Indications

– For iron– deficiency anemia (due to inadequate intake or iron depletion).
– Iron and Folic acid supplement in conditions with increased blood formation requirements such as: malnutrition, convalescence, postoperative period, pregnant women, puerperal women (nursing or not). Blood loss due to trauma, accident,…

Present

Blister of 25 film– coated tablets. Box of 4 blisters.

Composition

Ferrous fumarate …………………………………………..200mg
(equivalent to elemental iron …………………………..65mg)
Folic acid …………………………………………………………1mg
Excipients s.q. for…………………………………………1 tablet
(Corn starch, Povidone, Sodium starch glycolate, Magnesium stearate, Hypromellose, Titanium dioxide, Polyethylene glycol 6000, Talc, Brown HT, Black Ferric oxide, Ethanol 96%).

Pharmacology

– Ferrous fumarate is an organic iron compound with high elemental iron content. Iron is an essential component in organism tissues and is essential in heme complex necessary for oxygenation of living tissues.
– Folic acid is an essential factor for nucleoprotein synthesis and normal hemopoiesis.
Iron and Folic acid combination for treatment of anemia in pregnancy is more effective than use of monotherapy.

Pharmacokinetics

– Normally, iron is absorbed in duodenum and proximal jejunum of about 5 – 10% of the oral intake by active transport mechanism. This ratio can be increased to 20 – 30% if the iron reserve in the body is depleted or when there is an increase in erythrocyte production. Iron is transported in blood plasma in bound form of transferrin to the interstitial fluid, tissues, especially parenchymal tissue in the liver and stored there as Ferritin. Iron is eliminated mainly via alimentary tract.
– Folic acid is absorbed mainly at proximal small intestine, it is distributed widely in body tissues, it is stored mainly in the liver and actively concentrated in cerebrospinal fluid. Folic acid is eliminated via urine.

Contra-Indications

– Hypersensitivity to Ferrous fumarate.
– Hemochromatosis.
– Liver siderosis.
– Hemolytic anemia.
– Pernicious anemia.

Side effect

– Occasional side– effects: GI disturbances (nausea, epigastric pain, constipation, diarrhea).
– Dark stool may be noticed.
These side– effects may be ameliorated by taking the medication during meal and increasing slowly to the target dose.
Inform your doctor about side– effects when using this medicine.

Precaution

– Prolonged use should be avoided in patients with normal levels of iron in blood.
– Discontinue medication if intolerance occurs.

Interaction

– Antacids, tea, coffee, egg, milk decrease iron absorption if taken together.
– MEKOFERRAT– B9 can reduce absorption of Penicillamine, Tetracyclines.
– MEKOFERRAT– B9 can reduce concentration of Quinolones in plasma and urine.
– Oral contraceptive agents can reduce metabolized Folate.
OVERDOSAGE:
– The symptoms of iron salt overdosage include: acute GI irritation and erosion, nausea, vomiting, pallor, cyanosis, diarrhea, dehydration and shock.
– Treatment is initiated as soon as possible by gastric lavage with Sodium bicarbonate 1% solution or chelating agent, the most effective is Deferoxamine. For shock, dehydration and acid– base balance disturbance, carry out conventional supportive management.

Shelf life

24 months from the manufacturing date.

Storage

Store in a dry place (RH ≤ 70%), not exceeding 30^oC. Protect from light.

Dosage

– Treatment for iron– deficiency anemia:
+ Adults: 2 – 3 tablets daily.
+ Children: 1 – 2 tablets daily.
– Iron and Folic acid supplement: 1 tablet daily.