Ferrous fumarate/folic acid/intrinsic factor/vitamin B12 Uses
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Consists of Ferrous fumarate, folic acid, intrinsic factor, vitamin B12

What is Ferrous fumarate?

Ferrous fumarate is a type of iron. You normally get iron from the foods you eat. In your body, iron becomes a part of your hemoglobin (HEEM o glo bin) and myoglobin (MY o glo bin). Hemoglobin carries oxygen through your blood to tissues and organs. Myoglobin helps your muscle cells store oxygen.

Ferrous fumarate is used to treat iron deficiency anemia (a lack of red blood cells caused by having too little iron in the body).

Ferrous fumarate may also be used for purposes not listed in this medication guide.

Ferrous fumarate indications

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used to treat or prevent a lack of these nutrients which may occur in certain health conditions (e.g., anemia, pregnancy, poor diet, surgery recovery). Iron is an important mineral that the body needs to produce red blood cells. Vitamin C improves the absorption of iron from the stomach. Vitamin B12 is important for normal blood, cells, and nerves. Folic acid is needed to form healthy cells, especially red blood cells.

Women of childbearing age should maintain adequate amounts of folic acid either through diet or supplements to prevent spinal cord birth defects.

How should I use Ferrous fumarate?

Use Ferrous fumarate as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Ferrous fumarate.

Uses of Ferrous fumarate in details

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Use: Labeled Indications

Iron-deficiency anemia: Prevention and treatment of iron-deficiency anemias

Ferrous fumarate description

A metallic element found in certain minerals, in nearly all soils, and in mineral waters. It is an essential constituent of hemoglobin, cytochrome, and other components of respiratory enzyme systems. Its chief functions are in the transport of oxygen to tissue (hemoglobin) and in cellular oxidation mechanisms. Depletion of iron stores may result in iron-deficiency anemia. Ferrous fumarate is used to build up the blood in anemia.

Ferrous fumarate dosage

Ferrous Fumarate Dosage

Applies to the following strength(s): 325 mg; 90 mg; 300 mg; 100 mg; 100 mg/5 mL; 45 mg/0.6 mL; 200 mg; 350 mg; 150 mg; (as elemental iron) 50 mg; 324 mg; 63 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Iron Deficiency Anemia

Initial: 325 mg orally once a day.

Maintenance: 325 mg orally 3 times a day. Resolution of iron deficiency anemia may require ferrous fumarate supplementation for several weeks or months, depending on the duration and severity of the anemia.

Usual Adult Dose for Anemia Associated with Chronic Renal Failure

Initial: 325 mg orally once a day.

Maintenance: 325 mg orally 3 times a day.

In patients with chronic renal failure, iron status should be evaluated if epoetin alfa therapy is initiated.

A transferrin saturation of less than 20%, or a serum ferritin level of less than 100 mcg/L suggests inadequate iron stores and a need for iron replacement therapy.

Continued iron replacement therapy is needed in most patients receiving epoetin alfa treatment.

Usual Adult Dose for Vitamin/Mineral Supplementation during Pregnancy/Lactation

325 mg orally once a day.

The CDC has defined anemia during pregnancy as a hemoglobin concentration less than 100 g/L during the first and third trimesters and less than 105 g/L during the second trimester or a hematocrit value of less than 32%.

The recommended daily allowance (RDA) of elemental iron is 30 mg orally during pregnancy and 15 mg orally during lactation.

Usual Adult Dose for Vitamin/Mineral Supplementation

325 mg orally once a day.

The recommended daily allowance (RDA) of elemental iron is 10 mg for adult males, 15 mg for adult, premenopausal women, and 10 mg for postmenopausal women.

Usual Pediatric Dose for Iron Deficiency Anemia

Premature neonates:

2 to 4 mg elemental iron/kg/day divided every 12 to 24 hours (maximum daily dose = 15 mg).

Infants and children <12 years:

Prophylaxis: 1 to 2 mg elemental iron/kg/day (maximum 15 mg) in 1 to 2 divided doses.

Mild to moderate iron deficiency anemia:

3 mg elemental iron/kg/day in 1 to 2 divided doses.

Severe iron deficiency anemia:

4 to 6 mg elemental iron/kg/day in 3 divided doses.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Dialysis

Iron supplementation is routinely provided to peritoneal dialysis and hemodialysis patients for prevention or treatment of anemia associated with chronic renal failure.

Other Comments

Iron supplements are generally better absorbed on an empty stomach, however, if gastric intolerance occurs, iron may be taken with food.

Liquid formulations of iron may stain teeth and should therefore be administered with a straw.

Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6 years. Keep this product out of reach of children. In case of accidental overdose, call a physician or poison control center immediately.

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Ferrous fumarate interactions

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What other drugs will affect Ferrous fumarate?

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Oral absorption of iron may be increased when taken with ascorbic acid. May reduce the absorption of quinolones and tetracyclines when taken concurrently via the oral route. Concurrent admin with antacids may reduce the absorption of ferrous fumarate from the GI tract. May reduce the absorption of penicillamine in the gut when taken concurrently.

Ferrous fumarate side effects

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What are the possible side effects of Ferrous fumarate?

Applies to ferrous fumarate: chewable tablets, suspension

Other dosage forms:

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; darkened or green stools; diarrhea; nausea; stomach upset.

Seek medical attention right away if any of these SEVERE side effects occur while taking ferrous fumarate (the active ingredient contained in Ferrous fumarate)

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood or streaks of blood in the stool; fever; vomiting with continuing sharp stomach pain.

Ferrous fumarate contraindications

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What is the most important information I should know about Ferrous fumarate?

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do not use if:

* you are allergic to any ingredient in Ferrous Fumarate/Folic Acid/B Complex/Vitamin C/Minerals

* you have iron metabolism problems (eg, hemosiderosis, hemochromatosis), certain types of anemia (pernicious, hemolytic), or high levels of iron in your blood

* you have coppermetabolism problems (Wilson disease)

What is Folic acid?

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Folic acid (vitamin B 9) is necessary for strong blood.

Lack of folic acid may lead to anemia (weak blood). Your health care professional may treat this by prescribing folic acid for you.

Some conditions may increase your need for folic acid. These include:

In addition, infants smaller than normal, breast-fed infants, or those receiving unfortified formulas (such as evaporated milk or goat's milk) may need additional folic acid.

Increased need for folic acid should be determined by your health care professional.

Some studies have found that folic acid taken by women before they become pregnant and during early pregnancy may reduce the chances of certain birth defects (neural tube defects).

Claims that folic acid and other B vitamins are effective for preventing mental problems have not been proven. Many of these treatments involve large and expensive amounts of vitamins.

Injectable folic acid is given by or under the direction of your health care professional. Another form of folic acid is available without a prescription.

Folic acid indications

Folic acid is used in the treatment and prevention of the folate deficiency state. It does not correct folate deficiency due to dihydrofolate reductase inhibitors. Folic acid is also used in women of child-bearing potential and pregnant women to protect against neural tube defects in their offspring. It is also used for the treatment of folate-deficient megaloblastic anaemia, chronic haemolytic states such as thalassaemia major or sickle-cell anaemia.

How should I use Folic acid?

Use folic acid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use folic acid.

Uses of Folic acid in details

Folic acid is the man-made form of folate. Folate is a B-vitamin naturally found in some foods. It is needed to form healthy cells, especially red blood cells.

Folic acid supplements may come in different forms (such as L-methylfolate, levomefolate, methyltetrahydrofolate). They are used to treat or prevent low folate levels. Low folate levels can lead to certain types of anemia. Conditions that can cause low folate levels include poor diet, pregnancy, alcoholism, liver disease, certain stomach/intestinal problems, kidney dialysis, among others. Women of childbearing age should receive adequate amounts of folic acid either through their diet or supplements to prevent infant spinal cord birth defects.

How to use Folic acid

Take this product by mouth with or without food as directed by your doctor, usually once daily. If you are taking the over-the-counter product, follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.

Dosage is based on your medical condition and response to treatment. Do not increase your dose or take this product more often than directed.

Take this product regularly to get the most benefit from it. To help you remember, take it at the same time each day. Follow the diet plan recommended by your doctor or dietician. See also Notes section.

If your condition persists or worsens, or if you think you may have a serious medical problem, get medical help right away.

Folic acid description

A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses (poaceae). Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [PubChem]

Folic acid dosage

Folic Acid Dosage

Applies to the following strength(s): 1 mg; 0.4 mg; 5 mg/mL; 0.8 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Megaloblastic Anemia

1 mg orally, intramuscularly, subcutaneously or IV once a day. May continue until clinical symptoms of folate deficiency and the hematological profile have normalized.

Usual Adult Dose for Folic Acid Deficiency

400 to 800 mcg orally, intramuscularly, subcutaneously or IV once a day.

Women of childbearing age, pregnant, and lactating women: 800 mcg orally, intramuscularly, subcutaneously or IV once a day.

Usual Pediatric Dose for Folic Acid Deficiency

Infant:

0.1 mg orally, intramuscularly, subcutaneously or IV once a day.

Child:

Less than 4 years: up to 0.3 mg orally, intramuscularly, subcutaneously or IV once a day.

4 years or older: 0.4 mg orally, intramuscularly, subcutaneously or IV once a day.

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Recommended daily allowance (RDA):

Premature neonates: 50 mcg/day (15 mcg/kg/day).

Full-term neonates and infants 1 to 6 months: 25 to 35 mcg/day.

Children:

1 to 3 years: 150 mcg/day.

4 to 8 years: 200 mcg/day.

9 to 13 years: 300 mcg/day.

14 years and older: 400 mcg/day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Rarely, a dosage of 2 mg/day may be required, particularly in patients with malabsorption, alcoholism, chronic hemolysis, chronic exfoliative skin disease or who are on concomitant anticonvulsant therapy.

Dialysis

Folic acid is removed by both hemodialysis and peritoneal dialysis. The amount removed varies with type equipment used.

Because folate may accumulate in patients with end-stage renal disease, side effects may be more likely in this patient who is undergoing dialysis. Once this patient's body stores of folate are replete, three times a week dosing may be just as beneficial as once daily dosing but should portend a lower risk of side effects.

Other Comments

The recommended daily allowance of folic acid for adult males and females ranges from 150 to 200 and 150 to 180 mcg/day, respectively.

There is a potential danger in administering folic acid to patients with undiagnosed anemia, since folic acid may obscure the diagnosis of pernicious anemia by alleviating the hematologic manifestations of the disease while allowing the neurologic complications to progress.

Severe megaloblastic anemia may require therapy for 4 to 5 weeks. Once stabilized, if dietary intake is inadequate, maintenance therapy can be started.

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Folic acid interactions

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What other drugs will affect Folic acid?

Medications that interfere with your bodys ability to use folate may also increase the need for this vitamin. Medications can interfere with folate utilization, including: anticonvulsant medications (such as phenytoin, and primidone) metformin (sometimes prescribed to control blood sugar in type 2 diabetes) sulfasalazine (used to control inflammation associated with Crohns disease and ulcerative colitis) triamterene (a diuretic) Methotrexate There has been concern about the interaction between vitamin B12 and folic acid. Folic acid supplements can correct the anemia associated with vitamin B12 deficiency. Unfortunately, folic acid will not correct changes in the nervous system that result from vitamin B12 deficiency. Permanent nerve damage could theoretically occur if vitamin B12 deficiency is not treated. Therefore, intake of supplemental folic acid should not exceed 1000 micrograms (g, sometimes mcg) per day to prevent folic acid from masking symptoms of vitamin B12 deficiency. It is important for older adults to be aware of the relationship between folic acid and vitamin B12 because they are at greater risk of having a vitamin B12 deficiency. If you are 50 years of age or older, ask your physician to check your B12 status before you take a supplement that contains folic acid.

Folic acid side effects

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What are the possible side effects of Folic acid?

Allergic sensitization has been reported following both oral and parenteral administration of Folic Acid.

Folic Acid is relatively nontoxic in man. Rare instances of allergic responses to Folic Acid preparations have been reported and have included erythema, skin rash, itching, general malaise, and respiratory difficulty due to bronchospasm. One patient experienced symptoms suggesting anaphylaxis following injection of the drug. Gastrointestinal side effects, including anorexia, nausea, abdominal distention, flatulence, and a bitter or bad taste, have been reported in patients receiving 15 mg Folic Acid daily for 1 month. Other side effects reported in patients receiving 15 mg daily include altered sleep patterns, difficulty in concentrating, irritability, overactivity, excitement, mental depression, confusion, and impaired judgment. Decreased vitamin B12 serum levels may occur in patients receiving prolonged Folic Acid therapy.

In an uncontrolled study, orally administered Folic Acid was reported to increase the incidence of seizures in some epileptic patients receiving phenobarbital, primidone, or diphenylhydantoin. Another investigator reported decreased diphenylhydantoin serum levels in folate-deficient patients receiving diphenylhydantoin who were treated with 5 mg or 15 mg of Folic Acid daily.

CALL YOUR DOCTOR FOR MEDICAL ADVICE ABOUT SIDE EFFECTS. YOU MAY REPORT SIDE EFFECTS TO THE FDA AT 1-800-FDA-1088 OR LEADING PHARMA, LLC AT 844-740-7500.

Folic acid contraindications

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What is the most important information I should know about Folic acid?

Because it may mask the hematologic abnormalities while neurological damage progresses, folic acid should not be used in the therapy of patients with vitamin B12 deficiency of any cause, unless there is associated folate deficiency. The folic acid content of one tablet a day however, is unlikely to mask pernicious anemia should this condition be present. Also, pregnancy during pernicious anemia is very rare.

What is Vitamin B12?

Cyanocobalamin is a man-made form of vitamin B12. Vitamin B12 is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.

Cyanocobalamin is used to treat vitamin B12 deficiency in people with pernicious anemia and other conditions.

Cyanocobalamin may also be used for purposes not listed in this medication guide.

Vitamin B12 indications

Pernicious anemia, both uncomplicated and accompanied by nervous system involvement.

Dietary deficiency of Vitamin B12, occurring in strict vegetarians and in their breast-fed infants. (Isolated vitamin B12 deficiency is very rare).

Malabsorption of vitamin B12, resulting from structural or functional damage to the stomach, where intrinsic factor is secreted or to the ileum, where intrinsic factor facilitates vitamin B12 absorption. These conditions include tropical sprue, and nontropical sprue (idiopathic steatorrhea, gluten-induced enteropathy). Folate deficiency in these patients is usually more severe than vitamin B12 deficiency.

Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy). Total gastrectomy always produces vitamin B12 deficiency.

Structural lesions leading to vitamin B12 deficiency include regional ileitis, ileal resections, malignancies, etc.

Competition for Vitamin B12 by intestinal parasites or bacteria.

The fish tapeworm (Diphyilobothrium latum) absorbs huge quantities of vitamin B12 and infested patients often have associated gastric atrophy. The blind-loop syndrome may produce deficiency of Vitamin B12 or folate.

Inadequate utilization of vitamin B12. This may occur if antimetabolites for the vitamin are employed in the treatment of neoplasia.

For the Schilling Test.

Vitamin B12 description

Vitamin B12 (commonly known as Vitamin B12) is the most chemically complex of all the vitamins. Vitamin B12's structure is based on a corrin ring, which, although similar to the porphyrin ring found in heme, chlorophyll, and cytochrome, has two of the pyrrole rings directly bonded. The central metal ion is Co (cobalt). Vitamin B12 cannot be made by plants or by animals, as the only type of organisms that have the enzymes required for the synthesis of cyanocobalamin are bacteria and archaea. Higher plants do not concentrate cyanocobalamin from the soil and so are a poor source of the substance as compared with animal tissues. Vitamin B12 is naturally found in foods including meat (especially liver and shellfish), eggs, and milk products.

Vitamin B12 dosage

Vitamin B12 is used as injections SC, IV, IM, intralumbar, and also oral. With anemia associated with vitamin B12 deficiency is introduced on 100-200 mcg in 2 days. In anemia with symptoms of funicular myelosis and megalocytic anemia with diseases of the nervous system - 400-500 micrograms in the first 7 days daily, then 1 time every 5-7 days. In the period of remission in the absence of events funicular myelosis maintenance dose - 100 mcg 2 times a month, in the presence of neurological symptoms - at 200-400 mcg 2-4 times a month. In acute post-hemorrhagic anemia and iron anemia by 30-100 mcg 2-3 times a week. When aplastic anemia (especially in children) - 100 micrograms before clinical improvement. When nutritional anemia in infants and preterm - 30 mcg / day during 15 days.

In diseases of the central and peripheral nervous system and neurological diseases with a pain syndrome is administered in increasing doses - 200-500 mcg, with the improvement in the state - 100 mcg / day. The course of treatment with Vitamin B12 is 2 weeks. In traumatic lesions of peripheral nervous system - at 200-400 mcg every other day for 40-45 days.

When hepatitis and cirrhosis - 30-60 mcg / day or 100 mg every other day for 25-40 days.

Dystrophy in young children, Down syndrome and cerebral palsy - by 15-30 mcg every other day.

When funicular myelosis, amyotrophic lateral sclerosis can be introduced into the spinal canal at 15-30 mcg, gradually increasing the dose of 200-250 micrograms.

In radiation sickness, diabetic neuropathy, sprue - by 60-100 mcg daily for 20-30 days.

When deficiency of vitamin B12 to prevent - IV or IM for 1 mg 1 time a month; for treatment - IV or IM for 1 mg daily for 1-2 weeks, the maintenance dose is 1-2 mg IV or IM from 1 per week, up to 1 per month. Duration of treatment is determined individually.

Vitamin B12 interactions

In an application of Vitamin B12 Atlantic Laboratories with hormonal contraceptives for oral administration may decrease the concentration of cyanocobalamin in plasma.

In an application with anticonvulsant drugs decreased cyanocobalamin absorption from the gut.

In an Vitamin B12 Atlantic Laboratories application with neomycin, aminosalicylic acid, colchicine, cimetidine, ranitidine, drugs potassium decreased cyanocobalamin absorption from the gut.

Cyanocobalamin may exacerbate allergic reactions caused by thiamine.

When parenteral application of chloramphenicol may decrease the hematopoietic effects of cyanocobalamin with anemia.

Vitamin B12 side effects

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What are the possible side effects of Vitamin B12?

Applies to cyanocobalamin: intramuscular solution

Other dosage forms:

As well as its needed effects, cyanocobalamin (the active ingredient contained in Vitamin B12) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking cyanocobalamin, check with your doctor or nurse immediately:

Incidence not known:

Minor Side Effects

Some cyanocobalamin side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Incidence not known:

Vitamin B12 contraindications

Hypersensitivity to the components of the formula. History of allergy to the cobalamins (vitamin B12 and similar substances). Malignant tumors. By stimulating the growth of tissues, the Cobamamide could increase the high rate of cell multiplication. Sensitivity to cobalt. History of allergies to cobalamin (vitamin B12 and related substances).

- Malignant tumor: Due to the action of vitamin B12 on the growth of tissue cell multiplication rate high, the risk of exacerbation should be taken into account.

- Children under 6 years because of the dosage form

Active ingredient matches for Ferrous fumarate/folic acid/intrinsic factor/vitamin B12:

Ferrous fumarate/folic acid/intrinsic factor/vitamin B12


References

  1. DailyMed. "ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PHYTONADIONE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN 5'-PHOSPHATE SODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "INTRINSIC FACTOR". https://pubchem.ncbi.nlm.nih.gov/sub... (accessed September 17, 2018).
  3. PubChem. "folic acid". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).

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