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Iron/folic Acid/Vitamin/Mineral

    DEA Class; Rx, OTC

    Common Brand Names; Irospan 24/6, Nephron FA, Corvite FE

    • Vitamins, Combos

    Iron: Essential component in the formation of hemoglobin; adequate amounts of iron are necessary for effective erythropoiesis; also serves as a cofactor of several essential enzymes, including cytochromes that are involved in electron transport

    Folic acid: Required for nucleoprotein synthesis and the maintenance of normal erythropoiesis; folic acid is converted in the liver and plasma to its metabolically active form, tetrahydrofolic acid, by dihydrofolate reductase; prevents neural tube defects in women of childbearing potential and higher doses required during pregnancy

    Vitamin B12 (cyanocobalamin): Required for the maintenance of normal erthropoiesis, nucleprotein and myelin synthesis, cell reproduction and normal growth; intrinsic factor, a glycoprotein secreted by the gastric mucosa, is required for active absorption of Vitamin B12 from the GI tract

    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

    Indicated for folic acid supplementation for patients on kidney dialysis

    Ingesting >3 g of omega-fatty acids/day has potential antithrombotic effects, including increased bleeding time and INR; avoid omega-3 fatty acids in patients on anticoagulants and in those known to have a bleeding diathesis

    Folic acid alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient

    Hemochromatosis and hemosiderosis are contraindications to iron therapy

    • Hypersensitivity
    • Iron: Constipation, diarrhea, nausea, vomiting, dark stools, and abdominal pain
    • Folic acid: Allergic sensitization

    Do not exceed recommended dose

    Determine the type of anemia and the underlying cause or causes before starting therapy

    Folic acid >1 mg/day may obscure pernicious anemia in that hematologic remission can occur while neurological manifestations remain progressive

    Exclude the diagnosis of pernicious anemia before beginning therapy with folic acid (may mask symptom of pernicious anemia)

    Irospan contains formate, which if consumed above the recommended level, could cause visual impairment and other health effects; do not take more than the recommended amount

    Iron Deficiency Anemia

    Irospan 24/6: 1 iron/multivitamin/mineral tablet PO qDay on days 1-24, and then 1 succinic acid/multivitamin/mineral tablet PO qDay on days 25-30; repeat cycle

    Corvite FE: 1 tablet PO qDay

    Kidney Dialysis Supplement

    Nephron FA: 1 tablet PO qDay on empty stomach

    Iron/folic acid/vitamin/mineral

    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 100mg, calcium formate 155mg, thiamine 5mg, riboflavin 5mg, niacin 25mg, pyridoxine 30mg, folic acid 1mg, biotin 300mcg, calcium pantothenate 300mcg, ferrous bisglycinate 65mg, iron dextran 65mg

    • Succinic acid/multivitamin/mineral tablet (days 25-30): sodium ascorbate 100mg, calcium carbonate 100mg, thiamine 5mg, riboflavin 5mg, niacin 25mg, pyridoxine 30mg, folic acid 1mg, cyanocobalamin 10mcg, biotin 300mcg, calcium pantothenate 7mg, succinic acid 150mg

    Nephron FA

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

    Corvite FE

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