This combination contains Iron (III) Hydroxide Polymaltose complex (IPC) and folic acid for the treatment of iron deficiency and the prevention of iron and folic acid deficiency before, during and after pregnancy (during lactation).

Iron is an important constituent of hemoglobin, myoglobin, and the enzymes which contain iron. Iron deficiency is particularly frequent during pregnancy and lactation, and manifests itself as chronic fatigue, lack of concentration, irritability, nervousness, and headache, loss of appetite, susceptibility to stress and infection, paleness, cracks at the corners of the mouth (rhagades), dry skin, brittle hair and nails.

Clear advantages of IPC over Ferrous Salts:
● Iron in this syrup as iron (iii) hydroxide polymaltose complex associated with a lower incidence of adverse events related to the upper gastro intestinal tract. This protection inhibits interactions of the iron with food. Moreover, it ensures the bio-availability of the iron after oral administration, especially in iron-deficient subjects.
● The structure of Iron Polymaltose Complex is similar to ferritin, the naturally occurring iron storage protein. Due to this similarity, iron is absorbed through natural mechanisms.
● Iron Polymaltose Complex has no pro-oxidative properties such as there are with bivalent iron salts.
● Due to its kinetic properties, IPC is best given with meals, and probably an iron dose slightly higher than that of the classical iron salts.

Folic Acid in this tonic is an important vitamin for the development of an unborn child. Folic Acid deficiency in the first weeks of pregnancy can lead to malformation in the child.

Indications:
● Treatment of latent and manifest iron deficiency and prevention of iron and folic acid deficiency before, during and after pregnancy (during lactation).
● Iron deficiency anemia including
(I) Macrocytic anemia
(II) Anemia due to excessive hemorrhage
(III) Anemia associated with infections
(IV) Anemia associated with malignant disease

About Composition:
Iron (III) Hydroxide Polymaltose Complex: The Iron hydroxide Polymaltose Complex (IPC) is a water-soluble iron oxide, macromolecular complex of polynuclear iron (III) hydroxide and partially hydrolysed dextrin (Polymaltose).
The polynuclear iron (III) hydroxide cores are superficially surrounded by a number of non-covalently bound polymaltose molecules.
The iron polymaltose complex has been formulated in such a way that the elemental form is in a nonionic state. This ensures that there is no gastric irritation with iron polymaltose complex. In addition, the high elemental iron content of IPC eliminates the need for frequent dosing and therefore improves compliance.
Due to these chemical and pharmacological properties IPC is suitable for oral iron substitution.

Folic Acid: Folic acid is used for preventing and treating low blood levels of folic acid (Folic Acid Deficiency), as well as its complication, including ‘’tired blood’ (Anemia) and the inability of the bowel to absorb nutrients properly.

Common Side Effects:
Occasional side-effects include:
● Gastrointestinal irritation
● Sensation of repletion
● Pressure in the epigastric region
● Nausea
● Constipation and Diarrhea

Precautions:
In cases of anaemia due to infection or malignancy, the substituted iron is stored in the reticulo-endothelium system from which it is mobilized and utilized only after correcting the primary disease.

Interactions:
Until now interactions have not been observed:
● Since the iron is complex-bound, ionic interactions with foodstuff components (phytin, exalates, tannin etc.) and concomitant administration of medicament (Tetracycline, antacids) are unlikely to occur.
● This syrup does not cause teeth staining.
● The haemoccult-test (selective for haemoglobin) for the detection of occult blood is not impaired and therefore-iron therapy must not be interrupted.

Pregnancy & Lactation:
Reproduction studies in animals did not show any foetal risk. Controlled studies in pregnant women after the first trimester have not shown any undesirable effects on mother and neonates. There is no evidence of a risk during the first trimester and the possibility of a negative influence to the foetus is unlikely to occur.
Mother's milk contains iron bound to lactoferrin. It is not known how much iron from the complex is passed into mother's milk. The administration of this Syrup is unlikely to cause undesirable effects to the nursed child.
During pregnancy and lactation, this combination should be used on prescription.

Contraindications:
● Iron overload (e.g. haemochromatosis, haemosiderosis)
● Disturbances in iron utilization (e.g. lead anemia, sideroacrestic anemia, thalasaemia)
● Anemia not caused by iron deficiency (e.g. haemolytic anemia)
● Megaloblastic anaemia due to Vitamin B ₁₂ deficiency

Overdose:
In cases of overdose neither intoxication nor iron overload have been reported up to-date.

Storage:
Store in a cool place: Protect from heat, sunlight and moisture. Keep out of the reach of children.