NONPYROGENIC ACETATE HEMODIALYSIS CONCENTRATE F1 (3-001-010) Price

Overview

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This medicine contains an important and useful components, as it consists of
Acetate, Calcium, Chloride, Glucose, Magnesium, Sodiumis available in the market in concentration

Name

Elemental Iron (carbonyl iron) + Folic Acid

Precaution

The combination of **elemental iron (carbonyl iron)** and **folic acid** is used to prevent or treat **iron deficiency anemia** and **folate deficiency**. This combination should be used with caution in certain populations, particularly those with a **history of gastrointestinal disorders**, such as **peptic ulcers** or **inflammatory bowel disease**, as iron supplements can irritate the gastrointestinal tract. Patients with **hemochromatosis** or other conditions resulting in iron overload should avoid this combination, as excess iron can accumulate and lead to **organ damage**. In pregnant women, **folic acid** is crucial for fetal development, especially during the early stages of pregnancy. The recommended daily intake of folic acid during pregnancy is typically **400-800 mcg** to prevent neural tube defects. However, **iron supplementation** may be required if the woman is found to have low iron levels, and this combination is often used during pregnancy. Pregnant women should use this combination under the guidance of a healthcare provider, as excessive iron intake can lead to complications, such as **constipation** or **iron toxicity**. Patients with **renal impairment** or **chronic kidney disease** should be monitored closely while using this combination, as they may require dose adjustments, particularly with iron. **Geriatric patients** are also at an increased risk for **iron overload**, and extra caution should be exercised when prescribing iron supplements to older adults.

Indication

The combination of **elemental iron (carbonyl iron)** and **folic acid** is primarily indicated for the treatment of **iron deficiency anemia** and **megaloblastic anemia** due to **folate deficiency**. It is commonly used in cases of **anemia** during **pregnancy**, where both **iron** and **folic acid** are critical for **maternal health** and **fetal development**. Iron is essential for hemoglobin production, while folic acid is necessary for the synthesis of red blood cells and the prevention of **neural tube defects** in the fetus. The combination can also be used in patients with **iron deficiency** resulting from **poor diet**, **chronic blood loss** (such as from **gastrointestinal bleeding** or heavy menstrual periods), or **increased iron demand**, such as in **athletes** or those recovering from surgery. Additionally, **iron and folic acid supplementation** may be prescribed for individuals with **malabsorption syndromes** or who have undergone **gastric bypass surgery**, where nutrient absorption is compromised. Off-label uses may include the management of **anemia** in patients with **chronic disease**, particularly in those with **chronic kidney disease** or **heart failure**, where anemia is a common complication.

Contra indication

The combination of **elemental iron (carbonyl iron)** and **folic acid** is contraindicated in patients with a known **hypersensitivity** to any of its components. **Iron overload conditions**, such as **hemochromatosis** or **thalassemia**, are contraindications for the use of this combination, as excess iron can cause severe **organ damage**, particularly to the **liver**, **heart**, and **pancreas**. The use of iron supplements is also contraindicated in **anemia** of **non-iron-deficiency** origin, such as **hemolytic anemia** or **sickle cell disease**, where iron supplementation would not address the underlying cause and could potentially lead to **iron toxicity**. Patients with **peptic ulcers**, **gastritis**, or other active **gastrointestinal disorders** should avoid this combination unless recommended by a healthcare provider, as **iron supplementation** may exacerbate gastrointestinal irritation. **Folic acid** supplementation should be used cautiously in patients with **vitamin B12 deficiency**, as high folate levels can mask the symptoms of a **B12 deficiency**, leading to potential neurological damage if left untreated.

Side Effect

Common side effects of **iron (carbonyl iron)** and **folic acid** include **gastrointestinal disturbances** such as **nausea**, **constipation**, **diarrhea**, and **stomach discomfort**. Iron supplementation is also associated with **dark stools**, which is harmless but can be alarming for patients. More serious side effects may include **iron toxicity**, especially in children, which can lead to symptoms such as **abdominal pain**, **vomiting**, and **diarrhea**. In severe cases, iron toxicity can cause **organ damage**. The risk of **iron toxicity** can be minimized by ensuring the drug is kept out of reach of children. Excessive doses of folic acid (greater than **1 mg/day**) may cause **sleep disturbances**, **irritability**, and **nervousness**. Additionally, high doses of folic acid can **mask the symptoms** of **vitamin B12 deficiency**, leading to undiagnosed nerve damage.

Pregnancy Category ID

0

Mode of Action

The combination of **carbonyl iron** and **folic acid** works synergistically to address deficiencies in both **iron** and **folate**, which are essential nutrients for the production of **red blood cells** and the maintenance of **hematopoiesis** (the formation of blood cells). - **Iron** is necessary for the synthesis of **hemoglobin**, the protein in red blood cells that carries oxygen throughout the body. Iron is incorporated into the **heme group** of hemoglobin, and insufficient iron levels result in **anemia**. - **Folic acid** is involved in the synthesis of **DNA** and **RNA** and is essential for **cell division** and the **formation of red blood cells** in the **bone marrow**. Folate deficiency leads to **megaloblastic anemia**, where the red blood cells are larger than normal and immature, leading to ineffective oxygen transport.

Interaction

Several drug interactions may affect the efficacy or safety of **elemental iron (carbonyl iron)** and **folic acid**. 1. **Iron absorption** can be impaired by the presence of **antacids**, **calcium supplements**, **phosphate binders**, and **tetracycline antibiotics**, which should not be taken within 2 hours of taking iron supplements. 2. **Iron** can reduce the absorption of **levothyroxine**, a medication used for **hypothyroidism**. It is advised to separate the administration of these drugs by at least 4 hours. 3. **Folic acid** may reduce the effectiveness of **methotrexate** (a medication used to treat **cancer** and **autoimmune diseases**) by competing for the same metabolic pathways. Patients on methotrexate therapy should monitor folate intake. 4. **Iron** and **folic acid** can interfere with the effectiveness of **some antibiotics** (such as **quinolone antibiotics**), as they can bind to the medication, reducing its absorption. 5. **Alcohol** can interfere with iron absorption and contribute to **iron deficiency anemia**, so alcohol consumption should be limited during therapy.

Pregnancy Category Note

Information not available

Adult Dose

The typical adult dose for **iron and folic acid** supplementation is **one tablet daily**, although the specific dose may vary depending on the formulation and the severity of the deficiency. **Iron (carbonyl iron)** is generally administered at **50-100 mg/day**, while **folic acid** is often provided at **400 mcg/day** for general supplementation or higher doses for therapeutic purposes (e.g., **1 mg/day** for folate deficiency).

Child Dose

For children, the dosage of **elemental iron (carbonyl iron)** and **folic acid** varies based on age and the severity of the deficiency. For infants and young children, iron is typically dosed at **1–3 mg/kg/day**, and **folic acid** may be given at **50–400 mcg/day**, depending on the clinical condition. In summary, **elemental iron (carbonyl iron)** combined with **folic acid** is an effective treatment for **iron deficiency anemia** and **folate deficiency**. It should be used with care in populations at risk of **iron overload** and in individuals with underlying gastrointestinal or **liver disease**. Regular monitoring of **iron levels**, **liver function**, and **red blood cell indices** is essential for optimal therapy.

Renal Dose

In patients with **renal impairment**, no specific dose adjustment for **folic acid** is required, as it is **water-soluble** and excreted through the urine. However, for **iron supplements**, caution should be exercised in individuals with **severe kidney disease**, as iron overload can lead to **organ toxicity**, particularly in patients with **end-stage renal disease**.

Administration

Information not available