Difol TR

N/A

This capsule is a haematinic preparation for the treatment and prophylaxis of iron and folic acid deficiency, especially during pregnancy and lactation.

N/A

Contraindicated in patients receiving repeated blood transfusions or in patients with anaemias not produced by iron deficiency unless iron deficiency is also present.

Iron is an essential constituent of the body, being necessary for haemoglobin formation and for the oxidative processes of living tissues. Iron is primarily absorbed from the duodenum and upper jejunum. The ferrous salt form is absorbed three times more readily than the ferric salt form. The adult male has a requirement of only 13 µg/kg per day (about 1 mg), whereas the menstruating female requires about 21 µg/kg per day (about 1.4 mg). In the last two trimesters of pregnancy, requirements increase to about 80 µg/kg per day (5 to 6 mg). Folic acid is an important factor in cell division and without it, division stops. Adequate folic acid is required for normal erythropoiesis. Deficiency of Folic Acid causes megaloblastic anaemia

The absorption of both iron salts and tetracyclines is diminished when they are taken concomitantly by mouth. The absorption of iron salts may also be decreased by magnesium trisilicate-containing antacid.

Because iron salts are astringent, gastrointestinal irritation may occur. Nausea and epigastric pain are dose related.

Symptoms of overdosage with iron salts include epigastric pain, nausea and vomiting, haematemesis and circulatory collapse. In severe cases encephalopathy, acute hepatic necrosis and acute renal failure may develop after a latent period. The timed release capsule presentation of ferrous sulfate may delay excessive absorption of iron and allow more time for the initiation of appropriate counter measures. Treatment consists of gastric lavage followed by the introduction of 5 gm desferrioxamine into the stomach. Serum iron levels should be monitored, in severe cases intravenous desferrioxamine should be given together with supportive and symptomatic measures as required.

Iron chelates with antacid and tetracycline and absorption of all these may be impaired if taken concurrently. However, the administration of tetracycline during pregnancy is contraindicated.