Iron (Ferric ammonium citrate) + Vit B12 + Folic acid Pharmacology

Iron (Ferric ammonium citrate) + Vit B12 + Folic acid

About Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Mechanism of Action of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Pharmacokinets of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Onset of Action for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Duration of Action for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Half Life of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Side Effects of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
N/A
Contra-indications of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Special Precautions while taking Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Pregnancy Related Information
N/A
Old Age Related Information
N/A
Breast Feeding Related Information
N/A
Children Related Information
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Indications for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Interactions for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Typical Dosage for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Schedule of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Storage Requirements for Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Effects of Missed Dosage of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Effects of Overdose of Iron (Ferric ammonium citrate) + Vit B12 + Folic acid
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Iron (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/A
Duration of Action for Iron (Ferric ammonium citrate)
N/A
Half Life of Iron (Ferric ammonium citrate)
N/A
Side 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 Information
May be used
Old Age Related Information
Use with caution
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
Indications for Iron (Ferric ammonium citrate)
1. Iron deficiency
2. Iron deficiency anaemia
Interactions for Iron (Ferric ammonium citrate)
N/A
Typical 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)
H
Storage 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 B12
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Mechanism of Action of Vit B12
Vitamin 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 B12
Absorption: 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 B12
N/A
Duration of Action for Vit B12
N/A
Half Life of Vit B12
N/A
Side Effects of Vit B12
1. 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 B12
1. Hypersensitivity to the drug
2. Leber`s disease
Special Precautions while taking Vit B12
1. Anemic patients with coexisting cardiac, pulmonary and hypertensive diseases.
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
NEONATES : Use with caution
Indications for Vit B12
1. Vitamin B12 deficiency
2. Pernicious Anaemia
3. Peripheral neuropathy (diabetic, alcoholic, and drug induced)
Interactions for Vit B12
N/A
Typical Dosage for Vit B12
I.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 B12
C
Storage Requirements for Vit B12
Store 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 B12
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 Vit B12
Not applicable. Even in large doses Vitamin B12 isn`t usually toxic.

Folic Acid

About Folic Acid
Dietary supplement, Folate derivative( B9 ), Water Soluble Vitamin.
Mechanism of Action of Folic Acid
Folic 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 Acid
Absorption: 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 Acid
Oral: 20 to 30minutes
I.V.: 5 minutes
I.M.:10 to 20minutes
Duration of Action for Folic Acid
Oral: 3 to 6 hours
I.V.:3 to 6minutes
I.M.:3 to 6hours
Half Life of Folic Acid
N/A
Side Effects of Folic Acid
N/A
Contra-indications of Folic Acid
N/A
Special Precautions while taking Folic Acid
1. 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 Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
May be used
Indications for Folic Acid
1. 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 Acid
1. Hypersensitivity reactions with injection form
2. Bronchospasm
Typical Dosage for Folic Acid
Oral: 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 Acid
C1 (Oral)
C (Parenteral)
Storage Requirements for Folic Acid
Store 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 Acid
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 Folic Acid
Relatively non toxic. Provide symptomatic treatment and supportive measures.

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