Tearfresh Liquigel

Approved Indications:

• Iron Deficiency Anemia: Treatment and prevention of iron-deficiency anemia, particularly in pregnancy, lactation, menstruation, adolescence, and post-surgical recovery.
• Megaloblastic Anemia: Due to folic acid deficiency.
• Zinc Deficiency States: Including dietary deficiency, malabsorption syndromes, chronic diarrhea, and post-infectious states.
• Vitamin B Complex Deficiency: Correction of deficiencies in B1, B2, B3, B5, B6, B12 due to poor diet, chronic alcoholism, prolonged illness, or metabolic disorders.
• Vitamin C Deficiency (Scurvy): Prevention and treatment of scurvy or other conditions with increased ascorbic acid requirements.
• Pregnancy & Lactation Support: Comprehensive supplementation for maternal and fetal health during pregnancy and lactation.
• General Nutritional Support: In patients with poor nutrition, chronic disease, fatigue, or recovery from infections or surgery.

Important Off-label/Clinically Accepted Uses:

• Adjunctive in Chronic Diseases: To support nutritional balance in chronic renal failure, heart failure, or liver disease.
• Hair Loss Treatment (Telogen Effluvium): In iron and zinc deficiency-associated cases.
• Post-bariatric Surgery Supplementation

Route of Administration: Oral

Adults (including pregnant/lactating women):

• 1 capsule/tablet once daily with meals or as directed by a physician.

Adolescents (12–18 years):

• 1 capsule/tablet once daily with meals.

Pediatrics (<12 years):

• Not routinely recommended unless prescribed by a physician. Pediatric-specific formulations should be used.

Elderly:

• Same as adult dose; monitor for iron or vitamin accumulation due to slower metabolism.

Renal Impairment:

• Use with caution; adjust dosage if needed due to zinc and vitamin C accumulation risk.

Hepatic Impairment:

• Monitor liver function with long-term use due to potential iron overload.

Administration Advice:

• Take after food to reduce gastrointestinal discomfort.
• Avoid taking with antacids or calcium supplements within 2 hours.
• Swallow whole; do not crush or chew.

This combination provides essential micronutrients with synergistic roles in hematopoiesis, immune function, and cellular metabolism.

• Carbonyl Iron is a highly bioavailable form of elemental iron that is slowly absorbed in the duodenum and jejunum, replenishing iron stores and enabling hemoglobin synthesis.
• Folic Acid facilitates DNA synthesis and erythropoiesis, essential in megaloblastic anemia and fetal neural development.
• Zinc Sulfate is a cofactor in over 300 enzymatic processes, supporting immune defense and wound healing.
• Vitamin B Complex components (B1, B2, B3, B5, B6, B12) play vital roles in energy metabolism, neurological function, and red blood cell formation.
• Vitamin C (Ascorbic Acid) enhances iron absorption from the gut and acts as a potent antioxidant, maintaining capillary integrity and immune function.

Carbonyl Iron:

• Absorption: Slowly absorbed; bioavailability ~70%.
• Distribution: Binds to transferrin; stored in liver, spleen, bone marrow.
• Metabolism: Not metabolized.
• Excretion: Primarily via feces (unabsorbed); minimal renal elimination.

Folic Acid:

• Absorption: Rapid and complete in the proximal small intestine.
• Distribution: Stored in liver and tissues.
• Metabolism: Hepatic; converted to tetrahydrofolate.
• Excretion: Urine and bile.

Zinc Sulfate:

• Absorption: ~20–30% bioavailable; affected by phytates.
• Distribution: Widely distributed; high in muscle and bone.
• Excretion: Mainly feces; minor via urine and sweat.

Vitamin B Complex:

• Absorption: Mostly in small intestine.
• Metabolism: Converted to active coenzyme forms.
• Excretion: Water-soluble; primarily via urine.

Vitamin C:

• Absorption: Efficient at low doses, saturable at high doses.
• Distribution: Widespread; stored in adrenal and pituitary glands.
• Metabolism: Minimal.
• Excretion: Urine; increased during high plasma concentrations.

Pregnancy:

• Generally considered safe. Folic acid and iron are essential during pregnancy to prevent anemia and neural tube defects.
• Zinc and B-complex vitamins are necessary for fetal development.
• Vitamin C is safe in recommended doses.

Lactation:

• Safe for breastfeeding mothers.
• Iron, zinc, folic acid, and B-vitamins are excreted in small amounts into breast milk, but not known to harm the infant.
• Monitor for excess intake if infant receives other supplements.

Caution:
Avoid megadoses; always follow physician-prescribed dosages.

• Nutritional Supplement
• Subclass: Hematinic and Multivitamin Combination

• Known hypersensitivity to any component of the formulation
• Hemochromatosis or other iron overload syndromes
• Wilson’s disease (for zinc-containing products)
• Pernicious anemia (vitamin B12 alone may not suffice)
• Severe renal impairment (due to risk of vitamin/mineral accumulation)

• Iron Toxicity: Especially in children; keep out of reach.
• Gastrointestinal Effects: May cause constipation or dark stools.
• Chronic Use: Monitor iron stores and liver enzymes.
• Zinc Overload: Can cause copper deficiency with long-term high doses.
• Folic Acid: May mask vitamin B12 deficiency.
• Renal Impairment: Monitor for vitamin C and zinc accumulation.
• Allergic Reactions: Rare but possible; watch for rash, itching, or swelling.

Common (≥1%):

• Gastrointestinal: Nausea, constipation, abdominal discomfort, flatulence, metallic taste
• Neurological: Headache, dizziness
• Stool: Dark or black-colored stools (iron-related)

Less Common/Rare:

• Allergic rash, urticaria
• Flushing (niacin-related)
• Zinc-induced gastric irritation

Serious (Very Rare):

• Anaphylactic reactions (extremely rare)
• Iron overload in chronic use

• Antacids, calcium, and dairy products: Decrease iron and zinc absorption.
• Tetracyclines/Quinolones: Chelation with iron or zinc reduces antibiotic absorption.
• Levodopa: Vitamin B6 (pyridoxine) may reduce efficacy.
• Methotrexate and Sulfasalazine: Decrease folate levels; folic acid supplementation may be necessary.
• Vitamin C: Enhances iron absorption; avoid megadoses to reduce risk of oxalate kidney stones.
• CYP Enzyme Interactions: Not significant at therapeutic doses.

• WHO and CDC continue to recommend iron-folic acid supplementation during pregnancy.
• USPSTF reaffirms universal folic acid use for all women of childbearing age.
• Recent guidelines emphasize combined micronutrient therapy in pregnancy and chronic illness, favoring combinations like this formulation for improved adherence and synergistic benefit.

• Store below 25°C.
• Protect from light, moisture, and excessive heat.
• Keep in original packaging.
• Do not freeze.
• Keep out of reach of children.
• Do not use past the expiry date.