Ferrous sulfate with folic acid

The indication in the dose line is quoted from §4.6, verbatim: 'Ferrograd Folic is indicated for prevention and treatment of iron deficiency anaemia of pregnancy, and prophylaxis of megaloblastic anaemia of pregnancy.' CHILDREN (§4.2), verbatim: 'Not recommended for children under 12 years.' No paediatric dose is stated in this SPC, which is why paedDose is null. FOLIC ACID AND B12: pernicious anaemia is rare in women of childbearing age and is less likely in pregnancy, as vitamin B12 deficiency reduces fertility; however, folic acid at the recommended dosage may obscure the neurological manifestations of pernicious anaemia. ASPIRATION AND SWALLOWING: aspiration of iron sulfate tablets can cause necrosis of the bronchial mucosa, which may result in coughing, haemoptysis, bronchostenosis and/or pulmonary infection, even if aspiration happened days to months before the symptoms occurred; elderly patients and patients with difficulty swallowing should only be treated with iron sulfate tablets after careful evaluation of the individual risk of aspiration, and alternative formulations should be considered. The controlled-release tablet and its inert plastic matrix may cause a safety hazard in some elderly or other patients suffering from delayed intestinal transit. Due to the risk of mouth ulcerations and tooth discolouration, tablets must not be sucked, chewed or kept in the mouth. INTERACTION SPACING (§4.5): iron inhibits the absorption of tetracyclines and tetracycline inhibits the absorption of iron — if both must be given, tetracycline should be administered three hours after or two hours before oral iron. Oral iron should not be taken within one hour before or two hours after antacids, calcium supplements (carbonate or phosphate), tea, coffee, eggs, food or medicines containing bicarbonates, carbonates, oxalates or phosphates, milk or milk products, wholegrain breads and cereals, or dietary fibre. Iron also interacts with magnesium trisilicate, trientine and zinc salts (absorption of all may be impaired) and may interfere with the oral absorption of some quinolone anti-infectives. Some sections of the product information we used were incomplete — check the full SPC. EXCIPIENTS: contains lactose — patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine. STORAGE WARNING: keep out of children's reach; acute iron poisoning occurs rarely in adults but could happen if children swallow this medication, and overdose may be fatal.