iron/folic acid/vitamin/mineral (Rx)

Brand and Other Names:Irospan 24/6, Nephron FA, more...Corvite FE
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

Irospan 24/6 tablet

  • 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

  • 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

  • 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: 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: 1 tablet PO qDay

Kidney Dialysis Supplement

Indicated for folic acid supplementation for patients on kidney dialysis

Nephron FA: 1 tablet PO qDay on empty stomach

<18 years: Safety and efficacy not established

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Interactions

Interaction Checker

and iron/folic acid/vitamin/mineral

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          Minor

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            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (2)

                • omadacycline

                  iron/folic acid/vitamin/mineral will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

                • sarecycline

                  iron/folic acid/vitamin/mineral will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

                Minor (0)

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                  Adverse Effects

                  Frequency Not Defined

                  Hypersensitivity

                  Iron: Constipation, diarrhea, nausea, vomiting, dark stools, and abdominal pain

                  Folic acid: Allergic sensitization

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                  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

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                  Pharmacology

                  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

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                  Images

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                  Patient Handout

                  A Patient Handout is not currently available for this monograph.
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                  Formulary

                  FormularyPatient Discounts

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                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.