Iferra

Iferra Uses, Dosage, Side Effects, Food Interaction and all others data.

Folic acid is essential for the production of certain coenzymes in many metabolic systems such as purine and pyrimidine synthesis. It is also essential in the synthesis and maintenance of nucleoprotein in erythropoesis. It also promotes WBC and platelet production in folate-deficiency anaemia.

Folic acid is a water-soluble B-complex vitamin found in foods such as liver, kidney, yeast, and leafy, green vegetables. Also known as folate or Vitamin B9, folic acid is an essential cofactor for enzymes involved in DNA and RNA synthesis. More specifically, folic acid is required by the body for the synthesis of purines, pyrimidines, and methionine before incorporation into DNA or protein. Folic acid is the precursor of tetrahydrofolic acid, which is involved as a cofactor for transformylation reactions in the biosynthesis of purines and thymidylates of nucleic acids. Impairment of thymidylate synthesis in patients with folic acid deficiency is thought to account for the defective deoxyribonucleic acid (DNA) synthesis that leads to megaloblast formation and megaloblastic and macrocytic anemias. Folic acid is particularly important during phases of rapid cell division, such as infancy, pregnancy, and erythropoiesis, and plays a protective factor in the development of cancer. As humans are unable to synthesize folic acid endogenously, diet and supplementation is necessary to prevent deficiencies. In order to function properly within the body, folic acid must first be reduced by the enzyme dihydrofolate reductase (DHFR) into the cofactors dihydrofolate (DHF) and tetrahydrofolate (THF). This important pathway, which is required for de novo synthesis of nucleic acids and amino acids, is disrupted by anti-metabolite therapies such as Methotrexate as they function as DHFR inhibitors to prevent DNA synthesis in rapidly dividing cells, and therefore prevent the formation of DHF and THF.

In general, folate serum levels below 5 ng/mL indicate folate deficiency, and levels below 2 ng/mL usually result in megaloblastic anemia.

Mecobalamin is the neurologically active form of vitamin B12 and occurs as a water-soluble vitamin in the body. It is a cofactor in the enzyme methionine synthase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine. In anaemia, it increases erythrocyte production by promoting nucleic acid synthesis in the bone marrow and by promoting maturation and division of erythrocytes.

Zinc is an essential trace mineral, which means that it must be obtained from the diet since the body cannot make enough. Next to iron, zinc is the most abundant trace mineral in the body. Stored primarily in muscle, zinc is also found in high concentrations in red and white blood cells, the retina of the eye, bones, skin, kidneys, liver, and pancreas. Some of the symptoms of zinc deficiency include loss of appetite, poor growth, weight loss, impaired taste or smell, poor wound healing, skin abnormalities (such as acne, atopic dermatitis and psoriasis), hair loss, night blindness, hypogonadism and delayed sexual maturation, white spots on the fingernails and feelings of depression.

Iferra
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Iferra
Generic	Ferrous Ascorbate (Iron) + Folic Acid + Zinc Sulfate Monohydrate + Mecobalamin + Zinc Sulphate Monohydrate
Weight	100mg
Type	Tablet
Therapeutic Class
Manufacturer	Alexa Life Sciences
Available Country	India
Last Updated:	September 19, 2023 at 7:00 am

Uses

Prophylaxis of megaloblastic anaemia in pregnancy, Supplement for women of child-bearing potential, Folate-deficient megaloblastic anaemia, Prophylaxis of neural tube defect in pregnancy

Mecobalamin is used for-

Peripheral Neuropathies
Diabetic Neuropathy
Verteberal Syndrome
Nerve Compression Syndrome
Multiple sclerosis
Amyotrophic lateral sclerosis
Parkinson’s disease
Alzheimer’s disease
Diabetic retinopathy
Entrapment neuropathy
Drug induced neuropathy
Megaloblastic anemia due to Vitamin B12 deficiency

Zinc Sulphate is used for Recurrent Respiratory Tract Infections; Diarrhoea; Loss of appetite; Severe growth retardation; Deformed bone formation; Impaired immunological response; Acrodermatitis enteropathica; Parakeratatic skin lesions; Defective and delayed wound healing; Anaemia; Night blindness; Mental disturbances

Iferra is also used to associated treatment for these conditions: Anaemia folate deficiency, Folate deficiency, Iron Deficiency (ID), Iron Deficiency Anemia (IDA), Latent Iron Deficiency, Neural Tube Defects (NTDs), Vitamin Deficiency, Methotrexate toxicity, Nutritional supplementationVitamin B12 Deficiency, Nutritional supplementation

How Iferra works

Folic acid, as it is biochemically inactive, is converted to tetrahydrofolic acid and methyltetrahydrofolate by dihydrofolate reductase (DHFR). These folic acid congeners are transported across cells by receptor-mediated endocytosis where they are needed to maintain normal erythropoiesis, synthesize purine and thymidylate nucleic acids, interconvert amino acids, methylate tRNA, and generate and use formate. Using vitamin B12 as a cofactor, folic acid can normalize high homocysteine levels by remethylation of homocysteine to methionine via methionine synthetase.

Dosage

Iferra dosage

Supplement for women of child-bearing potential: 0.4 mg daily.

Folate-deficient megaloblastic anaemia: 5 mg daily for 4 mth, up to 15 mg daily in malabsorption states. Continued dosing at 5 mg every 1-7 days may be needed in chronic haemolytic states, depending on the diet and rate of haemolysis.

Prophylaxis of neural tube defect in pregnancy: 4 or 5 mg daily starting before pregnancy and continued through the 1st trimester.

Prophylaxis of megaloblastic anaemia in pregnancy: 0.2-0.5 mg daily.

Tablet: The usual adult dosage is one 500 mcg tablet three times daily. The dosage should be adjusted according to the age of patient and the severity of symptoms.

Injection:

Peripheral neuropathies: The usual adult dosage is one ampoule equivalent to 500 mcg of Mecobalamin, administered intramuscularly or intravenously three times a week.The dosage should be adjusted according to the age of patient and the severity of symptoms.
Megaloblastic anemia: The usual adult dosage is one ampoule equivalent to 500 mcg of Mecobalamin, administered intramuscularly or intravenously three times a week. After about two months of administration, dosage should be changed to one ampoule equivalent to 500 mcg of Mecobalamin every one to three months as maintenance therapy

Syrup-

Children under 10 kg: One teaspoonful 2 times daily.
Children within 10 to 30 kg: Two teaspoonful 1-3 times daily.
Adults and children over 30 kg body weight: Four teaspoonful 1-3 times daily.

Tablet-In the treatment of Diarrhoea Zinc should be given as soon as diarrhoea starts:

For infants between 2 to 6 months of age: 10 mg Zinc once daily for 10-14 days.
For children between 6 months to 5 years of age: 20 mg Zinc once daily for 10-14 days.

For other indications:

The recommended dose for children: 2 to 2.5 mg/kg/day.
Children under 10 kg: 10 mg Zinc 2 times daily.
Children within 10 to 30 kg: 20 mg Zinc 1-3 times daily.
Adults and children over 30 kg body weight: 40 mg Zinc 1-3 times daily.

May be taken with or without food.

Dispersible Tablet-

Place the tablet in a teaspoon
Add adequate amount of water
Let the tablet dissolve completely
Give the entire spoonful solution

Side Effects

GI disturbances, hypersensitivity reactions; bronchospasm.

Generally Mecobalamin is well tolerated. However, a few side effects like GI discomfort (including anorexia, nausea or diarrhea) & rash may be seen after administration of Mecobalamin.

In case of zinc mild side effects such as gastric ulcer, nausea, vomiting, metallic taste, headache, drowsiness have been observed.

Toxicity

IPR-MUS LD₅₀ 85 mg/kg,IVN-GPG LD₅₀ 120 mg/kg, IVN-MUS LD₅₀ 239 mg/kg, IVN-RAT LD₅₀ 500 mg/kg, IVN-RBT LD₅₀ 410 mg/kg

Precaution

Treatment resistance may occur in patients with depressed haematopoiesis, alcoholism, deficiencies of other vitamins. Neonates.

The medicine should not be used for months if there is no response at all after its use for a certain period of time.

Concurrent administration of Zinc salt with penicillamine might diminish the effect of Penicillamine. The absorption of Zinc, although poor, may be decreased by various compounds including some foods. Chelation may occur with tetracyclines.

Interaction

Antiepileptics, oral contraceptives, anti-TB drugs, alcohol, aminopterin, methotrexate, pyrimethamine, trimethoprim and sulphonamides may result to decrease in serum folate contrations. Decreases serum phenytoin concentrations.

Decreased GI tract absorption with neomycin, aminosalicylic acid, H2-blockers and colchicine. Reduced serum concentrations with oral contraceptives. Reduced effects in anaemia with parenteral chloramphenicol.

Zinc may inhibit the absorption of concurrently administered tetracyclines, when both are being given an interval of at least 3 hours.

Volume of Distribution

Tetrahydrofolic acid derivatives are distributed to all body tissues but are stored primarily in the liver.

Elimination Route

Folic acid is absorbed rapidly from the small intestine, primarily from the proximal portion. Naturally occurring conjugated folates are reduced enzymatically to folic acid in the gastrointestinal tract prior to absorption. Folic acid appears in the plasma approximately 15 to 30 minutes after an oral dose; peak levels are generally reached within 1 hour.

Elimination Route

After a single oral dose of 100 mcg of folic acid in a limited number of normal adults, only a trace amount of the drug appeared in the urine. An oral dose of 5 mg in 1 study and a dose of 40 mcg/kg of body weight in another study resulted in approximately 50% of the dose appearing in the urine. After a single oral dose of 15 mg, up to 90% of the dose was recovered in the urine. A majority of the metabolic products appeared in the urine after 6 hours; excretion was generally complete within 24 hours. Small amounts of orally administered folic acid have also been recovered in the feces. Folic acid is also excreted in the milk of lactating mothers.

Pregnancy & Breastfeeding use

Pregnancy Category A. Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).

Not recommended during pregnancy & lactation.

Pregnant women and nursing mothers should avoid zinc doses higher than RDA amounts.

Contraindication

Undiagnosed megaloblastic anaemia; pernicious, aplastic or normocytic anaemias.

Hypersensitivity to any component of this product.

It is contraindicated in patients with hypersensitivity to Zinc.

Special Warning

Use in children: Not recommended.

Acute Overdose

Zinc sulphate is corrosive in overdose. Symptoms are corrosion and inflammation of the mucous membrane of the mouth and stomach; ulceration of the stomach followed by perforation may occur. Gastric lavage and emesis should be avoided. Demulcents such as milk should be given. Chelating agents such as sodium edetate may be useful.