Ferrous fumarate + Cyanocobalamin + Folic acid + Ascorbic acid + Elemental Zinc

Indications

Ferrous fumarate + Cyanocobalamin + Folic acid + Ascorbic acid + Elemental Zinc is used for: Iron, Vitamin, Mineral deficiency

Adult Dose

Adult 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 known hypersensitivity to any of its ingredients; also, all iron compounds are contraindicated in patients with hemosiderosis, hemochromatosis, or hemolytic anemias. Pernicious anemia is a contraindication, as folic acid may obscure its signs and symptoms.

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. 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 Ferrous fumarate + Cyanocobalamin + Folic acid + Ascorbic acid + Elemental Zinc : Allergic sensitizations have been reported following both oral and parenteral administration of folic acid. Iron: Gastrointestinal disturbances (anorexia, nausea, diarrhea, constipation, heartburn and vomiting) occur occasionally, but are usually mild and may subside with continuation of therapy. Iron may turn stools black.

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. Zinc: Cofactor in over 100 enzymes; plays a role in DNA synthesis; supports a healthy immune system; helps maintain a sense of smell and taste; may assist in porper function of insulin. 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 B12 (cyanocobalamin): Required for the maintenance of normal erthropoiesis, nucleprotein and myelin synthesis, cell reproduction and normal growth; intrinsic factor, a glycoprotein secreted by the gastric mucosa, is required for active absorption of Vitamin B12 from the GI tract. Necessary for normal tissue respiration; plays a role in activation of pyridoxine and conversion of tryptophan to niacin. 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.