Fersolate Cm

Uses

Copper is a transition metal found in a variety of supplements and vitamins, including intravenous solutions for total parenteral nutrition (TPN).

For use in the supplementation of total parenteral nutrition and in contraception with intrauterine devices .

Ferrous Sulfate is used for the treatment and prevention of iron deficiency anaemia and anaemia of pregnancy where routine administration of iron is necessary.

Manganese is a transition metal used for supplementation of manganese during Total Parenteral Nutrition (TPN).

Indicated for use as a supplement to intravenous solutions given for Total Parenteral Nutrition (TPN). Administration helps to maintain plasma levels and to prevent depletion of endogenous stores and subsequent deficiency symptoms.

Fersolate Cm is also used to associated treatment for these conditions: Emergency Contraception, IUD, Trace Element Deficiency, Dietary supplementationMineral supplementation, Total parenteral nutrition therapy, Vitamin supplementation, Dietary supplementation

How Fersolate Cm works

Copper is absorbed from the gut via high affinity copper uptake protein and likely through low affinity copper uptake protein and natural resistance-associated macrophage protein-2 . It is believed that copper is reduced to the Cu1+ form prior to transport. Once inside the enterocyte, it is bound to copper transport protein ATOX1 which shuttles the ion to copper transporting ATPase-1 on the golgi membrane which take up copper into the golgi apparatus. Once copper has been secreted by enterocytes into the systemic circulation it remain largely bound by ceruloplasmin (65-90%), albumin (18%), and alpha 2-macroglobulin (12%).

Copper is an essential element in the body and is incorporated into many oxidase enzymes as a cofactor . It is also a component of zinc/copper super oxide dismutase, giving it an anti-oxidant role. Copper defiency occurs in Occipital Horn Syndrome and Menke's disease both of which are associated with impaired development of connective tissue due to the lack of copper to act as a cofactor in protein-lysine-6-oxidase. Menke's disease is also associated with progressive neurological impairment leading to death in infancy. The precise mechanisms of the effects of copper deficiency are vague due to the wide range of enzymes which use the ion as a cofactor.

Copper appears to reduce the viabilty and motility of spermatozoa . This reduces the likelihood of fertilization with a copper IUD, producing copper's contraceptive effect . The exact mechanism of copper's effect on sperm are unknown.

Dosage

Fersolate Cm dosage

Adult-

• Initial therapeutic dose: 3-4½ teaspoonful daily in divided doses or as prescribed by the physician.
• Maintenance dose: 1½ teaspoonful daily, but if needed up to 1.8g (9 teaspoonful) daily can be given.

Children-

• Under 1 year: ¼ th teaspoonful thrice daily or as directed by physician
• 1-5 years: 1 teaspoonful thrice daily
• 6-12 years: 1½ teaspoonful twice daily.

Should be taken on an empty stomach. Best taken on an empty stomach. May be taken with meals to reduce GI discomfort. Mix with water or fruit juice to avoid temporary staining of teeth. Do not mix with milk.

Side Effects

GI irritation, abdominal pain and cramps, nausea, vomiting, constipation, diarrhoea, dark stool and discoloration of urine; heartburn.

Toxicity

Copper toxicity is belevied to be due to fenton-type redox reactions occuring with high copper concentrations which produce damaging reactive oxygen species .

Precaution

Should be administered with caution when given to patients with iron storage or iron absorption disease, haemoglobinopathies or existing gastrointestinal disease.

Interaction

Absorption of iron salt and Tetracycline is diminished when taken concomitantly by mouth. If treatment with both drugs is required iron salt should be given 3 hours before or 2 hours after Tetracycline. Absorption of iron is also decreased in the presence of antacids or when taken with tea.

Elimination Route

Copper absorption varies inversely with intake. Absorption range is 12-65%.

Elimination Route

Copper appears to be eliminated primarily through bile .

Pregnancy & Breastfeeding use

Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.

Contraindication

Iron therapy is contraindicated in haemachromatosis and haemosiderosis.It should not be given to patients receiving repeated blood transfusion or with anaemia not produced by iron deficiency.

Acute Overdose

Symptoms: Nausea, vomiting, abdominal pain, diarrhoea of green or tarry stools, haematemesis, seizures, drowsiness, metabolic acidosis, hepatic dysfunction, renal failure, coma.

Treatment: Empty stomach contents by gastric lavage. In severe toxicity, IV desferrioxamine may be given. Treatment is supportive. Haemodialysis is unlikely to be useful.

Innovators Monograph

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