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- Pharmacology For Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3
Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3 Pharmacology
Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3
About Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AMechanism of Action of Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/APharmacokinets of Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AOnset of Action for Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/ADuration of Action for Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AHalf Life of Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/ASide Effects of Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AContra-indications of Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/ASpecial Precautions while taking Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AInteractions for Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/ATypical Dosage for Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/ASchedule of Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AStorage Requirements for Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AEffects of Missed Dosage of Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AEffects of Overdose of Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3N/AIron (Carbonyl Iron)
About Iron (Carbonyl Iron)A highly pure, nontoxic Iron(a minimum 98% iron content), Iron dietary supplement and to treat iron deficiency.Mechanism of Action of Iron (Carbonyl Iron)Iron formulations exerts haematinic action by being an essential constituent of haemoglobin. It is necessary for the oxidative process of living tissues.
Pharmacokinets of Iron (Carbonyl Iron)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 (Carbonyl Iron)4 daysDuration of Action for Iron (Carbonyl Iron)2 to 4 monthsHalf Life of Iron (Carbonyl Iron)N/ASide Effects of Iron (Carbonyl Iron)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 (Carbonyl Iron)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 (Carbonyl Iron)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 (Carbonyl Iron)1. Iron deficiency
2. Iron deficiency during pregnancy and lactation
3. Iron deficiency in infants and children
Interactions for Iron (Carbonyl Iron)(Oral Iron): Antacids: GI absorption of iron reduced.
Ascorbic acid: GI absorption of iron enhanced.
Chloramphenicol: Serum iron levels may be increased.
Cimetidine: GI absorption may be reduced.
Levodopa: Decreased levodopa serum levels.
Methyldopa: May result in decreased efficacy of methyldopa.
Quinolones: GI absorption of quinolones decreased.
Penicillamine: Marked reduction in GI absorption of penicillamine.
Tetracyclines: Decrease in the absorption of both tetracyclines and iron salts.
Food: Eggs and milk inhibit iron absorption. Administration of calcium and iron supplementation with food reduces ferrous sulfate absorption by one-third. If combined iron and calcium supplementation required then calcium carbonate should be used and the supplementation taken between meals.
Typical Dosage for Iron (Carbonyl Iron)Oral:
Ferrous fumarate:
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.
Ferrous sulphate:
Adults: 100 to 300mg; twice daily. Increases the dosage based on patient`s response if required up to 300mg 4 times daily.
Children (age 2 to 12): 3mg/kg/day in three to four divided doses
Children (age 6months to 2years): 3 to 6mg/kg/day in three to four divided doses
Infants: 10 to 25mg/day in three to four divided doses.
Ferrous gluconate:
300 to 1200mg daily in three to four divided doses.
Children (age 2 to 12): 3mg/kg/day in three to four divided doses
Children (age 6months to 2years): 3 to 6mg/kg/day in three to four divided doses
Infants: 10 to 25mg/day in three to four divided doses.
Schedule of Iron (Carbonyl Iron)HStorage Requirements for Iron (Carbonyl Iron)Store in a well closed container in a cool dry place. Protect from light.Effects of Missed Dosage of Iron (Carbonyl Iron)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 (Carbonyl Iron)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 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.Calcium
About CalciumCalcium is necessary for cardiac function, muscle contraction, nervous activity, coagulation of blood and for maintaining structural integrity of cell membranes.
Plasma concentration of calcium is kept in normal range by three endocrine factors which control metabolism of calcium. These are (a) Parathyroid hormone, (b) Calcitonin, (c) Vitamin D. Calcium in plasma is bound to albumin, is complexed with anions (e.g. phosphate) and as diffusible ionic calcium. The physiological effects are exerted by ionic calcium. The predominant source of calcium is dairy products and the daily intake varies from 200 - 2500 mg. Adequate calcium intake is particularly important during periods of bone growth in childhood and adolescence and during pregnancy and lactation.
Patients with advanced renal insufficiency exhibit phosphate retention and some degree of hyperphosphataemia. The retention of phosphate plays a pivotal role in causing secondary hyperparathyroidism associated with osteodystrophy and soft tissue calcification. Calcium acetate, when taken with meals, combines with dietary phosphate to form insoluble calcium phosphate which is excreted in the faeces.
Deficiency signs and symptoms: Osteoporosis, pathological fractures, brittle nails and hair.Mechanism of Action of CalciumCalcium is essential for maintaining the functional integrity of nervous, muscular, and skeletal system. It controls excitability of nerves and muscles and regulates permeability of cell membrane. It also regulates cell adhesion and maintains integrity of cell membrane. Calcium acts as intracellular messenger for hormones, autacoids, and transmitters. It is required for excitation-contraction coupling in all types of muscle and excitation-secretion coupling in exocrine and endocrine glands. It is essential for release of transmitters from nerve endings and other release reactions. It is also essential for impulse generation in heart and determines level of automaticity and
A-V conduction. Calcium is also required for blood-coagulation.
Pharmacokinets of CalciumAbsorption: Actively absorbed from gastrointestinal tract in an ionized form; and vitamin D in it`s active form is required for calcium absorption, Distribution: Distributed mainly in to skeletal tissue (99%) and 1% is distributed equally between the intracellular and extra cellular fluid. CSF levels are about half of the serum calcium levels, Metabolism: Not significantly metabolized in the body, Excretion: Excreted mainly through faeces and a small amount is excreted through urine.Onset of Action for CalciumN/ADuration of Action for CalciumN/AHalf Life of CalciumN/ASide Effects of Calcium1.Constipation
2.Bloating
3.Excess gas
4.Anorexia
5.Nausea
6.Vomiting
7.Abdominal pain
8.Thirst
9.Hypercalcaemia
10.Polyuria
11.Dry mouth
12.Delirium
13.Confusion
Contra-indications of Calcium1.Renal calculi
2.Hypophosphataemia
3.Hypercalcaemia
4.Ventricular fibrillation.
Special Precautions while taking Calcium1.Renal impairment
2.Cardiac diseases
3.Sarcoidosis
4.Cor pulmonale
5.Respiratory acidosis
6.Respiratory failure
7.End stage renal failure
8.Hypoparathyroid patients
9.Digitalized patients
10.Prolonged use of therapeutic amounts.
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationMay be usedChildren Related InformationUse with cautionIndications for Calcium1.Hypocalcaemia
2.Calcium and vitamin D deficiency
3.Calcium deficiency during pregnancy and lactation
4.Rickets
5.Prevention of osteoporosis in postmenopausal women
6.Chronic renal failure.
Interactions for CalciumN/ATypical Dosage for CalciumOral: 500mg to 2g daily in two to four divided doses.
Hypocalcaemia:
Adults: 1g daily. Increases to 2g daily if required.
Prevention of osteoporosis: 1 to 1.5g daily.
Children: 45 to 65mg/kg daily.
Neonates: 50 to 150mg/kg and should not exceed 1g.
Schedule of CalciumN/AStorage Requirements for CalciumStore in a well closed container in a cool and dry place. Protect from light.
Effects of Missed Dosage of CalciumTake 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 CalciumRemove calcium from stomach by induced emesis and gastric lavage. Provide symptomatic treatment and supportive measures.Vitamin D3
About Vitamin D3N/AMechanism of Action of Vitamin D3Vitamin D3 is a form of vitamin D. It is also called as Cholecalciferol.7-Dehydrocholesterol is the precursor of vitamin D3 and only forms the vitamin after being exposed to UV radiation.After exposure to the sun, cholecalciferol is sent to the liver to be hydroxylated where it becomes 25-Hydroxyvitamin D3.Next, it is sent to the kidney and once again hydroxylated becoming 1,25-Hydroxyvitamin D3. 1,25-Hydroxyvitmain D3 is the active form of vitamin D3, for this reason vitamin D is often referred to as a prohormone.Vitamin D exerts it`s action by influencing calcium homoeostasis. It increases the intestinal absorption of calcium and phosphate. It binds to the cytoplasmic Vitamin D receptor and translocates to the nucleus and thus increases the synthesis of specific m RNA and regulates protein synthesis. It increases the synthesis of a carrier protein for calcium called "calbindin" or calcium binding protein. Activation of Vitamin D receptor enhances endocytotic capture of calcium and it`s transport across duodenal mucosal cells in a vesicular form. Vitamin D promotes resorption of calcium and phosphate from bone by enhancing recruitment and differentiation of osteoclast precursors in the bone remodeling units. It helps in bone mineralization.Pharmacokinets of Vitamin D3Absorption: Well absorbed orally in the presence of bile salts, Malabsorption and steatorrhoea interfere with it`s absorption.
Distribution: Widely distributed in a protein bound form. It is stored in adipose tissue and liver.
Metabolism: It is hydroxylated in to both active and inactive metabolites and also metabolized in kidney.
Excretion: Metabolites are excreted mainly through bile.
Onset of Action for Vitamin D3N/ADuration of Action for Vitamin D3N/AHalf Life of Vitamin D3N/ASide Effects of Vitamin D31. Hypercalcaemia
2. Fatigue
3. Weakness
4. Diarrhoea
5. Vomiting
6. Sluggishness
7. Albuminuria
8. Polyuria
9. Calcification of soft tissues (blood vessels, parenchymal organs including heart)
10. Arrhythmias
11. Renal stones
12. Growh retardation in children
13. Hypertension
14. Anorexia
15. Nausea
16. Constipation
17. Elevated liver enzymes
Contra-indications of Vitamin D31. Hypercalcaemia
2. Hypervitaminosis D
3. Renal osteodystrophy with hyperphosphatemia
4. Renal impairment
Special Precautions while taking Vitamin D31. Renal diseases
2. Renal stones
3. Cardiac diseases
4. Arteriosclerosis
5. Coronary diseases
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Vitamin D31. Rickets and Osteomalacia
2. Hypoparathyroidism
3. Fanconi`s syndrome
4. Osteoporosis
Interactions for Vitamin D3Antacids: Hypermagnesemia may develop in patients on renal dialysis who take magnesium containing antacids.
Digitalis glycosides: May precipitate cardiac arrhythmias due to hypercalcemia.
Verapamil: Atrial fibrillation may occur.
Cholestyramine: Intestinal absorption of Vitamin D may be reduced.
Mineral Oil: Prolonged use of mineral oil may result in reduced absoprtion of Vitamin D.
Phenytoin, Barbiturates: Half life of vitamin D may be reduced.
Thaizide diuretics: Hypoparathyroid patients on Vitamin D may develop hypercalcemia due to thiazide diuretics.
Typical Dosage for Vitamin D3Oral:
Adults:
Nutritional Rickets and Osteomalacia: 25 to 125mcg daily in normal gastrointestinal absorption. In severe malabsorption; 250mcg to 7.5mg orally or 250mcg I.M.
Vitamin dependent Rickets: 250mcg to 1.5mg daily
Hypoparathyroidism: 625mcg to 5mg daily with calcium supplements
Fanconi`s syndrome: 1.25 to 5mg daily
Osteoporosis: 25 to 250mcg daily or 1.25mg once weekly with calcium and fluoride supplements.
Hypophosphatemia: 250mcg to 1.5mg along with phosphate supplements
Children:
Nutritional Rickets and Osteomalacia: 25 to 125mcg daily in normal gastrointestinal absorption. In severe malabsorption; 250mcg to 625mcg orally
Vitamin dependent Rickets: 75 to 125mcg daily.
Fanconi`s syndrome: 625mcg to 1.25mg daily
Hypophosphatemia: 1 to 2mg daily with phosphate supplements. Increase the dose in increments of 250 to 500mcg at intervals of 3 to 4months until desired therapeutic response is obtained.
Schedule of Vitamin D3N/AStorage Requirements for Vitamin D3Store in a well closed container in a cool place. Protect from light and excess heat. Keep out of reach of children.Effects of Missed Dosage of Vitamin D3Take 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 D3Provide supportive and symptomatic treatment. Stops the treatment and starting a low calcium diet. Increases the fluid intake and administer Loop diuretics like furosemide may be given with saline I.V. infusion to increase calcium excretion. Calcitonin may decrease hypercalcaemia. Home Delivery for Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3 in Your City
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Iron (Carbonyl Iron) + Folic acid + Calcium + Vitamin D3 is a generic medicine name and there are several brands available for it. Some of the brands for iron (carbonyl iron) + folic acid + calcium + vitamin d3 might be better known than iron (carbonyl iron) + folic acid + calcium + vitamin d3 itself. If the pharmacy that's willing to deliver medicines to your home doesn't have iron (carbonyl iron) + folic acid + calcium + vitamin d3 in stock, you can ask for one of the branded alternatives for iron (carbonyl iron) + folic acid + calcium + vitamin d3.