FERROUS FUMARATE + FOLIC ACID

Description: Ferrous fumarate is an essential compound of the body that is used to provide iron in the body. Folic acid is a vitamin B that is used in the prevention and treatment of folic acid deficiency. Pharmacokinetics:

Absorption: Ferrous fumarate: Absorption takes place mainly in the duodenum and jejunum; aided by stomach. Folic acid: Absorption takes place mainly in the proximal part of the small intestine.

Distribution: Ferrous fumarate: Ferrous iron passes through the Gastrointestinal mucosal cells, bind to transferrin and is then transported to the bone marrow and incorporated into haemoglobin. Folic acid: Extensively bound to plasma proteins.

Metabolism: Folic acid: Largely metabolised in the liver.

Excretion: Ferrous fumarate: Mainly through the feces and desquamation of cells e.g. skin, hair or GI mucosa. Folic acid: Mainly excreted in the urine.

Uses

This medication is an iron supplement used to treat or prevent low blood levels of iron (e.g., for anemia or during pregnancy). Iron is an important mineral that the body needs to produce red blood cells and keep you in good health. They are used together in pregnant women (2nd and 3rd trimesters) for the prevention of iron deficiency and megaloblastic anaemia of pregnancy.

How to use ferrous fumarate-folic acid

Follow all directions on the product package, or take as directed by your doctor. Do not take more than the recommended dosage. If you have any questions, ask your doctor or pharmacist.

Iron is best absorbed on an empty stomach (usually if taken 1 hour before or 2 hours after meals). If stomach upset occurs, you may take this medication with food. See the instructions below for the liquid drops for infants/children. Avoid taking antacids, dairy products, tea, or coffee within 2 hours before or after this medication because they will decrease its effectiveness.

Take tablets or capsules with a full glass of water (8 ounces or 240 milliliters) unless otherwise directed by your doctor. Do not lie down for 30 minutes after taking your tablet or capsule dose.

Swallow extended-release capsules whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

If you are taking chewable tablets, chew the medication thoroughly, then swallow.

If you are taking a liquid suspension form of this medication, shake the bottle well before each dose.

If you are taking the liquid form for adults, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Mix the dose in a glass of water or juice, and drink the mixture through a straw to prevent staining the teeth.

If you are giving the liquid drops to an infant or child, use the dropper provided to carefully measure the dose. The dose may be placed directly into the mouth (towards the back of the tongue) or it may be mixed in formula (not milk), fruit juice, cereal, or other food as directed to increase your child’s acceptance. It is best to give this medication right after a meal. Follow the directions on the product package for the brand that you use.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Warnings

Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children younger than 6 years. Keep this product out of reach of children. If overdose does occur, seek immediate medical attention or call a poison control center.

Folic Acid

Pregnancy risk: Category A (Studies show no risk)

Side Effects

Folic Acid Side effects:

nausea, loss of appetite;
bloating, gas;
bitter or unpleasant taste in your mouth;
sleep problems;
depression; or
feeling excited or irritable.

Ferrous fumarate side effects:

COMMON side effects persist or become bothersome:

Constipation;
darkened or green stools;
diarrhea;
nausea;
stomach upset.

Seek medical attention right away if any of these SEVERE side effects occur while taking ferrous fumarate:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue);
black, tarry stools;
blood or streaks of blood in the stool;
fever;

vomiting with continuing sharp stomach pain.

Precautions

This medication should not be used if you have certain medical conditions. Before taking this medication, consult your doctor or pharmacist if you have: iron overload disorder (e.g., hemochromatosis, hemosiderosis).

Before taking this medication, tell your doctor or pharmacist your medical history, especially of: use/abuse of alcohol, liver problems, stomach/intestinal problems (e.g., ulcer, colitis).

If your brand of iron supplement also contains folic acid, be sure to tell your doctor or pharmacist if you have vitamin B12 deficiency (pernicious anemia) before taking it. Folic acid may falsely improve certain laboratory tests for vitamin B12 deficiency without actually treating this anemia. Untreated vitamin B12 deficiency may result in serious nerve problems (e.g., peripheral neuropathy symptoms such as numbness/pain/tingling sensations). Consult your doctor or pharmacist for details.

Chewable tablets of this medicine may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to restrict your intake of aspartame (or phenylalanine), consult your doctor or pharmacist about using this drug safely.

Liquid preparations of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.

Interactions

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop or change the dosage of any medicine before checking with them first.

Before taking this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: certain antibiotics (e.g., penicillamine, chloramphenicol, quinolones such as ciprofloxacin/norfloxacin), bisphosphonates (e.g., alendronate), levodopa, methyldopa, thyroid replacement drugs (e.g., levothyroxine).

Avoid taking this medication at the same time as antacids or tetracycline antibiotics. Wait at least 2 hours between taking this medication and an antacid or tetracycline.

If your brand of iron also contains folic acid, be sure to tell your doctor or pharmacist if you take certain anti-seizure drugs (e.g., hydantoins such as phenytoin).

This medication may interfere with certain laboratory tests (e.g., fecal occult blood tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Overdose & Brands

If overdose is suspected, contact a poison control center or emergency room immediately. Symptoms of overdose may include: stomach pain, nausea, vomiting, diarrhea.

Notes

If your doctor has prescribed this medication, do not share it with others.

Laboratory and/or medical tests (e.g., complete blood count) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

This medication is not a substitute for a proper diet. It is important to maintain a well-balanced diet. Foods rich in iron include red meats (especially liver), fish, beans, dried fruit, and iron-fortified/enriched cereals and bread.

Missed Dose

If you are taking this product on a prescribed schedule and miss a dose, take it as soon as you remember. If it is near the time for the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not freeze liquid forms of this medication. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Brands

Also marketed as

Anemicon Plus [ San Marino ]

Fergesol [ IAE ]