A fixed-dose combination (FDC) hematinic preparation containing elemental iron as Ferrous Ascorbate (providing 50mg elemental iron), Cyanocobalamin (Vitamin B12), and Folic Acid. It is a cornerstone therapy for the prophylaxis and treatment of nutritional and deficiency anemias, particularly iron deficiency anemia (IDA) and megaloblastic anemia, which are highly prevalent in the Indian population due to dietary habits, parasitic infections, and increased demands in pregnancy.
Adult: One tablet once daily, preferably on an empty stomach (1 hour before or 2 hours after food) for optimal iron absorption. If GI upset occurs, can be taken with or just after food, though absorption is reduced.
Note: Swallow tablet whole with a full glass of water. Do not crush or chew. To enhance absorption: Take on empty stomach with Vitamin C-rich drink (e.g., orange juice). Avoid taking with tea, coffee, milk, calcium supplements, or antacids within 2 hours. Stools may turn dark green or black; this is harmless.
This combination acts synergistically to correct anemia by providing essential substrates for erythropoiesis. Iron is incorporated into heme, the oxygen-carrying component of hemoglobin. Cyanocobalamin and Folic Acid are cofactors in DNA synthesis, crucial for the maturation of red blood cell precursors in the bone marrow. Deficiency of either leads to impaired cell division and megaloblastic anemia.
Pregnancy: Category A (US FDA). Highly recommended for prophylaxis and treatment of anemia in pregnancy. Folic Acid (500mcg) helps prevent neural tube defects, though higher doses (4-5mg) are used for history of NTD. Iron requirements increase significantly. Safe in all trimesters.
Driving: No known effects on driving ability. However, severe dizziness from anemia itself may impair performance until treatment takes effect.
| Antacids, Calcium supplements, Proton Pump Inhibitors (e.g., Omeprazole) | Decreased absorption of iron (and possibly B12 with PPIs) due to increased pH or complex formation. | Major |
| Tetracyclines (e.g., Doxycycline), Fluoroquinolones (e.g., Ciprofloxacin), Bisphosphonates (e.g., Alendronate) | Decreased absorption of the antibiotic/bisphosphonate. Administer at least 2-4 hours apart. | Major |
| Levothyroxine | Decreased absorption of levothyroxine, reducing its efficacy. | Major |
| Chloramphenicol | May delay the hematologic response to iron therapy. | Moderate |
| Methotrexate, Trimethoprim, Pyrimethamine | Antifolate effect; may reduce efficacy of folic acid. Folic acid may reduce efficacy of these drugs. | Moderate |
| Colchicine, Aminoglycosides, Metformin | May reduce absorption of Vitamin B12. | Moderate |
Same composition (Iron (50mg) + Cyanocobalamin (50mcg) + Folic Acid (500mcg)), different brands: