Ferrous fumarate + Folic acid


Concise Prescribing Info
Indications/Uses
Prophylaxis of iron deficiency in pregnancy.
Dosage/Direction for Use
Adult : PO Each tab or cap contains ferrous fumarate (expressed as elemental Fe) and folic acid (amounts may vary according to product e.g. 100 mg/350 mcg, 106 mg/350 mcg, 106 mg/1,000 mcg): 1 tab or cap/day.
Dosage Details
Oral
Prophylaxis of iron deficiency in pregnancy
Adult: Each tab or cap contains ferrous fumarate (expressed as elemental Fe) and folic acid (amounts may vary according to product e.g. 100 mg/350 mcg, 106 mg/350 mcg, 106 mg/1,000 mcg): 1 tab or cap daily.
Contraindications
Anaemia other than those due to Fe deficiency (e.g. megaloblastic anaemia due to vit B12 deficiency), paroxysmal nocturnal haemoglobinuria, haemosiderosis, haemochromatosis and haemoglobinopathies, active peptic ulcer, inflammatory bowel disease, including regional enteritis and ulcerative colitis, intestinal strictures and diverticulae. Patients requiring repeated blood transfusion.
Special Precautions
Patient w/ folate dependent tumours, erythropoietic protoporphyria, history of peptic ulcer. Pregnancy and lactation.
Adverse Reactions
GI: Nausea, anorexia, vomiting, constipation or diarrhoea, abdominal cramps, heartburn, black stool.
Dermatologic: Allergic reactions.
Patient Counseling Information
This drug may colour the stool black.
Overdosage
Symptoms: Nausea, vomiting, pallor, cyanosis, melaena, shock, drowsiness, coma. CV collapse may occur in severe cases. Management: Perform gastric lavage w/ Na bicarbonate soln or milk. Administer IV fluids and electrolytes and use oxygen. Exchange transfusion and chelating agent may be used for specific therapy.
Drug Interactions
Ferrous fumarate: Fe chelates w/ tetracyclines, absorption of both agents may be impaired; it also chelates w/ acetohydroxamic acid, reducing the absorption of both. Reduced absorption w/ antacids and PPIs, neomycin, cholestyramine, Ca, oral Mg salts and other mineral supplements, Zn and trientine. May form insoluble complexes w/ bicarbonates, carbonates, oxalates, or phosphates, thus absorption is reduced. Increased absorption w/ ascorbic or citric acid. Chloramphenicol delays plasma clearance and incorporation of Fe into red blood cells by interfering w/ erythropoiesis. Reduces the hypotensive effect of methyldopa. May form toxic complexes w/ dimercaprol. Reduces the absorption of fluoroquinolones, levodopa, carbidopa, entacapone, bisphosphonates, penicillamine, thyroid hormones, mycophenolate, cefdinir and Zn. May reduce the absorption of eltrombopag (give at least 4 hr apart). Folic acid: May reduce serum levels of anticonvulsants (e.g. phenobarbital, phenytoin, primidone). Reduced absorption w/ sulfasalazine. May interfere w/ the action of raltitrexed.
Food Interaction
Reduced absorption w/ food esp tea, coffee, cereals, eggs and milk.
Lab Interference
May interfere w/ tests used for detection of occult blood in stool.
Action
Description: Ferrous fumarate is an Fe compound that is used in the prevention and treatment of iron deficiency anaemia. It provides a high level of elemental Fe w/ low incidence of gastric distress. Folic acid is a precursor of a large family of compounds which serve as coenzymes in carbon transfer reactions. These reactions are required for the synthesis of purine and pyrimidine bases, inter-conversion of glycine and serine, biosynthesis of methionine methyl groups and degradation of histidine. It also increases jejunal glycolytic enzymes and is involved in the desaturation and hydroxylation of long-chain fatty acids in the brain.
Pharmacokinetics:
Absorption: Ferrous fumarate: Absorbed in the duodenum and jejunum. Folic acid: Absorbed rapidly, mainly from the proximal part of the small intestine.
Distribution: Ferrous fumarate: Transported via the blood and is then bound to transferrin. Folic acid: Rapidly distributed in body tissues. Plasma protein binding: Extensive.
Metabolism: Folic acid: Largely metabolised in the liver to other active forms of folate; a proportion is stored as reduced and methylated folate.
Excretion: Folic acid: Mainly via urine.
Storage
Store between 15-30°C.
ATC Classification
B03AD - Iron in combination with folic acid ; Used in the treatment of anemia
References
Hemocyte F (US Pharmaceutical Corporation). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 28/02/2017 .

Joint Formulary Committee. Ferrous Fumarate with Folic Acid. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 28/02/2017 .

Pregaday 322 mg/0.35 mg Film-Coated Tablets (RPH Pharmaceuticals AB). MHRA. https://products.mhra.gov.uk/. Accessed 28/02/2017 .

Disclaimer: This information is independently developed by MIMS based on Ferrous fumarate + Folic acid from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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