MYHEMO BRV medicine for preventive treatment iron and folic acid during pregnancy (3 blisters x 10 tablets)

Dosage form Tablet
Specifications Box of 3 blisters x 10 tablets
Ingredient Ferrous fumarate, folic acid

Ingredient

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Composition information	Content
Ferrous Fumarate	305mg
Folic Acid	0.35mg

Uses

indications

Myhemo medicine used to prevent iron and folic acid during pregnancy.

Pharmacokic

ATC code: B03AD. Drug group: Iron combined with folic acid.

Myhemo is a combination of fumarate and folic acid. There is evidence that daily dose of 100mg elemental iron and 200-500 micrograms folic acid can be used to prevent iron and folic acid during pregnancy.

This product contains 305 mg of fumarate iron, equivalent to 100 mg of elemental iron and 350 micrograms of folic acid, so when using a tablet daily is enough to provide the necessary backup dose.

Dynamic pharmacokinetics

iron

absorption

iron is unevenly absorbed and not completely from the gastrointestinal tract, the absorption position is the duodenum and no colon. The absorption is enhanced by the acid secretion of the stomach or the acids in food (such as ascorbic acid), and is more likely to be affected when iron in the form of iron. The absorption also increases in iron deficiency or hunger, but the absorption will decrease if the body reserves are excess.

Distribution

After absorbing, most iron associated with Transferin and is transported into the bone marrow where iron merged into Haemoglobin, the rest is stored in the form of Ferritin or Haemosiderin or Myoglobin and a smaller amount in enzymes containing Haem or in similar bloodshed with Transferrin.

Elimination

Only a small amount of iron is eliminated, most iron released after destroying the Haemoglobin molecule is reused. Due to the reserves of the body and lack of excess iron elimination mechanism is the reason for creating excess iron when using overdose in treatment or many blood transfusions.

folic acid

absorption

Folic acid is quickly absorbed through the gastrointestinal tract, mainly in the duodenum and non -colon. Folats in food are thought to have only half the bioavailability of crystallized folic acid.

Distribution, metabolism

Natural folats, polyglutamate folats are mostly combined and reduced by dihydrofolat reductase in the intestine into 5-methyltetrahydrofolate, which appears in the circulation of, which is strongly connected to plasma proteins. Folic acid used in treatment mostly in the door circulation in constant form, as a substrate is less reduced by dihydrofolat reductase. It is transformed into a activity of 5 -Methyllahydrofolate in plasma and liver. The main reserve of folat is the liver and actively concentrated in cerebrospinal fluid.

Elimination

Folat after being metabolized in the liver, folat metabolites are eliminated through urine and excess folat parts in addition to body needs are excreted intact in the urine. Folat is excreted through breast milk. Folic acid can be excluded by hemorrhage.

Before taking MYHEMO BRV medicine for preventive treatment iron and folic acid during pregnancy (3 blisters x 10 tablets)

How to use

oral medication.

Dosage

Adults: One tablet daily during pregnancy or as instructed by a doctor.

Children: Do not use drugs for children.

Elderly: Do not take medicine for the elderly.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when using overdose? Take an amount of 75 mg/kg of elemental iron is considered extremely dangerous in young children.

Symptoms:

The starting symptoms of iron overdose include nausea, vomiting, diarrhea, abdominal pain, vomiting of blood, rectal bleeding, fidgety sleep and circulation. Hyperglycemia and metabolic acidosis may occur. However, if suspected of an overdose, should be treated immediately. In serious cases, after a hidden period, recurrence may occur after 24 - 48 hours manifested by hypotension, coma, hypothermia, liver necrosis, kidney failure, pulmonary edema, spreading blood vessels, blood clotting disorders and/or convulsions. In many cases, fully recovery can be complicated due to long -term sequelae such as liver necrosis, toxic encephalitis, central nerve damage and pyloric stenosis.

Management:

Take the following steps to minimize or prevent drug absorption.

Children:

for a vomiting substance such as ipeca syrup. Then pump more Desferrioxamine 5 g solution for 50 - 100 ml of water, to stay in the stomach. Diarrhea in children may be dangerous and need to be treated in young children. Continuous monitoring should be monitored to detect the possibility of vomiting, maintain an emergency suction device and prophylaxis in case of necessity. Desferrioxamine should be used 15mg/kg body weight per hour by transmitting IV slowly to up to 80 mg/kg/24 hours. (Warning: hypotension may occur if the rate of transmission is too fast).
Extracting iron overdose during pregnancy must be the same as for patients who are not pregnant and if clinically indicated, the treatment with desferrioxamine cannot be delayed.
1. for a vomiting drug. The Desferrioxamine solution should be used (2 g/l). After cleansing the stomach, pump into the stomach of Desferrioxamine 5 g solution in 50 - 100 ml of water. For patient monitoring continuously to detect the possibility of vomiting; Maintain preventive emergency suction and exhalation equipment in case of necessity. The recommended dose of desferroxamine is 5 mg/kg/hour by transmitting IV slowly to a maximum of 80 mg/kg/24 hours. (Warning: hypotension may occur if the rate of transmission is too fast).
  What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

can minimize the side effects by using the same food or after eating or starting to use small doses and increasing the dose gradually.

Side effects arranged by classification and frequency listed in the following table:

Disorder classification

(≥ 1/100 -
(≥ 1/1000 - rare
(≥ 1/10000 - Clearly

the immune system Allergic reaction Anaphylactic reaction The overdose or improper treatment

gastrointestinal tract Gastrointestinal disorders (such as nausea, vomiting, constipation, diarrhea)

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

MYHEMO drug contraindicated in the following cases:

Hypersensitivity to the active ingredients or any ingredients of the drug. Other than iron deficiency.

Be cautious when used

This drug is only used for preventing iron deficiency and folic acid during pregnancy. The folic acid dose is not enough to treat huge red blood cell anemia. The development of anemia, despite having prophylaxis with this drug, still needs more research and appropriate treatment.

Iron -containing preparations should be used cautiously in patients with protoporphyrin metabolic disorders due to red blood cells.

Preparations containing iron dyed black stool, which can affect blood detection tests in the stool.

lactose

Because this product contains Lactose Monohydrate excipients, should not be used for patients with rare genetic problems in tolerance of galactose, lactase deficiency, or poorly absorbed glucose-galactose.

The effect of the drug on the ability to drive and operate machinery

The drug does not affect the ability to drive, operate machinery.

Use drugs for women during pregnancy and lactation

Pregnant women:

Medicines suitable for pregnant women.

breastfeeding women:

Suitable drug for breastfeeding women.

Drug interaction

iron chelate when used in combination with tetracyclin and the absorption of both substances are reduced, if used in combination with 2 drugs, it must be used about 2-3 hours away. Iron also chelate with acetohydroxamic acid reduces the absorption of both drugs.

iron absorption may be reduced when the presence of antacids and proton pump inhibitors reduce stomach acid. Iron absorption may also be reduced when food (such as tea, coffee, whole grains, eggs and milk), neomycin and cholestyramine. Bicarbonate, carbonate, oxalate or phosphate can reduce iron absorption due to the formation of insoluble complexes. Iron absorption can be increased by ascorbic acid or citric acid.

iron absorption may be reduced by calcium, oral magnesium salts and other mineral supplements, accompanied and trientine. If the treatment of iron and trientine is necessary, it is necessary to use a suitable time away.

iron response may be slow in patients using chloramphenicol. Chloramphenicol slowed down the iron clearance in plasma and iron combination into red blood cells due to the influence of red blood cells.

iron reduces the hypotension effect of methyldopa.

Should avoid simultaneous use of iron and dimercaprol because it can form a toxic complex.

iron reduces the absorption of fluoroquinolone, levodopa, carbidopa, entacapone, bisphosphonate, penicillamine, thyroid hormones such as levothyroxin (for at least 2 hours apart), mycophenolate, cefdinir and zinc. Iron can reduce the absorption of Eltrombopag (for at least 4 hours apart).

Serum anti -convulsed drug concentration may be reduced when used with folate, such as folic acids can reduce the plasma concentrations of phenobarbital, phenytoin and primidone.

Should avoid simultaneous use of folic acid with raltitrexed.

The absorption of folic acid may be reduced by sulfasalazine.

Storage

Leave a cool place, avoid light, temperatures below 30⁰C.

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