Ferrous Ascorbate + Folic Acid + Zinc Sulfate

Indications
It is indicated on prophylaxis of iron deficiency especially when inadequate diet calls for supplementary zinc and iron during pregnancy and anemia.

Therapeutic Class
Iron, Vitamin & Mineral Combined preparation

Description
It is an oral iron, folic acid and zinc preparation indicated for the treatment of iron, folic acid and zinc deficiency.
Pharmacology
Ferrous Ascorbate when administered is converted to ferric form and immediately is reduced to the ferrous form into the stomach. This reduced ferrous form is then transferred to the duodenum where it is highly absorbed. Ferrous Ascorbate has the advantage of providing both ferrous ion and ascorbate in the same compound. There is no dissociation on entering GI Tract due to the stable chelate of iron with ascorbate. Folic Acid itself is biochemically inactive, is converted to tetrahydrofolic acid and methyltetrahydrofolate by dihydrofolate reductase in liver. These folic acid congeners are transported across cells by receptor-mediated endocytosis where they are needed to maintain numerous body functions.
Folic acid enhances chemical reactions that contribute to the production of red blood cells, the manufacture of DNA needed for cell replication and the metabolism of amino acids (compounds necessary for the manufacture of proteins).
Zinc is essential to numerous physiological processes, including the function of many enzymes in the body. Deficiency may lead to poor night vision, slow healing of wounds, poor sexual development and function in males, poor appetite (perhaps owing to a decrease in the sense of taste and smell), a reduced ability to ward off infections, diarrhea, dermatitis and in children, retarded growth.

Dosage & Administration
Adult & Elderly: One tablet a day before or after meal (food independent absorption) or as directed by the physician. In more severe cases, two tablets a day may be required as prescribed by the physician. Safety and effectiveness in pediatric patients have not been established.

Interaction
Iron chelates with tetracycline. Since oral iron products interfere with absorption of oral tetracycline antibiotics, this product should not be taken within two hours of each other. Occasional gastrointestinal discomfort may be minimized by taking with meals. Absorption of iron may be impaired by concurrent administrations of penicillamine and antacid. In patients with renal failure, a risk of zinc accumulation may exist.

Contraindications
It is contraindicated in patients with haemolytic anaemia and in conditions with increased hypersensitivity to any of its components and increased body iron content.

Side Effects
Side effects of iron, folic acid and zinc supplementation are mild and transient. These include epigastric pain, nausea, constipation, vomiting, diarrhoea, heart burn, etc. Allergic sensitization has been reported following both oral and parenteral administration of folic acid.

Pregnancy & Lactation
If pregnant, or planning to become pregnant or are currently breast-feeding please contact your physician, before taking or continuing the drug. Administration in first trimester of pregnancy should be avoided unless definite evidence of iron deficiency is observed. Prophylaxis of iron deficiency is justified during the remainder of pregnancy specifically when zinc supplementation is required.

Precautions & Warnings
Care should be taken in patients who may develop iron overload, such as those with haemochromatosis, haemolytic anemia or red cell aplasia. Failure to respond to treatment may indicate other causes of anemia and should be further investigated.

Overdose Effects
The clinical course of acute iron overdosage can be variable. Initial symptoms may include abdominal pain, nausea, vomiting, diarrhoea, tarry stools, melena, hematemesis, hypotension, tachycardia, metabolic acidosis, hyperglycemia, dehydration, drowsiness, pallor, cyanosis, lassitude, seizures, shock and coma.

Storage Conditions
Keep in a cool & dry place, protected from light. Keep out of the reach of children.