CYRON

Carbonyl Iron Equ. to Elemental Iron (100 mg), Folic acid (1.5 mg), Cyanocobalamin (Vit. B12) (15 mcg), Ascorbic acid (Vit. C) (75 mg), Zinc Sulphate Mono. (61.8 mg)

Carbonyl iron is an iron replacement product. You usually take iron from the foods you eat. Iron helps your body produce red blood cells that carry oxygen through your blood to tissues and organs. Carbonyl iron is used to treat or prevent iron deficiency and iron-deficiency anemia.

Cyanocobalamin injection is used to treat and prevent vitamin B12 deficiency that can be caused by any of the following: Dangerous anemia (a natural substance deficiency required to absorb vitamin B12 from the intestine); Certain diseases, infections, or medications that reduce the number of vitamin B12 absorbed from food; Or vegetarian diet (a strict vegetarian diet that excludes any animal products, including dairy products and eggs). Vitamin B12 deficiency can cause anemia (a condition in which red blood cells do not bring enough oxygen to the organs) and permanent damage to nerves.

Cyron Capsule is used for Megaloblastic anemia due to folic acid deficiency, Treatment of anemia of nutritional origin, Pregnancy, Childhood or Vitamin B12 deficiency, Pernicious anemia, Scurvy, Cell damage, Wound healing, Wound repair, Tissue repair is. , Red blood cell production, iron deficiency, and other conditions. Caron Capsulesme is also used for purposes not listed in this medication guide.

Mechanism of Action:

Iron formulations exerts haematinic action by being an essential constituent of haemoglobin. It is necessary for the oxidative process of living tissues.

Mechanism of Action of folic acid reduced by enzymes folate reductase and dihydrofolate reductase and forms dihydrofolic acid tetrahydrofolic acid respectively. Tetrahydrofolic acid acts as a coenzyme which mediates a number of one carbon transfer reactions by carrying a methyl group as an adduct. It involves a number of reactions such as 1).conversion of homocysteine to methionine. 2).synthesis of thymidylate which is an essential constituent of DNA from methylene-tetrahydrofolic acid. 3). Conversion of serine to glycine by tetrahydrofolic acid and forms methylene-tetrahydrofolic acid. 4).to introduce carbon units at position 2 and 8 during de novo purine synthesis requires formyl-tetrahydrofolic acid and methenyl-tetrahydrofolic acid.5).generation and utilization of “formate pool”. 6).For mediating formino group transfer in histidine metabolism. Folic acid is required to maintain normal erythropoiesis and nucleoprotein synthesis.

Mechanism of Action of Zinc acts as a cofactor for more than 70 different enzymes. Zinc dependent enzymes are involved in the metabolism of carbohydrates, lipids, and proteins. Zinc facilitates wound healing, normal growth rates, normal skin hydration and maintains senses of taste and smell. It provides normal growth and tissue repair. It also helps in development of cell mediated immunity.

Indications:

Indications for Iron (Carbonyl Iron) 1. Iron deficiency
2. Iron deficiency during pregnancy and lactation
3. Iron deficiency in infants and children

Indications for Folic Acid1. Megaloblastic anaemia
2. Folic acid deficiency
3. Anaemias of pregnancy
4. Nutritional anaemia
5. Alcoholism
6. Tropical sprue
7. Non tropical sprue

Indications for Zinc1. Zinc deficiency
2. Acne vulgaris
3. Chronic skin ulcers
4. Adjunct to antimicrobials
5. Delayed wound healing
6. Alopecia

Pharmacokinetic Properties:

Pharmacokinets of Iron (Carbonyl Iron)Absorption: Absorbed orally in ferrous form and poorly absorbed in healthy individuals (about 10%) but in patients suffering from iron deficiency anaemia up to 60% dose is absorbed.
Distribution: Transported in a transferrin bound form in to bone marrow for incorporation in to haemoglobin.
Metabolism: Iron liberated by destruction of haemoglobin is reused by the body.
Excretion: Excretion of iron is minimal. Loss usually occurs in nails, faeces, urine, hair, sweat, and bile.

Pharmacokinets of Folic Acid Absorption: Well absorbed orally
Distribution: Widely distributed in the body and highest concentration is seen in liver. It appears in the CSF and breast milk
Metabolism: Metabolized in to N-methyl tetrahydrofolic acid in liver
Excretion: Extra drug is excreted unchanged in urine. A small portion of folate is lost by a combination of urinary and fecal excretion and oxidative cleavage of molecule.

Pharmacokinets of ZincAbsorption: Poorly absorbed orally, Distribution: Zinc is distributed mainly in to skeletal muscle, skin, bone, pancreas, kidney, liver, retina, prostate, RBC, and WBC. Excretion: Excreted mainly through intestine; only 2% loss in the urine.

Drug-Drug interactions:

Interactions for Iron (Carbonyl Iron)(Oral Iron): Antacids: GI absorption of iron reduced.
Ascorbic acid: GI absorption of iron enhanced.
Chloramphenicol: Serum iron levels may be increased.
Cimetidine: GI absorption may be reduced.
Levodopa: Decreased levodopa serum levels.
Methyldopa: May result in decreased efficacy of methyldopa.
Quinolones: GI absorption of quinolones decreased.
Penicillamine: Marked reduction in GI absorption of penicillamine.
Tetracyclines: Decrease in the absorption of both tetracyclines and iron salts.
Food: Eggs and milk inhibit iron absorption. Administration of calcium and iron supplementation with food reduces ferrous sulfate absorption by one-third. If combined iron and calcium supplementation required then calcium carbonate should be used and the supplementation taken between meals.

Interactions for Folic Acid. Hypersensitivity reactions with injection form
2. Bronchospasm

Interactions for ZincFluoroquinolones, Tetracyclines: Decreased GI absorption and serum levels of some fluoroquinolone.
Pencillamine: Reduced absorption of zinc.
Iron: Reduced absorption of iron and vice versa.

Precautions:

Special Precautions while taking Iron (Carbonyl Iron)1. Prolonged use
2. Minimise gastrointestinal discomfort by taking along with meals and gradually increasing the recommended dosage
3. Discontinue if intolerance occurs
4. Higher doses are required for geriatric patients

Special Precautions while taking Folic Acid. In patients with undiagnosed anaemia; because it may mask pernicious anaemia
2. In pernicious anaemia and other megaloblastic where vitamin B12 is deficient

Special Precautions while taking Zinc. Don`t exceed prescribed dose
2.Renal failure
3.Biliary obstruction

Fertility:

Dosage:

Usual Adult Dose for Iron Deficiency Anemia:

50 mg orally three times a day.

Usual Pediatric Dose for Iron Deficiency Anemia:

Premature neonates:
2 to 4 mg elemental iron/kg/day divided every 12 to 24 hours (maximum daily dose = 15 mg).

Infants and children <12 years:
Prophylaxis: 1 to 2 mg elemental iron/kg/day (maximum 15 mg) in 1 to 2 divided doses.

Mild to moderate iron deficiency anemia:
3 mg elemental iron/kg/day in 1 to 2 divided doses.

Severe iron deficiency anemia:
4 to 6 mg elemental iron/kg/day in 3 divided doses.

Typical Dosage for Folic Acid Oral: 5mg 1 to 4 times daily; depending up on the severity of deficiency.
Maintenance dosage: Half of the therapeutic dosage.
Children: 2.5 to 5mg 1 to 2 times daily.

Adults: 25 to 50mg zinc daily or 1 to 2 tablets daily.
Children: 5mg/kg 1 to 3 times daily.

Duration of action:

Duration of Action for Iron (Carbonyl Iron)2 to 4 months

Duration of Action for Folic AcidOral: 3 to 6 hours
I.V.:3 to 6minutes
I.M.:3 to 6hours

Adverse Reaction:

Storage:

Store at room temperature, away from moisture and heat.

Storage Requirements for Folic Acid Store at controlled room temperature at a range of 15 to 25 degree C in a well closed container. Protect from excess heat, light and moisture.

Storage Requirements for Zinc Store at a temperature below 30 degree C

Overdosage:

Treatment includes immediate support of airway, respiration, and circulation. In conscious patients induce emesis with ipecac; if not empty stomach by gastric lavage. Follow emesis with lavage, using a 1% sodium bicarbonate solution to convert iron to less irritating poorly absorbed form. Take abdominal X-ray to determine presence of excess iron. Deferoxamine may be used for systemic chelation if serum levels of iron exceed 350mg/dl.

Effects of Overdose of Folic AcidRelatively non toxic. Provide symptomatic treatment and supportive measures.

Contraindictions:

Contra-indications of Iron (Carbonyl Iron)1. Haemolytic anaemia unless iron deficiency anaemia is also present
2. Haemochromatosis
3. Haemosiderosis
4. Peptic ulcer
5. Regional enteritis
6. Ulcerative colitis
7. Those receiving repeated blood transfusions

Side effects:

Side Effects of Iron (Carbonyl Iron)1. Nausea
2. Epigasttric distress
3. Vomiting
4. Constipation
5. Diarrhoea
6. Black stools
7. Temporary staining of teeth with liquid formulations

Side Effects of Zinc1. Nausea
2. Vomiting
3. Abdominal distress
4. Gastric ulceration
5. Rashes

Warnings:

Pregnancy:

There is no information available on use of carbonyl iron during pregnancy. Consult your doctor.

Breast Feeding:

Carbonyl iron is excreted in breast milk. Consult your doctor before breastfeeding.

Old Age