Usage
This combination medication is primarily prescribed for the treatment and prevention of nutritional deficiencies, especially iron-deficiency anemia. It is also used to address deficiencies in vitamin B12, folic acid, and zinc. Specific conditions it is used for include:
- Iron deficiency anemia
- Vitamin B12 deficiency anemia
- Folic acid deficiency anemia
- Zinc deficiency
- Prevention of neural tube defects in developing fetuses
- Anemia associated with chronic blood loss, poor diet, malabsorption syndromes (e.g., celiac disease, inflammatory bowel disease)
Pharmacological Classification: Hematinic, Nutritional Supplement
Mechanism of Action: This combination works by replenishing deficient nutrients essential for various physiological processes.
- Sodium Feredetate: Provides a readily absorbable source of iron, crucial for hemoglobin synthesis and oxygen transport.
- Folic Acid: Essential for DNA synthesis, red blood cell formation, and cell division. It is converted to tetrahydrofolic acid, a coenzyme necessary for nucleic acid synthesis and amino acid metabolism.
- Vitamin B12 (Cyanocobalamin): Essential for red blood cell formation, DNA synthesis, and nerve function. It is converted into its active forms, methylcobalamin and adenosylcobalamin, which are involved in various metabolic pathways.
- Zinc Sulphate Monohydrate: Essential for immune function, cell growth, wound healing, and numerous enzymatic reactions.
Alternate Names
While the generic name is Folic Acid + Sodium Feredetate + Vitamin B12 + Zinc Sulphate Monohydrate, some alternate names and brand names include:
- Cobalfer
- Solfe
- Solfe Extra
- Ferisan
- Feranid
- Lycofer
- Fersure
- Aferite
How It Works
Pharmacodynamics: The combined effects of these nutrients result in improved red blood cell production, enhanced oxygen-carrying capacity, improved nerve function, and better overall cellular health.
Pharmacokinetics:
- Absorption: Iron from Sodium Feredetate is absorbed in the duodenum and jejunum. Folic acid is absorbed primarily in the jejunum. Vitamin B12 absorption requires intrinsic factor and occurs in the ileum. Zinc is absorbed in the small intestine.
- Metabolism: Folic acid is converted to tetrahydrofolic acid in the liver. Vitamin B12 is converted to its active forms.
- Elimination: Iron is primarily lost through shedding of cells. Excess folic acid is excreted in urine. Vitamin B12 is stored in the liver and slowly eliminated. Zinc is primarily excreted in feces.
Dosage
Standard Dosage
Adults: 1-2 capsules or tablets per day or as prescribed by the physician.
Children: One capsule or tablet daily for children over 12 years. For children under 12, dosage must be determined by a physician considering age and weight.
Special Cases:
- Elderly Patients: Similar to adult dosage unless there is renal or hepatic impairment.
- Patients with Renal Impairment: Dosage adjustment may be necessary.
- Patients with Hepatic Dysfunction: Use with caution and monitor liver function. Dosage adjustment may be necessary.
- Patients with Comorbid Conditions: Individualized dosing is needed, especially for patients with heart, liver, or kidney diseases, or iron overload disorders.
Clinical Use Cases
This combination is typically not used in acute medical settings such as intubation, surgical procedures, mechanical ventilation, ICU, or emergencies. It’s meant for managing chronic deficiencies.
Dosage Adjustments
Adjustments might be necessary based on patient-specific factors like renal/hepatic function, other medical conditions, and concomitant medications. Always refer to the most up-to-date clinical guidelines.
Side Effects
Common Side Effects:
- Nausea
- Constipation
- Diarrhea
- Stomach upset
- Dark stools
Rare but Serious Side Effects:
- Allergic reactions (rash, itching, difficulty breathing)
Long-Term Effects: Generally, this combination is safe for long-term use when taken as directed. However, monitoring of iron levels is recommended to prevent iron overload.
Contraindications
- Hypersensitivity to any component of the medication.
- Iron overload disorders (hemochromatosis, hemosiderosis).
- Undiagnosed megaloblastic anemia.
Drug Interactions
This combination may interact with:
- Antacids (aluminum hydroxide, ranitidine, omeprazole)
- Antibiotics (tetracycline, chloramphenicol)
- Anticonvulsants (phenytoin, carbamazepine)
- Levodopa
- Penicillamine
- Quinolone antibiotics (ciprofloxacin, levofloxacin)
- Thyroid medications (levothyroxine)
- Alcohol
- Dairy products
- Eggs
Pregnancy and Breastfeeding
Consult a physician before use during pregnancy or breastfeeding. While generally considered safe, the dosage may need to be adjusted. Folic acid is crucial during pregnancy for preventing neural tube defects.
Drug Profile Summary
- Mechanism of Action: Replenishes iron, vitamin B12, folic acid, and zinc, essential for red blood cell production, DNA synthesis, nerve function, and immune function.
- Side Effects: Nausea, constipation, diarrhea, stomach upset, dark stools. Rarely, allergic reactions.
- Contraindications: Hypersensitivity, iron overload, undiagnosed megaloblastic anemia.
- Drug Interactions: Antacids, antibiotics, anticonvulsants, levodopa, and others.
- Pregnancy & Breastfeeding: Consult a physician before use.
- Dosage: Adults: 1-2 capsules/tablets daily. Children (over 12): 1 capsule/tablet daily.
- Monitoring Parameters: Hemoglobin, iron levels, vitamin B12 levels, folate levels, zinc levels.
Popular Combinations
It is often prescribed as a standalone supplement. Sometimes, other vitamins and minerals may be added depending on the patient’s needs.
Precautions
- Pre-existing medical conditions (kidney/liver disease, gastrointestinal conditions): Consult a doctor before use.
- Alcohol consumption should be limited as it can affect iron absorption.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Folic Acid + Sodium Feredetate + Vitamin B12 + Zinc Sulphate Monohydrate?
A: Adults: 1-2 capsules/tablets daily. Children (over 12): 1 capsule/tablet daily. Consult a physician for pediatric dosing below 12 years of age.
Q2: What are the common side effects?
A: Nausea, constipation, diarrhea, stomach upset, and dark stools are common side effects.
Q3: Can I take this medication during pregnancy?
A: Consult your doctor before taking this medication during pregnancy.
Q4: Are there any drug interactions I should be aware of?
A: Yes, this combination may interact with antacids, antibiotics, anticonvulsants, levodopa, and others. Consult your physician about potential interactions with your current medications.
Q5: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and take your next dose at the regular time. Do not double the dose.
Q6: Can this medication be taken on an empty stomach?
A: It is generally recommended to take this medication with food to minimize gastrointestinal upset.
Q7: How should this medication be stored?
A: Store at room temperature away from light and moisture.
Q8: What are the signs of an allergic reaction to this medication?
A: Signs of an allergic reaction may include rash, itching, swelling, dizziness, or difficulty breathing. Seek immediate medical attention if you experience any of these symptoms.
Q9: How does alcohol interact with this medication?
A: Alcohol may affect iron absorption and should be avoided or limited while taking this medication. Consult your physician for specific recommendations.
Q10: Can this combination treat all types of anemia?
A: No. This combination primarily targets iron-deficiency anemia, vitamin B12 deficiency anemia, and folic acid deficiency anemia. Other types of anemia require different treatment approaches. Consult a doctor for diagnosis and appropriate management.
