Prenat Plus

• Treatment and prevention of nutritional deficiencies including:
• Iron deficiency anemia and related iron deficiency states
• Folic acid deficiency and prevention of neural tube defects during pregnancy
• Vitamin B complex deficiencies (including B1 [thiamine], B2 [riboflavin], B3 [niacin], B5 [pantothenic acid], B6 [pyridoxine], B7 [biotin], B9 [folic acid], B12 [cyanocobalamin])
• Vitamin C deficiency (scurvy prevention and treatment)
• Supportive therapy for:
• Pregnancy and lactation to meet increased micronutrient demands
• Malnutrition and malabsorption syndromes
• Chronic illnesses causing vitamin and mineral depletion
• Clinically accepted off-label uses: treatment of peripheral neuropathy, certain anemias, and to improve general nutritional status.

Adults:

• Oral administration, typically once daily.
• Typical daily doses (may vary by formulation):
• Elemental Iron: 30–60 mg
• Folic Acid: 400–800 mcg
• Vitamin B complex (varies per B vitamin, e.g., B1 1.1–1.5 mg, B6 1.3–2 mg, B12 2.4 mcg, etc.)
• Vitamin C: 60–100 mg

Pregnant women:

• Iron 30–60 mg elemental daily
• Folic acid 400–600 mcg daily
• B vitamins and vitamin C at recommended dietary allowances

Pediatrics:

• Dose adjusted according to age and weight; specific pediatric formulations available.

Elderly:

• Similar to adults; monitor for tolerance and absorption issues.

Renal/Hepatic Impairment:

• Use with caution; no specific dose adjustment but monitor closely.

Administration:

• Oral route; preferably taken with meals to minimize gastrointestinal upset.
• Vitamin C enhances iron absorption; co-administration improves efficacy.
• Avoid concurrent intake with calcium, antacids, or dairy products which may impair absorption.

• Iron replenishes body stores vital for hemoglobin synthesis and oxygen transport.
• Folic acid supports DNA synthesis and red blood cell formation.
• Vitamin B complex plays diverse roles in energy metabolism, nerve function, red blood cell production, and DNA/RNA synthesis.
• Vitamin C enhances iron absorption by reducing ferric to ferrous iron and acts as an antioxidant, supporting immune defense and collagen synthesis.
  Together, these micronutrients correct deficiencies, promote hematologic health, improve neurological function, and enhance immune response.

• Iron: Absorbed mainly in the duodenum; bioavailability influenced by iron form and dietary factors. Transported by transferrin; stored as ferritin or hemosiderin; eliminated mostly via mucosal cell loss and minor excretion.
• Folic Acid: Absorbed in the small intestine, converted intracellularly to active forms; excreted primarily in urine.
• Vitamin B Complex: Each B vitamin has distinct absorption and metabolism; generally absorbed in the small intestine, transported in plasma, metabolized in liver, and excreted mainly via urine.
• Vitamin C: Rapidly absorbed in the small intestine; distributed widely in tissues; water-soluble and excreted in urine.

• Considered safe within recommended dietary doses.
• Folic acid and iron supplementation is standard during pregnancy to prevent anemia and fetal neural tube defects.
• Vitamin B complex and vitamin C are generally safe at recommended doses.
• Caution to avoid excessive doses beyond recommended levels.
• Components pass into breast milk at low levels; generally considered safe during breastfeeding.

• Multivitamin and mineral nutritional supplement

• Known hypersensitivity to any component.
• Hemochromatosis or other iron overload conditions.
• Unexplained anemia without proper diagnosis.

• Iron can cause gastrointestinal irritation; keep out of reach of children due to toxicity risk.
• Monitor hematologic parameters during prolonged use.
• Use caution in patients with renal or hepatic impairment.
• Vitamin B6 in high doses over long term may cause neuropathy.

Common:

• Gastrointestinal discomfort (nausea, constipation, diarrhea, abdominal pain)
• Dark stools (due to iron)
• Mild headache or flushing (rare)

Serious/Rare:

• Iron overdose toxicity — vomiting, metabolic acidosis, shock
• Allergic reactions — rash, itching, anaphylaxis (very rare)
• Peripheral neuropathy with excessive vitamin B6

• Calcium, antacids, dairy products reduce iron absorption.
• Certain antibiotics (tetracyclines, quinolones) have reduced absorption when taken with iron or zinc.
• Vitamin C enhances iron absorption.
• Vitamin B6 may interact with levodopa, phenobarbital, and phenytoin.
• High doses of certain B vitamins may affect some anticonvulsants or chemotherapeutic agents.

• Reinforced recommendation for folic acid supplementation in women of childbearing age to prevent neural tube defects.
• Emphasis on combined micronutrient supplementation in maternal and child health programs.
• Monitoring of high-dose vitamin B6 use due to neuropathy risk.

• Store at 20°C–25°C (room temperature).
• Protect from moisture and light.
• Keep in tightly closed containers.
• Keep out of reach of children.
• No refrigeration required.