iron/folic acid/vitamin/mineral

Iron/folic acid/vitamin/mineral is a combination of micronutrients such as multivitamins, iron and minerals used to supplement natural deficiency in adults. Iron/folic acid/vitamin/mineral is used in the treatment of iron deficiency anemia that is responsive to oral iron therapy and for folic acid supplementation in patients on kidney dialysis. Iron/folic acid/vitamin/mineral oral tablets contain iron, B group of vitamins including B9 (folic acid) and B12 (cobalamin), and minerals such as calcium and sodium.

Iron is an important component of hemoglobin, the protein in red blood cells that delivers oxygen to all the tissues, and myoglobin, the muscle protein that stores oxygen and releases it to the muscle cells when oxygen saturation drops. In addition to oxygen transport and storage, iron is essential for many cellular processes, synthesis of enzymes and hormones, DNA synthesis and repair, electron transport and energy metabolism.

Folic acid is the synthetic form of folate, the natural vitamin B9 present in foods, and is commonly used in supplements. Folate is a water-soluble vitamin crucial for many cellular functions including metabolism of amino acids, DNA and RNA synthesis, and the synthesis and growth of all cells, particularly, red blood cells.

Vitamin B12 is another micronutrient essential for normal cell reproduction, red blood cell formation, DNA synthesis, and synthesis of myelin, a substance that forms a protective sheath over nerve fibers enabling normal transmission of nerve signals. Intrinsic factor, a glycoprotein secreted by the gastric mucous layer, is required for active absorption of vitamin B12 from the gastrointestinal tract.

Iron/folic acid/vitamin/mineral supplementation is used to treat:

• Iron deficiency anemia that responds to oral iron therapy, including:
  • Hypochromic anemia associated with pregnancy
  • Chronic and/or acute blood loss
  • Metabolic disease
  • Post-surgical recovery
  • Dietary needs
• Nutrient supplement for patients on kidney dialysis

• Do not take iron/folic acid/vitamin/mineral if you are hypersensitive to any of its components.
• Do not administer iron/folic acid/vitamin/mineral to anyone below age 18.
• The type of anemia and the underlying cause or causes should be determined before initiating supplementation with iron/folic acid/vitamin/mineral. The underlying cause must be treated, if possible.
• The iron/folic acid/vitamin/mineral treatment regimen contains succinic acid, an alpha, omega acid. Ingestion of more than 3 g of omega fatty acids per day can have anticlotting effects and increase bleeding time and international normalized ratio (INR).
  • Avoid concurrent use with anticoagulants, it can increase the risk of bleeding.
  • Avoid use in patients with bleeding disorders.
• Do not use iron therapy in patients with hemochromatosis or hemosiderosis, disorders that cause iron buildup in the body.
• Folic acid must not be used as a monotherapy for megaloblastic or pernicious anemia if the individual also has vitamin B12 deficiency.
• Doses of folic acid higher than 0.1 mg/day may mask B12 deficiency pernicious anemia while irreversible nerve damage continues to progress.
• Some formulations contain formate which can cause visual impairment and other adverse effects, with ingestion of higher than recommended doses. Adhere to your prescribed dosage.

Common side effects of iron/folic acid/vitamin/mineral include:

• Hypersensitivity
• Allergic sensitization
• Nausea
• Vomiting
• Abdominal pain
• Diarrhea
• Dark stools
• Constipation

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Irospan 24/6 tablet

• Regimen consists of 24 tablets of iron, vitamins, and minerals PLUS 6 tablets of succinic acid with vitamins and minerals
• Iron/multivitamin/mineral tablet (days 1-24): sodium ascorbate 100 mg, calcium formate 155 mg, thiamine 5 mg, riboflavin 5 mg, niacin 25 mg, pyridoxine 30 mg, folic acid 1 mg, biotin 300 mcg, calcium pantothenate 300 mcg, ferrous bisglycinate 65 mg, iron dextran 65 mg
• Succinic acid/multivitamin/mineral tablet (days 25-30): sodium ascorbate 100 mg, calcium carbonate 100 mg, thiamine 5 mg, riboflavin 5 mg, niacin 25 mg, pyridoxine 30 mg, folic acid 1 mg, cyanocobalamin 10 mcg, biotin 300 mcg, calcium pantothenate 7 mg, succinic acid 150 mg

Nephron FA

• Tablet: iron (ferrous cation) 66 mg, ascorbic acid 40 mg, niacinamide 20 mg, pyridoxine 10 mg, pantothenic acid 10 mg, riboflavin 1.7 mg, thiamine 1.5 mg, folic acid 1 mg, biotin 0.3 mg, and cobalamin 0.006 mg

Corvite FE

• Tablet: calcium ascorbate 160 mg, calcium threonate 5 mg, ferrous carbonyl (elemental iron) 150 mg, cholecalciferol 1000 IU, pyridoxine 10 mg, folic acid 1 mg, cyanocobalamin 15 mcg, magnesium malate 15 mg, and zinc glycinate 25 mg

Adult:

Iron Deficiency Anemia

• Indicated for the treatment of anemias that are responsive to oral iron therapy, including hypochromic anemia associated with pregnancy, chronic and/or acute blood loss, metabolic disease, post-surgical convalescence, and bleeding diathesis
• Irospan 24/6: 1 iron/multivitamin/mineral tablet orally once daily on days 1-24, and then 1 succinic acid/multivitamin/mineral tablet orally once daily on days 25-30; repeat cycle
• Corvite FE: 1 tablet orally once daily

Kidney Dialysis Supplement

• Indicated for folic acid supplementation for patients on kidney dialysis
• Nephron FA: 1 tablet orally once daily on empty stomach

Pediatric:

• Safety and efficacy not established

Overdose

• The initial symptoms of acute iron overdose may include abdominal pain, nausea, vomiting, diarrhea, tarry stools (melena), blood in vomit (hematemesis), low blood pressure (hypotension), rapid heart rate (tachycardia), excessive acidity of body fluids (metabolic acidosis), high blood sugar (hyperglycemia), dehydration, drowsiness, pallor, bluish skin (cyanosis), lassitude, seizures, shock, and coma.
• Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children younger than 6 years of age.
• Iron/folic acid/vitamin/mineral overdose may be treated with symptomatic and supportive care as required.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Iron/folic acid/vitamin/mineral has no known severe interactions with other drugs.
• Serious interactions of iron/folic acid/vitamin/mineral include:
  • pafolacianine
• Moderate interactions of iron/folic acid/vitamin/mineral include:
  • omadacycline
  • sarecycline
• Iron/folic acid/vitamin/mineral has no known mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Deficiency of micronutrients is common in pregnant and breastfeeding women, because they have a higher requirement of nutrients, which may be difficult to meet with diet alone.
• Supplementation of nutrients is recommended in women before conception, during pregnancy and in lactating mothers for maintaining good health of the mother and the fetus/baby. 
• Obtaining the necessary micronutrients from dietary sources remains the most preferred method. Iron/folic acid/vitamin/mineral is recommended for use in pregnant and breastfeeding women to prevent iron, folic acid and other micronutrient deficiencies, and reduce the risk of maternal anemia and low birth weight in the newborn.
• Pregnant and breastfeeding women should take micronutrient supplements after consulting with their healthcare providers on the right product for their individual needs.

• Take iron/folic acid/vitamin/mineral exactly as directed. Do not exceed recommended dosages.
• If you are taking any other medications, consult with your physician before taking iron/folic acid/vitamin/mineral.
• Discontinue use and consult with your physician if you experience any adverse effects.
• Store iron/folic acid/vitamin/mineral safely out of reach of children. Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children below 6 years of age.
• In case of overdose, seek immediate medical help or contact Poison Control.