedule of Iron (Ferric ammonium citrate)HStorage Requirements for Iron (Ferric ammonium citrate)Store in a well closed container in a cool dry place. Protect from light.Effects of Missed Dosage of Iron (Ferric ammonium citrate)Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of Iron (Ferric ammonium citrate)Treatment includes immediate support of airway, respiration, and circulation. In conscious patients induce emesis with ipecac; if not empty stomach by gastric lavage. Follow emesis with lavage, using a 1% sodium bicarbonate solution to convert iron to less irritating poorly absorbed form. Take abdominal X-ray to determine presence of excess iron. Deferoxamine may be used for systemic chelation if serum levels of iron exceed 350mg/dl. Vit B12
About Vit B12N/AMechanism of Action of Vit B12Vitamin B12 is an essential constituent for growth, cell reproduction, hematopoiesis, and nucleoprotein and myelin synthesis. Vitamin B12 is converted in to coenzyme B12 in the tissues which is essential for conversion of methyl-malonate to succinate and synthesis of methionine from homocystine. It is also associated with fat and carbohydrate metabolism and protein synthesis. Cells characterized by rapid division such as epithelial cells, bone marrow, and myeloid cells appear to have greatest requirement of Cyanocobalamin.Pharmacokinets of Vit B12Absorption: Absorbed irregularly after oral administration and absorption depends on Ca and intrinsic factor. It is also administered subcutaneously and intramuscularly.
Distribution: Distributed in to liver, bone marrow, and other tissues. It crosses the placenta and appears in breast milk.
Metabolism: It is metabolized in liver.
Excretion: In normal dosage it is reabsorbed from bile and a minute portion is excreted through urine but the extra drug is excreted through urine.
Onset of Action for Vit B12N/ADuration of Action for Vit B12N/AHalf Life of Vit B12N/ASide Effects of Vit B121. Anaphylaxis
2. Anaphylactoid reactions
3. Pain and burning sensation at injection site
4. Itching
5. Urticaria
6. Transient diarrhea
7. Peripheral vascular thrombosis
8. Pulmonary oedema
Contra-indications of Vit B121. Hypersensitivity to the drug
2. Leber`s disease
Special Precautions while taking Vit B121. Anemic patients with coexisting cardiac, pulmonary and hypertensive diseases.Pregnancy Related InformationMay be usedOld Age Related InformationMay be usedBreast Feeding Related InformationMay be usedChildren Related InformationUse with caution
NEONATES : Use with caution
Indications for Vit B121. Vitamin B12 deficiency
2. Pernicious Anaemia
3. Peripheral neuropathy (diabetic, alcoholic, and drug induced)
Interactions for Vit B12N/ATypical Dosage for Vit B12I.M., S.C.:
Pernicious Anaemia: 100mcg daily for 1 week followed by the same dose given on alternate days for 7 doses and then every 3 to 4days for another 3 weeks. This regimen should be followed by 100mcg monthly for life. Concurrently administer folic acid if required.
Vitamin B12 deficiency other than pernicious Anaemia: 30mcg daily for 5 to 10days depending up on the severity of the condition.
Maintenance dosage: 100 to 200mcg once monthly.
Children: 100mcg I.M. or S.C. over the course of 2 or more weeks.
Maintenance dosage: 60mcg monthly I.M. or S.C.
Schilling test flushing dose:
Adults and Children: 1000mcg I.M. in single dose
Recommended RDA (recommended dietary allowance) for Vitamin B12:
Infants up to 6months of age: 0.3mcg.
Children age 6 months to 1 year: 0.5mcg.
Children age 1 to 3: 0.7mcg.
Children age 4 to 6: 1mcg.
Children age 7 to 10: 1.4mcg.
Children age 11 to adult: 2mcg..
Pregnant women: 2.2mcg.
Breast feeding women: 2.6mcg.
Schedule of Vit B12CStorage Requirements for Vit B12Store at room temperature range of 15 to 30 degree C.in a light resistant well closed container in a dry place.Effects of Missed Dosage of Vit B12Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of Vit B12Not applicable. Even in large doses Vitamin B12 isn`t usually toxic.Folic Acid
About Folic AcidDietary supplement, Folate derivative( B9 ), Water Soluble Vitamin.Mechanism of Action of Folic AcidFolic acid reduced by enzymes folate reductase and dihydrofolate reductase and forms dihydrofolic acid tetrahydrofolic acid respectively. Tetrahydrofolic acid acts as a coenzyme which mediates a number of one carbon transfer reactions by carrying a methyl group as an adduct. It involves a number of reactions such as 1).conversion of homocysteine to methionine. 2).synthesis of thymidylate which is an essential constituent of DNA from methylene-tetrahydrofolic acid. 3). Conversion of serine to glycine by tetrahydrofolic acid and forms methylene-tetrahydrofolic acid. 4).to introduce carbon units at position 2 and 8 during de novo purine synthesis requires formyl-tetrahydrofolic acid and methenyl-tetrahydrofolic acid.5).generation and utilization of "formate pool". 6).For mediating formino group transfer in histidine metabolism. Folic acid is required to maintain normal erythropoiesis and nucleoprotein synthesis.Pharmacokinets of Folic AcidAbsorption: Well absorbed orally
Distribution: Widely distributed in the body and highest concentration is seen in liver. It appears in the CSF and breast milk
Metabolism: Metabolized in to N-methyl tetrahydrofolic acid in liver
Excretion: Extra drug is excreted unchanged in urine. A small portion of folate is lost by a combination of urinary and fecal excretion and oxidative cleavage of molecule.
Onset of Action for Folic AcidOral: 20 to 30minutes
I.V.: 5 minutes
I.M.:10 to 20minutes
Duration of Action for Folic AcidOral: 3 to 6 hours
I.V.:3 to 6minutes
I.M.:3 to 6hours
Half Life of Folic AcidN/ASide Effects of Folic AcidN/AContra-indications of Folic AcidN/ASpecial Precautions while taking Folic Acid1. In patients with undiagnosed anaemia; because it may mask pernicious anaemia
2. In pernicious anaemia and other megaloblastic where vitamin B12 is deficient
Pregnancy Related InformationMay be usedOld Age Related InformationMay be usedBreast Feeding Related InformationMay be usedChildren Related InformationMay be usedIndications for Folic Acid1. Megaloblastic anaemia
2. Folic acid deficiency
3. Anaemias of pregnancy
4. Nutritional anaemia
5. Alcoholism
6. Tropical sprue
7. Non tropical sprue
Interactions for Folic Acid1. Hypersensitivity reactions with injection form
2. Bronchospasm
Typical Dosage for Folic AcidOral: 5mg 1 to 4 times daily; depending up on the severity of deficiency.
Maintenance dosage: Half of the therapeutic dosage.
Children: 2.5 to 5mg 1 to 2 times daily.
Schedule of Folic AcidC1 (Oral)
C (Parenteral)
Storage Requirements for Folic AcidStore at controlled room temperature at a range of 15 to 25 degree C in a well closed container. Protect from excess heat, light and moisture.Effects of Missed Dosage of Folic AcidTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of Folic AcidRelatively non toxic. Provide symptomatic treatment and supportive measures.Zinc
About ZincTrance metal, Dietary mineral, Nutritional supplement,Treatment of zinc deficiency,in wound healing.Mechanism of Action of ZincZinc acts as a cofactor for more than 70 different enzymes. Zinc dependent enzymes are involved in the metabolism of carbohydrates, lipids, and proteins. Zinc facilitates wound healing, normal growth rates, normal skin hydration and maintains senses of taste and smell. It provides normal growth and tissue repair. It also helps in development of cell mediated immunity.Pharmacokinets of ZincAbsorption: Poorly absorbed orally, Distribution: Zinc is distributed mainly in to skeletal muscle, skin, bone, pancreas, kidney, liver, retina, prostate, RBC, and WBC. Excretion: Excreted mainly through intestine; only 2% loss in the urine.Onset of Action for ZincN/ADuration of Action for ZincN/AHalf Life of ZincN/ASide Effects of Zinc1. Nausea
2. Vomiting
3. Abdominal distress
4. Gastric ulceration
5. Rashes
Contra-indications of ZincN/ASpecial Precautions while taking Zinc1.Don`t exceed prescribed dose
2.Renal failure
3.Biliary obstruction
Pregnancy Related InformationUse with cautionOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Zinc1. Zinc deficiency
2. Acne vulgaris
3. Chronic skin ulcers
4. Adjunct to antimicrobials
5. Delayed wound healing
6. Alopecia
Interactions for ZincFluoroquinolones, Tetracyclines: Decreased GI absorption and serum levels of some fluoroquinolone.
Pencillamine: Reduced absorption of zinc.
Iron: Reduced absorption of iron and vice versa.
Typical Dosage for ZincAdults: 25 to 50mg zinc daily or 1 to 2 tablets daily.
Children: 5mg/kg 1 to 3 times daily.
Schedule of ZincN/AStorage Requirements for ZincStore at a temperature below 30 degree CEffects of Missed Dosage of ZincTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of ZincProvide symptomatic treatment and supportive measuresHome Delivery for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid + Zinc in Your City
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