Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc Pharmacology

Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

About Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Mechanism of Action of Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Pharmacokinets of Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Onset of Action for Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Duration of Action for Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Half Life of Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Side Effects of Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Contra-indications of Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Special Precautions while taking Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Pregnancy Related Information

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Old Age Related Information

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Breast Feeding Related Information

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Children Related Information

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Indications for Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Interactions for Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Typical Dosage for Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Schedule of Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Storage Requirements for Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Effects of Missed Dosage of Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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Effects of Overdose of Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc

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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)

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

N/A

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

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.

Vit B6

About Vit B6

Physiological functions: It is involved as a coenzyme (Pyridoxal phosphate) in metabolism of tryptophan, in several metabolic transformations of amino acids including transamination, decarboxylation & racemization.
Deficiency symptoms: Peripheral neuritis, seizures, stomatitis, glossitis, anaemia, seborrhea like lesions.

Mechanism of Action of Vit B6

Vitamin B6 is a collective term for Pyridoxine, Pyridoxal, Pyridoxamine and their phosphorylated derivatives such as Pyridoxine phosphate, Pyridoxal phosphate and Pyridoxamine derivatives respectively. Vitamin B6 is essential for the metabolism of amino acid, glycogen and fatty acids, for nerve functions, for the formation of red blood cells and also helps the skin healthy. Vitamin B6 is also used for the synthesis of nucleic acid, Haemoglobin, Sphingomyelin, other Sphingolipids, Serotonin, Dopamine, Noradrenaline and GABA.

Pharmacokinets of Vit B6

Absorption: Vitamin B6 is readily absorbed after oral administration.
Distribution: It is mainly distributed in the body in protein bound form. It is stored primarily in the liver and to a lesser extent muscle and brain.
Metabolism: It is metabolised in the liver

Onset of Action for Vit B6

N/A

Duration of Action for Vit B6

N/A

Half Life of Vit B6

15-20 days

Side Effects of Vit B6

1. Neuropathy
2. Unstable gait
3. Drowsiness
4. Perioral numbness
5. Paresthesia
6. Numbness of feet
7. Somnolence
8. Sensory neuropathy
9. Ataxia

Contra-indications of Vit B6

1. Hypersensitivity to Vitamin B6

Special Precautions while taking Vit B6

N/A

Pregnancy Related Information

May be used

Old Age Related Information

May be used

Breast Feeding Related Information

Use with caution

Children Related Information

Use with caution
NEONATES: Contraindicated

Indications for Vit B6

1. Vitamin B6 deficiency including inadequate diet and drug induced causes
2. Neuropathy
3. Premenstrual syndrome
4. Hyperoxaluria type 1
5. Metabolic disorder
6. Isoniazid poisoning

Interactions for Vit B6

Cycloserine, Hydralazine, Isoniazide, Oral contraceptive, Penicillamine: Increase Pyridoxine requirement.
Levodopa: Pyridoxine reverses the therapeutic effect of Levodopa.
Phenobarbital, Phenytoin: Pyridoxine decreases serum level of these anticonvulsants.

Typical Dosage for Vit B6

Adult: 10 - 20 mg / day
Dietary deficiency: 2.5 -10 mg / day for effective therapeutic response is obtained.
Maintenance dose: 2 - 5 mg / day for several weeks.
Drug induced deficiency: 100 - 200 mg / day for 3 weeks.
Maintenance dose: 25 - 100 mg / day
Neuropathy: 50 - 200 mg /day
Premenstrual syndrome: 40 - 500 mg / day
Hyperoxaluria type 1: 25 - 300 mg / day
Metabolic disorder: 100-500 mg /day.
Isoniazid poisoning: Initial dose: 1 - 4 g as IV administration, then 1 g IM every 30 minute until Pyridoxine dose is equal to the Isoniazid dose has been given.

Schedule of Vit B6

N/A

Storage Requirements for Vit B6

Store it at 15 - 30 degree C. Protect from moisture and heat.

Effects of Missed Dosage of Vit B6

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 B6

Give supportive measures and symptomatic treatment. The signs of Pyridoxine overdose can be resolved by discontinuation (withdrawal) of Pyridoxine.

Vit B3

About Vit B3

N/A

Mechanism of Action of Vit B3

Niacin refers to Nicotinic acid as well as Nicotinamide which exerts it`s action by influencing metabolic reactions. It is converted in to coenzymes Ncotinamide adenine dinucleotide (NAD) and it`s phosphate Ncotinamide adenine dinucleotide phosphate (NADP) involved in oxidation reduction reactions. These pyridine nucleotides act as hydrogen acceptors in the electron transport chain in tissue respiration, glycolysis, and fat synthesis. Nicotinic acid in high doses has vasodilator effects and also improves lipid profile; reduces serum cholesterol, raises HDL level, lowers VLDL, and LDL levels.

Pharmacokinets of Vit B3

Absorption: Well absorbed orally, Distribution: Widely distributed in the body, and also secreted in to breast milk, Modest amounts are stored in liver, Metabolism: Metabolized in to active metabolites in liver, Excretion: Extra drug is excreted through urine.

Onset of Action for Vit B3

N/A

Duration of Action for Vit B3

N/A

Half Life of Vit B3

N/A

Side Effects of Vit B3

1. Flushing
2. Activation of peptic ulcer
3. Nausea
4. Vomiting
5. Diarrhoea
6. Headache
7. Rashes
8. Pruritus
9. Hypotension
10. Arrhythmias
11. Hepatic impairment

Contra-indications of Vit B3

1. Hypersensitivity to the drug
2. Hepatic impairment
3. Peptic ulcer
4. Severe hypotension
5. Arterial haemorrhage

Special Precautions while taking Vit B3

1.History of liver disease
2.Gall bladder diseases
3.Gout
4.Coronary artery diseases
5.Diabetes mellitus
6.When use along with Statins reduces the dosage of Statins

Pregnancy Related Information

Use with caution

Old Age Related Information

Use with caution

Breast Feeding Related Information

Use with caution

Children Related Information

Use with caution

Indications for Vit B3

1. Pellagra
2. Niacin deficiency
3. Hartnup disease
4. Hyperlipidaemia (only nicotinic acid
5. Peripheral vascular diseases (only nicotinic acid)

Interactions for Vit B3

Aspirin: May decrease the metabolic clearance of nicotinic acid
Sympathetic blocking agent: May cause added vasodilation and hypotension
Isoniazid: may deplete levels of niacin and cause deficiency.

Typical Dosage for Vit B3

Oral:
Pellagra: 200 to 500mg daily in divided doses
Prophylactically: 20 to 50mg daily.
Dietary supplement: 10 to 20mg daily
Peripheral vascular diseases (only nicotinic acid): 100 to 150mg three to five times daily. Alternatively 1000 to 2000g once daily at bed time.
Hyperlipidaemia (only nicotinic acid): 1.5 to 6g daily in two to four divided doses with or after meals.
Hartnup disease: 50 to 200mg daily in divided doses.

Schedule of Vit B3

Storage Requirements for Vit B3

Store at controlled room temperature at a range of 15 to 30 degree C

Effects of Missed Dosage of Vit B3

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 B3

Provide supportive measures and symptomatic treatment

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.

Zinc

About Zinc

Trance metal, Dietary mineral, Nutritional supplement,Treatment of zinc deficiency,in wound healing.

Mechanism of Action of Zinc

Zinc 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 Zinc

Absorption: 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 Zinc

N/A

Duration of Action for Zinc

N/A

Half Life of Zinc

N/A

Side Effects of Zinc

1. Nausea
2. Vomiting
3. Abdominal distress
4. Gastric ulceration
5. Rashes

Contra-indications of Zinc

N/A

Special Precautions while taking Zinc

1.Don`t exceed prescribed dose
2.Renal failure
3.Biliary obstruction

Pregnancy Related Information

Use with caution

Old Age Related Information

N/A

Breast Feeding Related Information

N/A

Children Related Information

N/A

Indications for Zinc

1. Zinc deficiency
2. Acne vulgaris
3. Chronic skin ulcers
4. Adjunct to antimicrobials
5. Delayed wound healing
6. Alopecia

Interactions for Zinc

Fluoroquinolones, 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 Zinc

Adults: 25 to 50mg zinc daily or 1 to 2 tablets daily.
Children: 5mg/kg 1 to 3 times daily.

Schedule of Zinc

N/A

Storage Requirements for Zinc

Store at a temperature below 30 degree C

Effects of Missed Dosage of Zinc

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 Zinc

Provide symptomatic treatment and supportive measures

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Iron (Ferric ammonium citrate) + Vit B12 + Vit B6 + Vit B3 + Folic acid + Zinc is a generic medicine name and there are several brands available for it. Some of the brands for iron (ferric ammonium citrate) + vit b12 + vit b6 + vit b3 + folic acid + zinc might be better known than iron (ferric ammonium citrate) + vit b12 + vit b6 + vit b3 + folic acid + zinc itself. If the pharmacy that's willing to deliver medicines to your home doesn't have iron (ferric ammonium citrate) + vit b12 + vit b6 + vit b3 + folic acid + zinc in stock, you can ask for one of the branded alternatives for iron (ferric ammonium citrate) + vit b12 + vit b6 + vit b3 + folic acid + zinc.