Optifer

A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses (poaceae). Folic acid (Optifer) is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [PubChem]

A central respiratory stimulant with a brief duration of action. (From Martindale, The Extra Pharmocopoeia, 30th ed, p1225)

A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, Vitamin C (Optifer), functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C (Optifer) is considered an antioxidant.

Iron deficiency due to blood loss, pregnancy, lactation, iron deficiency anemia, hemorrhoids, worm infestation, ulcerative colitis.

Zinc is a naturally occurring mineral. Zinc is important for growth and for the development and health of body tissues.

Nutritional supplement and general tonic.copper and zinc defficiency.

Folic acid (Optifer) is used in the treatment and prevention of the folate deficiency state. It does not correct folate deficiency due to dihydrofolate reductase inhibitors. Folic acid (Optifer) is also used in women of child-bearing potential and pregnant women to protect against neural tube defects in their offspring. It is also used for the treatment of folate-deficient megaloblastic anaemia, chronic haemolytic states such as thalassaemia major or sickle-cell anaemia.

Pernicious anaemia, peripheral neuritis especially diabetic and alcoholic polyneuritis, trigeminal neuritis, vomiting of pregnancy, Vitamin B (Optifer) complex deficiency, anorexia, agranulocytosis, radiation sickness, coeliac and idiopathic, steatorrhoea which are usually accompanied by malabsorption of Vitamin B (Optifer) 12 and during administration of broad-spectrum antibiotics.

For systemic use of Vitamin C (Optifer): prevention and treatment of hypo- and avitaminosis of Vitamin C (Optifer); providing increased need for Vitamin C (Optifer) during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.

For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Folic acid (Optifer) (vitamin B 9) is necessary for strong blood.

Lack of Folic acid (Optifer) may lead to anemia (weak blood). Your health care professional may treat this by prescribing Folic acid (Optifer) for you.

Some conditions may increase your need for Folic acid (Optifer). These include:

• Alcoholism
• Anemia, hemolytic
• Diarrhea (continuing)
• Fever (prolonged)
• Hemodialysis
• Illness (prolonged)
• Intestinal diseases
• Liver disease
• Stress (continuing)
• Surgical removal of stomach

In addition, infants smaller than normal, breast-fed infants, or those receiving unfortified formulas (such as evaporated milk or goat's milk) may need additional Folic acid (Optifer).

Increased need for Folic acid (Optifer) should be determined by your health care professional.

Some studies have found that Folic acid (Optifer) taken by women before they become pregnant and during early pregnancy may reduce the chances of certain birth defects (neural tube defects).

Claims that Folic acid (Optifer) and other B vitamins are effective for preventing mental problems have not been proven. Many of these treatments involve large and expensive amounts of vitamins.

Injectable Folic acid (Optifer) is given by or under the direction of your health care professional. Another form of Folic acid (Optifer) is available without a prescription.

Ascorbic acid (Vitamin C (Optifer)) occurs naturally in foods such as citrus fruit, tomatoes, potatoes, and leafy vegetables. Vitamin C (Optifer) is important for bones and connective tissues, muscles, and blood vessels. Vitamin C (Optifer) also helps the body absorb iron, which is needed for red blood cell production.

Ascorbic acid is used to treat and prevent Vitamin C (Optifer) deficiency.

Ascorbic acid may also be used for purposes not listed in this medication guide.

Usual Adult Dose for Megaloblastic Anemia

1 mg orally, intramuscularly, subcutaneously or IV once a day. May continue until clinical symptoms of folate deficiency and the hematological profile have normalized.

Usual Adult Dose for Folic acid (Optifer) Deficiency

400 to 800 mcg orally, intramuscularly, subcutaneously or IV once a day.

Women of childbearing age, pregnant, and lactating women: 800 mcg orally, intramuscularly, subcutaneously or IV once a day.

Usual Pediatric Dose for Folic acid (Optifer) Deficiency

Infant:

0.1 mg orally, intramuscularly, subcutaneously or IV once a day.

Child:

Less than 4 years: up to 0.3 mg orally, intramuscularly, subcutaneously or IV once a day.

4 years or older: 0.4 mg orally, intramuscularly, subcutaneously or IV once a day.

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Recommended daily allowance (RDA):

Premature neonates: 50 mcg/day (15 mcg/kg/day).

Full-term neonates and infants 1 to 6 months: 25 to 35 mcg/day.

Children:

1 to 3 years: 150 mcg/day.

4 to 8 years: 200 mcg/day.

9 to 13 years: 300 mcg/day.

14 years and older: 400 mcg/day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Rarely, a dosage of 2 mg/day may be required, particularly in patients with malabsorption, alcoholism, chronic hemolysis, chronic exfoliative skin disease or who are on concomitant anticonvulsant therapy.

Dialysis

Folic acid (Optifer) is removed by both hemodialysis and peritoneal dialysis. The amount removed varies with type equipment used.

Because folate may accumulate in patients with end-stage renal disease, side effects may be more likely in this patient who is undergoing dialysis. Once this patient's body stores of folate are replete, three times a week dosing may be just as beneficial as once daily dosing but should portend a lower risk of side effects.

Other Comments

The recommended daily allowance of Folic acid (Optifer) for adult males and females ranges from 150 to 200 and 150 to 180 mcg/day, respectively.

There is a potential danger in administering Folic acid (Optifer) to patients with undiagnosed anemia, since Folic acid (Optifer) may obscure the diagnosis of pernicious anemia by alleviating the hematologic manifestations of the disease while allowing the neurologic complications to progress.

Severe megaloblastic anemia may require therapy for 4 to 5 weeks. Once stabilized, if dietary intake is inadequate, maintenance therapy can be started.

Initially 3ml i.m daily. Subsequently 2-3 times/week.

This medication administered orally, IM, IV, intravaginally.

For the prevention of deficiency conditions Vitamin C (Optifer) dose is 25-75 mg / day, for the treatment - 250 mg / day or more in divided doses.

For intravaginal used ascorbic acid drugs in appropriate dosage forms.

Renal failure

Severe kidney disease

See also:
What is the most important information I should know about Folic acid (Optifer)?

Because it may mask the hematologic abnormalities while neurological damage progresses, Folic acid (Optifer) should not be used in the therapy of patients with vitamin B12 deficiency of any cause, unless there is associated folate deficiency. The Folic acid (Optifer) content of one tablet a day however, is unlikely to mask pernicious anemia should this condition be present. Also, pregnancy during pernicious anemia is very rare.

Due to its benzyl alcohol content, doxapram injection is contraindicated in neonates.

Vitamin B (Optifer) should not be used in patients with epilepsy or other convulsive disorders.

Vitamin B (Optifer) is contraindicated in patients with mechanical disorders of ventilation such as mechanical obstruction, muscle paresis, flail chest, pneumothorax, acute bronchial asthma, pulmonary fibrosis or other conditions resulting in restriction of chest wall, muscles of respiration or alveolar expansion.

Vitamin B (Optifer) is contraindicated in patients with evidence of head injury or cerebral vascular accident and in those with significant cardiovascular impairment, severe hypertension, or known hypersensitivity to the drug or any of the injection components.

AV-block II and III degree, sinoatrial block, SSS, bradycardia (HR < 40 bpm), hypotension (in case of myocardial infarction, systolic blood pressure less than 100 mm Hg), cardiogenic shock, congestive heart failure IIB-III stages, acute heart failure, Prinzmetal's angina, lactation, concomitant use of MAO inhibitors, hypersensitivity to atenolol.

Use Folic acid (Optifer) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Folic acid (Optifer) may be administered as an injection by your health care professional.
• If you are using Folic acid (Optifer) at home, carefully follow the injection procedures taught to you by your health care provider. If the medicine contains particles, is discolored, or if the vial is cracked or damaged in any way, do not use it.
• Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for selecting an appropriate container and properly disposing of the container when full.
• If you miss a dose of Folic acid (Optifer), use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Folic acid (Optifer).

Iron supplements are takrn orally to treat and prevent anemia due to iron deficiency (lack of enough iron that affects development of red blood cells causing reduction in number of red blood cells in the body).Iron is also used in the form of iron dextran injection is used to treat iron deficiencies and iron deficiency anemia (low red blood cells) in severe deficiencies or when the patient cannot tolerate iron orally. Iron sucrose injection is used to treat iron deficiency anemia in people with kidney disease. It is usually given with another medication to promote the growth of red blood cells

Folic acid (Optifer) is the man-made form of folate. Folate is a B-vitamin naturally found in some foods. It is needed to form healthy cells, especially red blood cells.

Folic acid (Optifer) supplements may come in different forms (such as L-methylfolate, levomefolate, methyltetrahydrofolate). They are used to treat or prevent low folate levels. Low folate levels can lead to certain types of anemia. Conditions that can cause low folate levels include poor diet, pregnancy, alcoholism, liver disease, certain stomach/intestinal problems, kidney dialysis, among others. Women of childbearing age should receive adequate amounts of Folic acid (Optifer) either through their diet or supplements to prevent infant spinal cord birth defects.

How to use Folic acid (Optifer)

Take this product by mouth with or without food as directed by your doctor, usually once daily. If you are taking the over-the-counter product, follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.

Dosage is based on your medical condition and response to treatment. Do not increase your dose or take this product more often than directed.

Take this product regularly to get the most benefit from it. To help you remember, take it at the same time each day. Follow the diet plan recommended by your doctor or dietician. See also Notes section.

If your condition persists or worsens, or if you think you may have a serious medical problem, get medical help right away.

This product is a combination of B vitamins used to treat or prevent vitamin deficiency due to poor diet, certain illnesses, alcoholism, or during pregnancy. Vitamins are important building blocks of the body and help keep you in good health. B vitamins include thiamine, riboflavin, niacin/niacinamide, vitamin B6, vitamin B12, Vitamin B (Optifer), and pantothenic acid.

Some brands of B vitamins also contain ingredients such as vitamin C, vitamin E, biotin, or zinc. Consult your doctor or pharmacist if you have questions about the ingredients in your brand.

How to use Vitamin B (Optifer)

Take this medication by mouth, usually once daily or as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.

If you are taking a brand that contains vitamin C, take this medication by mouth with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise.

If you are taking chewable tablets, chew the tablet thoroughly before swallowing.

If you are taking extended-release capsules, swallow them whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

If you are taking a liquid product, use a medication-measuring device to carefully measure the dose. Do not use a household spoon. Some liquid products need to be shaken before each dose. Some products that contain vitamin B12 need to be placed under the tongue and held there before swallowing. Follow label directions carefully to get the most benefit.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.

Ascorbic acid (Vitamin C (Optifer)) is used to prevent or treat low levels of Vitamin C (Optifer) in people who do not get enough of the vitamin from their diets. Most people who eat a normal diet do not need extra ascorbic acid. Low levels of Vitamin C (Optifer) can result in a condition called scurvy. Scurvy may cause symptoms such as rash, muscle weakness, joint pain, tiredness, or tooth loss.

Vitamin C (Optifer) plays an important role in the body. It is needed to maintain the health of skin, cartilage, teeth, bone, and blood vessels. It is also used to protect your body's cells from damage. It is known as an antioxidant.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This vitamin may also be used with other vitamins for a certain eye condition (macular degeneration).

How to use Vitamin C (Optifer)

Take this vitamin by mouth with or without food, usually 1 to 2 times daily. Follow all directions on the product package, or take as directed by your doctor.

If you are taking the extended-release capsules, swallow them whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Take this product with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise.

If you are taking the wafers or chewable tablets, chew them thoroughly and then swallow. If you are taking the lozenges, place the lozenge in your mouth and allow it to slowly dissolve.

If you are taking the powder, mix it thoroughly in the proper amount of liquid and stir well. Drink all of the liquid right away. Do not prepare a supply for future use. If you are using the liquid form of this vitamin, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

Dosage is based on your medical condition and response to treatment.

Use this vitamin regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

If you think you may have a serious medical problem, seek immediate medical attention.

Concomitant administration of zinc and iron and copper salts, the absorption of zinc in the body is reduced.

Some drugs absorb zinc salts and thereby reduce the Zink in the body. These drugs include D-penicillamine, and Dimercaptopropansulfoedetic acid. Between the use of these drugs and preparations of zinc should be at least two hours interval.

See also:
What other drugs will affect Folic acid (Optifer)?

Medications that interfere with your bodys ability to use folate may also increase the need for this vitamin. Medications can interfere with folate utilization, including: anticonvulsant medications (such as phenytoin, and primidone) metformin (sometimes prescribed to control blood sugar in type 2 diabetes) sulfasalazine (used to control inflammation associated with Crohns disease and ulcerative colitis) triamterene (a diuretic) Methotrexate There has been concern about the interaction between vitamin B12 and Folic acid (Optifer). Folic acid (Optifer) supplements can correct the anemia associated with vitamin B12 deficiency. Unfortunately, Folic acid (Optifer) will not correct changes in the nervous system that result from vitamin B12 deficiency. Permanent nerve damage could theoretically occur if vitamin B12 deficiency is not treated. Therefore, intake of supplemental Folic acid (Optifer) should not exceed 1000 micrograms (g, sometimes mcg) per day to prevent Folic acid (Optifer) from masking symptoms of vitamin B12 deficiency. It is important for older adults to be aware of the relationship between Folic acid (Optifer) and vitamin B12 because they are at greater risk of having a vitamin B12 deficiency. If you are 50 years of age or older, ask your physician to check your B12 status before you take a supplement that contains Folic acid (Optifer).

If you are taking this product under your doctor's direction, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not stop, start, or change the dosage of any medicine before checking with them first.

Before using this product, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: altretamine, cisplatin, certain antibiotics (e.g., chloramphenicol), certain anti-seizure drugs (e.g., phenytoin), levodopa, other vitamin/nutritional supplements.

This product may interfere with certain laboratory tests (e.g., urobilinogen, intrinsic factor antibodies), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this product.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

In an application with barbiturates, primidone increases the excretion of ascorbic acid in the urine.

With the simultaneous use of oral contraceptives reduces the concentration of ascorbic acid in blood plasma.

In an application of Vitamin C (Optifer) with iron preparations ascorbic acid, due to its regenerative properties, transforms ferric iron in the bivalent, which improves its absorption.

Ascorbic acid in high doses can decrease urine pH that while the application reduces the tubular reabsorption of amphetamine and tricyclic antidepressants.

With the simultaneous use of aspirin reduces the absorption of ascorbic acid by about a third.

Vitamin C (Optifer) in an application with warfarin may decrease effects of warfarin.

With the simultaneous application of ascorbic acid increases the excretion of iron in patients receiving deferoxamine. In the application of ascorbic acid at a dose of 500 mg / day possibly left ventricular dysfunction.

In an application with tetracycline is increased excretion of ascorbic acid in the urine.

There is a described case of reducing the concentration of fluphenazine in plasma in patients treated with ascorbic acid 500 mg 2 times / day.

May increase the concentration of ethinyl estradiol in the blood plasma in its simultaneous application in the oral contraceptives.

Applies to carbonyl iron: suspension

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; darkened or green stools; diarrhea; loss of appetite; nausea; stomach cramps, pain, or upset; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur while taking carbonyl iron (the active ingredient contained in Elemental iron (Optifer))

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or tarry stools; blood or streaks of blood in the stool; fever; severe or persistent nausea, stomach pain, or vomiting; vomit that looks like blood or coffee grounds.

Those listed here, known side effects. They can occur, but need not, as each person responds differently to medications.

If you experience symptoms of an allergic reaction, tell your doctor or pharmacist.

So far no side effects are known.

See also:
What are the possible side effects of Folic acid (Optifer)?

Allergic sensitization has been reported following both oral and parenteral administration of Folic acid (Optifer).

Folic acid (Optifer) is relatively nontoxic in man. Rare instances of allergic responses to Folic acid (Optifer) preparations have been reported and have included erythema, skin rash, itching, general malaise, and respiratory difficulty due to bronchospasm. One patient experienced symptoms suggesting anaphylaxis following injection of the drug. Gastrointestinal side effects, including anorexia, nausea, abdominal distention, flatulence, and a bitter or bad taste, have been reported in patients receiving 15 mg Folic acid (Optifer) daily for 1 month. Other side effects reported in patients receiving 15 mg daily include altered sleep patterns, difficulty in concentrating, irritability, overactivity, excitement, mental depression, confusion, and impaired judgment. Decreased vitamin B12 serum levels may occur in patients receiving prolonged Folic acid (Optifer) therapy.

In an uncontrolled study, orally administered Folic acid (Optifer) was reported to increase the incidence of seizures in some epileptic patients receiving phenobarbital, primidone, or diphenylhydantoin. Another investigator reported decreased diphenylhydantoin serum levels in folate-deficient patients receiving diphenylhydantoin who were treated with 5 mg or 15 mg of Folic acid (Optifer) daily.

CALL YOUR DOCTOR FOR MEDICAL ADVICE ABOUT SIDE EFFECTS. YOU MAY REPORT SIDE EFFECTS TO THE FDA AT 1-800-FDA-1088 OR LEADING PHARMA, LLC AT 844-740-7500.

Mild upset stomach or flushing may occur. These effects are usually temporary and may disappear as your body adjusts to this product. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

If your doctor has directed you to take this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Applies to ascorbic acid: oral capsule, oral capsule extended release, oral capsule liquid filled, oral granule, oral liquid, oral lozenge/troche, oral powder, oral powder for solution, oral powder for suspension, oral solution, oral syrup, oral tablet, oral tablet chewable, oral tablet extended release, oral wafer

As well as its needed effects, ascorbic acid (the active ingredient contained in Vitamin C (Optifer)) may cause unwanted side effects that require medical attention.

Severity: Moderate

If any of the following side effects occur while taking ascorbic acid, check with your doctor or nurse as soon as possible:

Less common or rare: - with high doses

• Side or lower back pain

Minor Side Effects

Some ascorbic acid side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common or rare: - with high doses

• Diarrhea
• dizziness or faintness (with the injection only)
• flushing or redness of skin
• headache
• increase in urination (mild)
• nausea or vomiting
• stomach cramps