Dosing and uses of Irospan 24/6, Nephron FA (iron/folic acid/vitamin/mineral)
Adult dosage forms and strengths
Irospan 24/6 tablet (OTC)
- 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 (Rx)
- 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 (Rx)
- 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
Iron Deficiency Anemia
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
Irospan 24/6 (OTC): 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 (Rx): 1 tablet PO qDay
Kidney Dialysis Supplement
Indicated for folic acid supplementation for patients on kidney dialysis
Nephron FA (Rx): 1 tablet PO qDay on empty stomach
Pediatric dosage forms and strengths
<18 years: Safety and efficacy not established
Irospan 24/6, Nephron FA (iron/folic acid/vitamin/mineral) adverse (side) effects
Frequency not defined
Hypersensitivity
Iron: Constipation, diarrhea, nausea, vomiting, dark stools, and abdominal pain
Folic acid: Allergic sensitization
Warnings
Black box warnings
Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children younger than 6 years
Keep product out of reach of children
In case of accidental overdose, call a doctor or poison control center immediately
Initial symptoms of acute overdose may include abdominal pain, nausea, vomiting, diarrhea, tarry stools melena, hematemesis, hypotension, tachycardia, metabolic acidosis, hyperglycemia, dehydration, drowsiness, pallor, cyanosis, lassitude, seizures, shock, and coma
Contraindications
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
Cautions
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
Pregnancy and lactation
Pregnancy category: C
Lactation: Distributed in human breast milk
Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Irospan 24/6, Nephron FA (iron/folic acid/vitamin/mineral)
Mechanism of action
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
