Iron (Carbonyl Iron) + Vit B12 Pharmacology
Iron (Carbonyl Iron) + Vit B12
Iron (Carbonyl Iron)
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.
2. Epigasttric distress
3. Vomiting
4. Constipation
5. Diarrhoea
6. Black stools
7. Temporary staining of teeth with liquid formulations
2. Haemochromatosis
3. Haemosiderosis
4. Peptic ulcer
5. Regional enteritis
6. Ulcerative colitis
7. Those receiving repeated blood transfusions
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
2. Iron deficiency during pregnancy and lactation
3. Iron deficiency in infants and children
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.
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.
Vit B12
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.
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
2. Leber`s disease
NEONATES : Use with caution
2. Pernicious Anaemia
3. Peripheral neuropathy (diabetic, alcoholic, and drug induced)
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.
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