Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C Pharmacology

Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C

About Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Mechanism of Action of Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Pharmacokinets of Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Onset of Action for Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Duration of Action for Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Half Life of Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Side Effects of Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Contra-indications of Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Special Precautions while taking Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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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
N/A
Indications for Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Interactions for Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Typical Dosage for Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Schedule of Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Storage Requirements for Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Effects of Missed Dosage of Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C
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Effects of Overdose of Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + 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.

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
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.

Vit B2

About Vit B2
N/A
Mechanism of Action of Vit B2
Riboflavin exerts it`s action by influencing metabolic reactions. Riboflavin functions in the forms of flavin adenine dinucleotide (FAD), and flavin mononucleotide (FMN) which are coenzymes for flavoproteins involved in many oxidation-reduction reactions. Both FMN and FAD play a vital metabolic role in numerous tissue respiration systems. Riboflavin also directly involves in maintaining erythrocyte integrity.
Pharmacokinets of Vit B2
Absorption: Well absorbed orally; bioavailability increases when administer along with food.
Distribution: Widely distributed in the tissues and limited amount is stored in the liver, spleen, kidneys, and heart. It crosses the placenta and also secreted in to the breast milk.
Metabolism: Phosphorylated in the intestine, liver and other tissues to FMN and metabolized in to FAD the liver.
Excretion: Larger doses are excreted unchanged in urine.
Onset of Action for Vit B2
N/A
Duration of Action for Vit B2
N/A
Half Life of Vit B2
66 to 84 minutes
Side Effects of Vit B2
1. Bright yellow urine with higher doses
Contra-indications of Vit B2
No known contraindications.
Special Precautions while taking Vit B2
N/A
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 Vit B2
1. Ariboflavinosis
2. Arteriosclerosis
3. Hypertension
4. Obesity
5. Diabetis
6. Cholepathy
7. Glossitis
8. Stomatitis
9. Dermatitis of trunk and extremities
10. Other riboflavin deficiency symptoms
Interactions for Vit B2
Oral contraceptive:Dose of Riboflavin may need to be increased
Propantheline Bromide:Delays absorption rate of Riboflavin
Typical Dosage for Vit B2
Oral:
Adults: 20 to 40mg three times daily or depending up on the severity.
Children: 20mg daily.
Riboflavin deficiency:
Adults and children over 12 years: 5 to 30mg/day depending up on the severity .
Children (below 12years): 3 to 10mg/day depending up on the severity.
Schedule of Vit B2
C1
Storage Requirements for Vit B2
Store in a well closed container; in a cool place and protect from light.
Effects of Missed Dosage of Vit B2
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 B2
Provide symptomatic treatment and supportive measures.

Vit B1

About Vit B1

Physiological functions: Thiamine pyrophosphate is a coenzyme and the active form of vitamin B. It functions as coenzyme in decarboxylation of a-keto acid and in Hexose Monophosphate shunt.
Deficiency symptoms: In severe vitamin B1 deficiency beriberi develops. It is of two types:
a) Wet beriberi
b) Dry beriberi
Wet beriberi: In this the symptoms are related to the cardiovascular system and they are palpitations, tachycardia, dyspnoea, ECG changes, oedema, and high output cardiac failure.
Dry beriberi: The symptoms and signs are related to the Nervous system. The main features are peripheral neuritis, hyperaesthesia (localized areas) or anaesthesia, there is gradual loss in muscle strength, wrist drop, poor memory, depression, lack of initiative and anorexia.
Mechanism of Action of Vit B1
Thiamine exerts it`s action by influencing carbohydrate metabolism. It combines with ATP to form thiamine pyrophosphate in the body. Thiamine pyrophosphate acts as a coenzyme for carbohydrate metabolism, decarboxylation of ketoacids, and hexose monophosphate shunt. It also have plays some role in neuromuscular transmission.
Pharmacokinets of Vit B1
Absorption: Well absorbed orally.
Distribution: Widely distributed in the body. It is also distributed in to breast milk.
Metabolism: Metabolized in the liver.
Excretion: Excess thiamine is excreted through urine.
Onset of Action for Vit B1
N/A
Duration of Action for Vit B1
N/A
Half Life of Vit B1
N/A
Side Effects of Vit B1
1. Angioedema
2. Cardiovascular collapse
3. Cyanosis
4. Restleessness
5. Nausea
6. Haemorrhage
7. Weakness
8. Allergic reactions
9. Tightness of throat
10. Feeling of warmth
11. Urticaria
12. Pruritus
13. Tenderness and induration following I. M. administration
Contra-indications of Vit B1
1. Hypersensitivity to the drug
Special Precautions while taking Vit B1
N/A
Pregnancy Related Information
Use with caution
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Vit B1
1. Thiamine deficiency
2. Dry beriberi
3. Wet beriberi
4. Wernicke`s encephalopathy
5. Hyperemesis gravidarum
6. Korsakoffs syndrome
7. Polyneuritis secondary to alcoholism
8. Multiple neurosis
9. Toxic and confusional states
10. Anorexia nervosa
11. Delirium
Interactions for Vit B1
N/A
Typical Dosage for Vit B1
Oral :
In mild deficiency: 10 to 25mg/day.
In severe deficiency: 200 to 300mg/day.
I.M, I.V.:
Beriberi:
Adults: 10 to 20mg I.M. depending up on the severity of the condition (Up to 100mg I.M. or I.V. for severe cases); thrice daily for two weeks followed by dietary correction and multivitamin supplement containing 5 to 30mg Thiamine/day in single or divided doses for 1 month.
Wernicke`s encephalopathy: 100mg I.V. followed by 50 to 100mg IM. or I.V./day.
"Wet beriberi with heart failure": 10 to 30mg I.V. for emergency treatment.

Schedule of Vit B1
C1 (Oral)
Storage Requirements for Vit B1
Store in a well closed container; in a cool place and protect from light.
Effects of Missed Dosage of Vit B1
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 B1
Provide symptomatic treatment and supportive measures.

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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Iron (Ferrous fumarate) + Vit B12 + Vit B2 + Vit B1 + Folic acid + Vitamin C is a generic medicine name and there are several brands available for it. Some of the brands for iron (ferrous fumarate) + vit b12 + vit b2 + vit b1 + folic acid + vitamin c might be better known than iron (ferrous fumarate) + vit b12 + vit b2 + vit b1 + folic acid + vitamin c itself. If the pharmacy that's willing to deliver medicines to your home doesn't have iron (ferrous fumarate) + vit b12 + vit b2 + vit b1 + folic acid + vitamin c in stock, you can ask for one of the branded alternatives for iron (ferrous fumarate) + vit b12 + vit b2 + vit b1 + folic acid + vitamin c.