Iron (Ferrous fumarate) + Folic acid + Vitamin C Pharmacology

Iron (Ferrous fumarate) + Folic acid + Vitamin C

About Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Mechanism of Action of Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Pharmacokinets of Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Onset of Action for Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Duration of Action for Iron (Ferrous fumarate) + Folic acid + Vitamin C
N/A
Half Life of Iron (Ferrous fumarate) + Folic acid + Vitamin C
N/A
Side Effects of Iron (Ferrous fumarate) + Folic acid + Vitamin C
N/A
Contra-indications of Iron (Ferrous fumarate) + Folic acid + Vitamin C
N/A
Special Precautions while taking Iron (Ferrous fumarate) + Folic acid + Vitamin C
N/A
Pregnancy Related Information
N/A
Old Age Related Information
N/A
Breast Feeding Related Information
N/A
Children Related Information
N/A
Indications for Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Interactions for Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Typical Dosage for Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Schedule of Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Storage Requirements for Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Effects of Missed Dosage of Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Effects of Overdose of Iron (Ferrous fumarate) + Folic acid + Vitamin C
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Iron (Ferrous fumarate)

About Iron (Ferrous fumarate)
Iron (II) salt of fumaric acid, Oral iron preparation, Antianemic,hematinic.
Mechanism of Action of Iron (Ferrous fumarate)
Ferrous fumarate is used as a source of iron for iron-deficiency anaemia. It is given by mouth in usual doses of up to 600 mg daily (equivalent to about 200 mg of iron daily). Iron formulations exert haematinic action by being an essential constituent of haemoglobin. It is necessary for the oxidative process of living tissues.
Ferrous fumarate has similar efficacy as that of Ferrous sulphate.But it is more stable and almost tasteless as compared to Ferrous fumarate and it does not precipitate proteins and does not interfere with enzymes of digestive system.
Pharmacokinets of Iron (Ferrous fumarate)
Absorption: Absorbed orally in ferrous form and 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 (Ferrous fumarate)
N/A
Duration of Action for Iron (Ferrous fumarate)
N/A
Half Life of Iron (Ferrous fumarate)
N/A
Side Effects of Iron (Ferrous fumarate)
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 (Ferrous fumarate)
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 (Ferrous fumarate)
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 (Ferrous fumarate)
1. Iron deficiency
2. Iron deficiency anaemia
Interactions for Iron (Ferrous fumarate)
N/A
Typical Dosage for Iron (Ferrous fumarate)
Oral:
Adults: Starts with 50 to 100mg 2 to 3 times daily. Adjust the dosage based on patient`s response.
Children: 4 to 6mg/kg daily in three divided doses.
Schedule of Iron (Ferrous fumarate)
H
Storage Requirements for Iron (Ferrous fumarate)
Store in a well closed container in a cool dry place. Protect from light.
Effects of Missed Dosage of Iron (Ferrous fumarate)
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 (Ferrous fumarate)
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.

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.

Vitamin C

About Vitamin C
Water soluble vitamin, antioxidant.
Mechanism of Action of Vitamin C
Vitamin C exerts it`s action by influencing the biologic oxidations and reductions used in cellular respirations. It directly stimulates collagen synthesis and maintains intracellular connective tissue. It involves in various metabolic reactions such as 1).Hydroxylation of praline and lysine residues of protocollagen which is essential for formation and stabilization of collagen triple helix, 2).hydroxylation of carnitine, 3).Conversion of folic acid to folinic acid, 4).biosynthesis of adrenal steroids, catecholamines, oxytocin, and ADH, 5).Metabolism of cyclic nucleotides and prostaglandins. Vitamin C is important in resistance to infections.
Pharmacokinets of Vitamin C
Absorption: Well absorbed orally.
Distribution: Widely distributed both extracellularly and intracellularly, It crosses the placenta and also distributed in to the breast milk.
Metabolism: Metabolized in the liver; partly oxidized in to active dehydroascorbic acid and inactive metabolites.
Excretion: Inactive metabolites and extra drug is excreted through urine.
Onset of Action for Vitamin C
N/A
Duration of Action for Vitamin C
N/A
Half Life of Vitamin C
N/A
Side Effects of Vitamin C
1. Discomfort at injection site
2. Acid urine
3. Renal calculi
4. Oxaluria
Contra-indications of Vitamin C
No known contraindications
Special Precautions while taking Vitamin C
1. Renal impairment
2. Ingestion of large doses during pregnancy has resulted in scurvy in neonates
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Vitamin C
1. Scurvy
2. Prophylaxis and treatment of vitamin C deficiency
3. As an antioxidant to maintain natural colour and flavour of food items
4. For acidification of urine
5. Capillary fragility
6. Dental caries

Interactions for Vitamin C
Oral contraceptives and estrogens: Vitamin C increases serum levels of oestrogen resulting in adverse reactions .
Warfarin: The anticoagulant effects of warfarin is reduced.
Lab Tests: Large doses (>500 mg) of vitamin C may cause false negative urine glucose determinations. May result in false negative amine dependent stool occult blood tests.
Typical Dosage for Vitamin C
Oral:
Adults: 50 to 1000mg/day depending up on the requirement.
Pregnancy and lactation: 100 to 150mg/day
Children: 30 to 100mg/day.
Scurvy:
Oral:
Adults: 1000mg twice daily to thrice daily.
Children: 300mg to 1000mg daily.
Sub clinical scurvy:
Oral, S.C., I.M., or I.V.: 100 to 250mg once daily or twice daily depending up on the severity of the condition. Then give a maintenance dosage of 50mg/day.
Children: 100 to 300mg depending up on the severity. Then give a maintenance dose of 35mg/day.

Schedule of Vitamin C
C1 (Oral)
C (Parenteral)
Storage Requirements for Vitamin C
Store in a cool dry area in a well closed container. Protects from moisture, light and direct heat.
Effects of Missed Dosage of Vitamin C
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 Vitamin C
Discontinue the therapy and provide symptomatic and supportive measures.

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