Pregmin

• Iron Deficiency Anemia:
  Treatment and prevention of iron deficiency anemia, including cases due to blood loss, poor dietary intake, or increased physiological demands (e.g., pregnancy, lactation, infancy).
• Folic Acid Deficiency:
  Prevention and treatment of folic acid deficiency anemia, often associated with nutritional deficits, malabsorption, or increased requirement (pregnancy, hemolytic anemia).
• Combined Iron and Folic Acid Deficiency:
  Management of anemia where both iron and folic acid deficiencies coexist.
• Pregnancy and Lactation:
  Prophylaxis for iron and folate supplementation to prevent maternal anemia and fetal neural tube defects.

• Adults and Adolescents:
  Typical dose provides elemental iron 50–100 mg daily and folic acid 0.4–1 mg daily, given orally.
  Common regimens include 1–2 tablets daily, preferably taken on an empty stomach to enhance absorption or with food to reduce gastrointestinal irritation.
• Pregnant Women:
  Often 1 tablet daily containing approximately 60 mg elemental iron and 0.4 mg folic acid throughout pregnancy.
• Pediatrics:
  Dosing adjusted by body weight and clinical need; usually under specialist guidance.
• Elderly:
  Standard adult dosing, with attention to tolerance.
• Renal/Hepatic Impairment:
  Use with caution; no specific dose adjustments, but monitor iron and folate status closely.
• Administration Route:
  Oral tablets or capsules.
• Duration:
  Typically administered for several months until anemia resolves and iron stores replenish; continued folic acid as needed.

Carbonyl Iron: Provides elemental iron, which is absorbed primarily in the duodenum and jejunum. Iron is essential for hemoglobin synthesis in red blood cells, facilitating oxygen transport. It replenishes iron stores and corrects iron-deficiency anemia.

Folic Acid: A water-soluble B-vitamin (B9) that participates in DNA synthesis and repair, red blood cell formation, and cellular division. Folic acid supplementation corrects folate deficiency anemia by enabling proper erythropoiesis.

The combination synergistically treats anemias caused by deficiencies in iron and folate, ensuring effective red blood cell production and preventing associated complications.

• Absorption:
  Carbonyl iron is absorbed slowly and steadily, reducing gastrointestinal irritation. Folic acid is rapidly absorbed from the small intestine.
• Bioavailability:
  Carbonyl iron has high elemental iron content (~100%) but lower solubility; folic acid has near-complete oral bioavailability.
• Distribution:
  Iron is transported bound to transferrin to the bone marrow and other tissues; folic acid is widely distributed in body tissues.
• Metabolism:
  Iron is incorporated into hemoglobin or stored as ferritin; folic acid is converted intracellularly to active tetrahydrofolate.
• Half-life:
  Iron stores remain for months; folic acid half-life approximately 3–4 hours.
• Elimination:
  Iron lost via shedding of intestinal mucosa and minor bleeding; folic acid excreted in urine.

• Pregnancy:
  Category A. Safe and recommended during pregnancy for prevention and treatment of anemia and to reduce risk of neural tube defects.
• Lactation:
  Considered safe; iron and folic acid are excreted in small amounts in breast milk without adverse effects on the infant.

• Primary: Hematinic
• Subclass: Iron supplement + Vitamin (Folic Acid)

• Known hypersensitivity to carbonyl iron, folic acid, or any excipients.
• Hemochromatosis or other iron overload disorders.
• Megaloblastic anemia due to vitamin B12 deficiency without appropriate diagnosis.
• Severe liver disease or active peptic ulcer disease.

• Avoid use in undiagnosed anemia to prevent masking other serious conditions.
• Monitor iron status to avoid overload, especially in patients requiring repeated supplementation.
• Folic acid may mask vitamin B12 deficiency, potentially leading to neurological damage.
• Caution in patients with gastrointestinal disorders as iron may cause irritation.
• Keep out of reach of children; iron overdose is a leading cause of fatal poisoning in children.

Common:

• Gastrointestinal: nausea, constipation, diarrhea, abdominal discomfort, dark stools
• Taste disturbance

Serious/Rare:

• Allergic reactions (rash, itching)
• Iron overload toxicity (with excessive dosing)
• Hypersensitivity reactions (rare)

• Decreased Absorption: Antacids, calcium supplements, tetracyclines, quinolones—administer iron separately by at least 2 hours.
• Increased Iron Absorption: Vitamin C enhances iron absorption.
• Folic Acid: May reduce serum levels of phenytoin and other anticonvulsants.
• Iron: May interfere with absorption of levothyroxine and some antibiotics.

• WHO and national guidelines emphasize combined iron and folic acid supplementation in pregnant women to prevent anemia and neural tube defects.
• Recent recommendations stress early anemia screening and tailored supplementation to reduce adverse effects.
• Updated dosing strategies focus on intermittent vs daily supplementation to improve tolerability.

• Store at 20°C to 25°C (room temperature).
• Protect from moisture and light.
• Keep tightly closed in original container.
• Keep out of reach of children.