This preparation is indicated in:

• Prophylaxis and treatment of iron deficiency anaemia in pregnancy.
• Prevention of megaloblastic anaemia of pregnancy.

Iron is an essential constituent of the body, being necessary for haemoglobin formation and for the oxidative processes of living tissues. Iron salts should only be given for the treatment and as prophylaxis of iron deficiency anaemia. Iron deficiency anaemias are most often the result of chronic haemorrhage, nutritional deficiency, pregnancy, parasite infestation, or malabsorption of iron.

A deficiency of folic acid, typically during pregnancy, has long been known to cause a megaloblastic anaemia. The vitamin is not storable in the body, and the combination of fetal demand during pregnancy and malnutrition can lead to a deficiency, hence anaemia. It has been observed that the rapid production of red blood cells following treatment with iron may deplete body folate if there is inadequate intake; the combination of folic acid and ferrous fumarate avoids this complication. Iron and folic acid are absorbed in the proximal small intestine, particularly the duodenum. Ferrous fumarate and folic acid supplements replenish iron deficiency, thereby arresting the anaemia process. Absorbed iron is taken up by the bone marrow's tissues that form blood cells, where it is used to synthesize haemoglobin.

Adults: One tablet daily. When necessary, one tablet may be given twice daily. In pregnancy, it is recommended that this tablet should be started at the first antenatal consultation and continued for 3 months after delivery. The tablet should preferably be taken before meals; if there are gastrointestinal disturbances, doses may be taken after meals.

The absorption of iron salts and tetracycline is diminished when they are taken concomitantly by mouth. If treatment with both drugs is required, the iron salt should be administered 3 hours before or 2 hours after the tetracycline. The absorption of iron salts is also decreased in the presence of antacids or when taken with tea. Iron salts appear to reduce the effects of penicillamine. Co-trimoxazole may inhibit megaloblastic haemopoiesis. Serum anticonvulsant levels may be reduced by administration of folate.

This preparation is contraindicated in patients with pernicious anaemia and anaemia other than those due to iron deficiency. The nature and causes of anaemia should be established. Absorption of Ferrous Fumarate & Folic Acid is inhibited by magnesium trisilicate and antacids containing carbonate.

Side effects of iron and folic acid preparations which have been reported include nausea, vomiting, gastrointestinal symptoms, constipation, and diarrhea.

Administration of this preparation during the first trimester of pregnancy may be undesirable. Very few pregnant women are not protected by physiological doses of folic acid. If anaemia develops despite prophylaxis with this preparation, the patient should be investigated further. Some post-gastrectomy patients show poor absorption of iron. Care is needed when treating patients with peptic ulcer.

Patients who have taken an overdose should have gastric lavage performed, if possible within four hours of the overdosage occurring. In addition, patients should receive such symptomatic treatment as appears necessary. In order to eliminate excess free iron, a chelating agent such as desferrioxamine should be administered as soon as possible. Giving milk and/or a 5% solution of sodium bicarbonate by mouth will be helpful in the meantime.

Iron & Vitamin Combined preparations

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.