Description
This oral tablet is a combination supplement containing a ferrous salt (which provides elemental iron) and folic acid. The specific formulation you mentioned provides 100 mg of elemental iron from the ferrous salt and 500 mcg (micrograms) of folic acid. This combination is designed to treat and prevent deficiencies of both iron and folic acid, which are crucial for red blood cell formation and various metabolic processes. The ferrous salt ensures good absorption of iron, while folic acid, a B vitamin, is essential for cell division and DNA synthesis.
Common Ferrous Salts in India
In India, common ferrous salts used in such formulations include:
- Ferrous Fumarate: Often chosen for its high elemental iron content per tablet.
- Ferrous Ascorbate: A popular choice due to enhanced iron absorption (Vitamin C in ascorbate aids absorption) and often better gastrointestinal tolerability.
- Ferrous Sulfate: A widely available and cost-effective option.
- Ferrous Gluconate: Generally better tolerated but with lower elemental iron content per tablet.
- Ferrous Bisglycinate: A chelated form known for higher bioavailability and reduced GI side effects.
The specific ferrous salt used will vary by manufacturer, but the elemental iron content is standardized.
Advantages
- Comprehensive Anemia Treatment: Addresses both iron deficiency anemia and folate deficiency anemia simultaneously, which often co-exist or require combined management.
- Essential for Pregnancy: Critically important during pregnancy to support increased maternal blood volume, fetal growth, and prevent neural tube defects.
- Improved Compliance: A single tablet combining two vital nutrients can improve patient adherence compared to taking separate supplements.
- Restores Energy and Vitality: By correcting anemia, it alleviates symptoms like fatigue, weakness, and shortness of breath, leading to improved overall well-being.
- Supports Cellular Health: Both iron and folic acid are vital for healthy cell division and function throughout the body.
Uses
This combination tablet is primarily used for the management and prevention of:
- Iron Deficiency Anemia: To replenish iron stores, boost hemoglobin levels, and improve the oxygen-carrying capacity of blood.
- Folate Deficiency Anemia: To increase folic acid levels, crucial for the production of healthy red blood cells.
- Nutritional Supplementation during Pregnancy: This is a major indication, especially in India, to meet the increased demands for iron and folic acid, preventing anemia in the mother and reducing the risk of neural tube defects (NTDs) and other developmental issues in the baby.
- Anemia in Adolescent Girls and Women of Reproductive Age: To combat high prevalence of anemia in these groups, often part of national public health programs (like the Weekly Iron and Folic Acid Supplementation (WIFS) Programme in India, though specific doses might vary for weekly vs. daily).
- Other Conditions with Increased Demand or Deficiency: Such as chronic blood loss, certain malabsorption syndromes, or periods of rapid growth.
Typical Indications in India
In India, this combination is widely indicated for:
- Pregnant and Lactating Women: As a standard part of antenatal care. The National Health Mission (NHM) recommends a tablet containing 60 mg elemental iron + 500 mcg folic acid daily for pregnant women from the fourth month of pregnancy (second trimester) for a minimum of 180 days, continuing for 180 days postpartum.
- Adolescent Girls and Boys (10-19 years): Under the WIFS program, 60 mg elemental iron + 500 mcg folic acid (often a blue-colored tablet, “Iron ki nili goli”) is given weekly to prevent anemia.
- Women of Reproductive Age (non-pregnant, non-lactating): Also receive 60 mg elemental iron + 500 mcg folic acid weekly.
- Treatment of Diagnosed Anemia: Higher doses or daily regimens may be prescribed for individuals with clinically diagnosed iron deficiency anemia or megaloblastic anemia due to folate deficiency.
Nature
This tablet combines two essential micronutrients:
- Elemental Iron (from Ferrous Salt):
- Nature: Iron is a crucial component of hemoglobin, the protein in red blood cells that transports oxygen from the lungs to all body tissues. It’s also vital for myoglobin (oxygen storage in muscles), various enzymes, and energy production. In this tablet, iron is typically present in its ferrous (Fe$^{2+}$) form, which is more readily absorbed by the body.
- Mechanism of Action: After ingestion, the ferrous iron is absorbed primarily in the duodenum and upper jejunum. It then binds to transferrin for transport in the bloodstream to the bone marrow, where it is incorporated into newly formed red blood cells. It also replenishes iron stores (ferritin, hemosiderin) in the liver, spleen, and bone marrow.
- Folic Acid (Vitamin B9):
- Nature: Folic acid is a synthetic form of folate, a water-soluble B vitamin. It is essential for DNA synthesis and repair, cell division, and the formation of red blood cells.
- Mechanism of Action: Folic acid is converted into its active forms (e.g., tetrahydrofolate) within the body. These active forms act as coenzymes in various metabolic pathways, particularly in the synthesis of purines and pyrimidines (components of DNA and RNA), and in amino acid metabolism. Adequate folic acid is critical for rapid cell growth and division, such as during pregnancy and in the bone marrow for red blood cell production. Its deficiency can lead to megaloblastic anemia, where red blood cells are abnormally large and immature