Trinsicon M

A metallic element found in certain minerals, in nearly all soils, and in mineral waters. It is an essential constituent of hemoglobin, cytochrome, and other components of respiratory enzyme systems. Its chief functions are in the transport of oxygen to tissue (hemoglobin) and in cellular oxidation mechanisms. Depletion of iron stores may result in iron-deficiency anemia. Ferrous Fumarate (Trinsicon M) is used to build up the blood in anemia.

Vitamin B12 (Trinsicon M) (commonly known as Vitamin B12 (Trinsicon M)) is the most chemically complex of all the vitamins. Vitamin B12 (Trinsicon M)'s structure is based on a corrin ring, which, although similar to the porphyrin ring found in heme, chlorophyll, and cytochrome, has two of the pyrrole rings directly bonded. The central metal ion is Co (cobalt). Vitamin B12 (Trinsicon M) cannot be made by plants or by animals, as the only type of organisms that have the enzymes required for the synthesis of cyanocobalamin are bacteria and archaea. Higher plants do not concentrate cyanocobalamin from the soil and so are a poor source of the substance as compared with animal tissues. Vitamin B12 (Trinsicon M) is naturally found in foods including meat (especially liver and shellfish), eggs, and milk products.

used to treat or prevent a lack of these nutrients which may occur in certain health conditions (e.g., anemia, pregnancy, poor diet, surgery recovery). Iron is an important mineral that the body needs to produce red blood cells. Vitamin C improves the absorption of iron from the stomach. Vitamin B12 is important for normal blood, cells, and nerves. Folic acid is needed to form healthy cells, especially red blood cells.

Women of childbearing age should maintain adequate amounts of folic acid either through diet or supplements to prevent spinal cord birth defects.

Pernicious anemia, both uncomplicated and accompanied by nervous system involvement.

Dietary deficiency of Vitamin B12 (Trinsicon M), occurring in strict vegetarians and in their breast-fed infants. (Isolated Vitamin B12 (Trinsicon M) deficiency is very rare).

Malabsorption of Vitamin B12 (Trinsicon M), resulting from structural or functional damage to the stomach, where intrinsic factor is secreted or to the ileum, where intrinsic factor facilitates Vitamin B12 (Trinsicon M) absorption. These conditions include tropical sprue, and nontropical sprue (idiopathic steatorrhea, gluten-induced enteropathy). Folate deficiency in these patients is usually more severe than Vitamin B12 (Trinsicon M) deficiency.

Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy). Total gastrectomy always produces Vitamin B12 (Trinsicon M) deficiency.

Structural lesions leading to Vitamin B12 (Trinsicon M) deficiency include regional ileitis, ileal resections, malignancies, etc.

Competition for Vitamin B12 (Trinsicon M) by intestinal parasites or bacteria.

The fish tapeworm (Diphyilobothrium latum) absorbs huge quantities of Vitamin B12 (Trinsicon M) and infested patients often have associated gastric atrophy. The blind-loop syndrome may produce deficiency of Vitamin B12 (Trinsicon M) or folate.

Inadequate utilization of Vitamin B12 (Trinsicon M). This may occur if antimetabolites for the vitamin are employed in the treatment of neoplasia.

For the Schilling Test.

Ferrous Fumarate (Trinsicon M) is a type of iron. You normally get iron from the foods you eat. In your body, iron becomes a part of your hemoglobin (HEEM o glo bin) and myoglobin (MY o glo bin). Hemoglobin carries oxygen through your blood to tissues and organs. Myoglobin helps your muscle cells store oxygen.

Ferrous Fumarate (Trinsicon M) is used to treat iron deficiency anemia (a lack of red blood cells caused by having too little iron in the body).

Ferrous Fumarate (Trinsicon M) may also be used for purposes not listed in this medication guide.

Cyanocobalamin is a man-made form of Vitamin B12 (Trinsicon M). Vitamin B12 (Trinsicon M) is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.

Cyanocobalamin is used to treat Vitamin B12 (Trinsicon M) deficiency in people with pernicious anemia and other conditions.

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

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet,

Oral:

Ferretts: 325 mg (106 mg elemental iron) [scored]

Ferrimin 150: Elemental iron 150 mg

Hemocyte: 324 mg (106 mg elemental iron)

Generic: 324 mg (106 mg elemental iron), Elemental iron 29 mg

Dosing: Adult

Note: Immediate-release oral iron products are preferred for treatment of iron deficiency anemia; enteric coated and slow/sustained release preparations are not desired due to poor absorption (Hershko 2014; Liu 2012). Doses expressed in terms of elemental iron; Ferrous Fumarate (Trinsicon M) contains 33% elemental iron.

Iron-deficiency anemia, prevention (in areas where anemia prevalence is ≥40%) (off-label use):

Oral: Menstruating women (nonpregnant females of reproductive potential)

Iron-deficiency anemia, treatment:

Oral: 65 to 200 mg elemental iron/day (Liu 2012; Schrier 2019; Stoltzfus 1998; WHO 2001); may administer in up to 3 divided doses. Note: Alternate-day dosing (eg, every other day or Monday, Wednesday, Friday) has been shown to result in greater absorption of iron; some experts recommend this dosing schedule in patients who can maintain adherence (Schrier 2019; Stoffel 2017).

Dosing: Geriatric

Lower doses (15 to 50 mg elemental iron/day) may have similar efficacy and less GI adverse events (eg, nausea, constipation) as compared to higher doses (eg, 150 mg elemental iron/day) (Rimon 2005).

Dosing: Pediatric

Note: Doses expressed as elemental iron. Ferrous Fumarate (Trinsicon M) contains 33% elemental iron.

Iron deficiency, prevention in areas where anemia prevalence is >40%:

Oral:

Infants ≥6 months and Children <2 years: 10 to 12.5 mg daily for 3 consecutive months in a year (WHO 2016b)

Children 2 years to <5 years: 30 mg daily for 3 consecutive months in a year (WHO 2016b)

Children ≥5 to 12 years: 30 to 60 mg daily for 3 consecutive months in a year (WHO 2016b)

Adolescent menstruating females (non-pregnant females of reproductive potential): 30 to 60 mg daily for 3 consecutive months in a year (WHO 2016a)

Iron deficiency, treatment:

Oral: Children and Adolescents: 3 to 6 mg/kg/day in 3 divided doses; suggested maximum daily dose: 200 mg/day (ASPEN Pediatric Nutrition Support Core Curriculum [Corkins 2015]; Kliegman 2016)

Vitamin B12 (Trinsicon M) Atlantic Laboratories is used as injections SC, IV, IM, intralumbar, and also oral. With anemia associated with Vitamin B12 (Trinsicon M) deficiency is introduced on 100-200 mcg in 2 days. In anemia with symptoms of funicular myelosis and megalocytic anemia with diseases of the nervous system - 400-500 micrograms in the first 7 days daily, then 1 time every 5-7 days. In the period of remission in the absence of events funicular myelosis maintenance dose - 100 mcg 2 times a month, in the presence of neurological symptoms - at 200-400 mcg 2-4 times a month. In acute post-hemorrhagic anemia and iron anemia by 30-100 mcg 2-3 times a week. When aplastic anemia (especially in children) - 100 micrograms before clinical improvement. When nutritional anemia in infants and preterm - 30 mcg / day during 15 days.

In diseases of the central and peripheral nervous system and neurological diseases with a pain syndrome is administered in increasing doses - 200-500 mcg, with the improvement in the state - 100 mcg / day. The course of treatment with Vitamin B12 (Trinsicon M) Atlantic Laboratories is 2 weeks. In traumatic lesions of peripheral nervous system - at 200-400 mcg every other day for 40-45 days.

When hepatitis and cirrhosis - 30-60 mcg / day or 100 mg every other day for 25-40 days.

Dystrophy in young children, Down syndrome and cerebral palsy - by 15-30 mcg every other day.

When funicular myelosis, amyotrophic lateral sclerosis can be introduced into the spinal canal at 15-30 mcg, gradually increasing the dose of 200-250 micrograms.

In radiation sickness, diabetic neuropathy, sprue - by 60-100 mcg daily for 20-30 days.

When deficiency of Vitamin B12 (Trinsicon M) to prevent - IV or IM for 1 mg 1 time a month; for treatment - IV or IM for 1 mg daily for 1-2 weeks, the maintenance dose is 1-2 mg IV or IM from 1 per week, up to 1 per month. Duration of treatment is determined individually.

See also:
What is the most important information I should know about Ferrous Fumarate (Trinsicon M)?

do not use if:

* you are allergic to any ingredient in Ferrous Fumarate (Trinsicon M)/Folic Acid/B Complex/Vitamin C/Minerals

* you have iron metabolism problems (eg, hemosiderosis, hemochromatosis), certain types of anemia (pernicious, hemolytic), or high levels of iron in your blood

* you have coppermetabolism problems (Wilson disease)

See also:
What is the most important information I should know about Vitamin B12 (Trinsicon M)?

Hypersensitivity to the components of the formula. History of allergy to the cobalamins (Vitamin B12 (Trinsicon M) and similar substances). Malignant tumors. By stimulating the growth of tissues, the Cobamamide could increase the high rate of cell multiplication. Sensitivity to cobalt. History of allergies to cobalamin (Vitamin B12 (Trinsicon M) and related substances).

- Malignant tumor: Due to the action of Vitamin B12 (Trinsicon M) on the growth of tissue cell multiplication rate high, the risk of exacerbation should be taken into account.

- Children under 6 years because of the dosage form

Use Ferrous Fumarate (Trinsicon M) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Ferrous Fumarate (Trinsicon M) is absorbed better on an empty stomach but may be taken with food if it upsets your stomach.
• Shake well before using a dose.
• Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
• If you are also taking a bisphosphonate (eg, alendronate), cephalosporin (eg, cephalexin), methyldopa, penicillamine, quinolone (eg, ciprofloxacin), or tetracycline (eg, minocycline) along with Ferrous Fumarate (Trinsicon M), you may need to space the doses several hours apart. Ask your doctor or pharmacist how much time is needed between doses of Ferrous Fumarate (Trinsicon M) and your other medicines.
• Do not take Ferrous Fumarate (Trinsicon M) within 1 hour before or 2 hours after antacids, eggs, whole grain breads or cereal, milk, milk products, coffee, or tea.
• Take Ferrous Fumarate (Trinsicon M) with a full glass of water (8 oz/240 mL). Do not lie down for 30 minutes after taking Ferrous Fumarate (Trinsicon M).
• Ferrous Fumarate (Trinsicon M) may temporarily stain the teeth. Mixing Ferrous Fumarate (Trinsicon M) with water or fruit juice or drinking it through a straw may help to decrease this effect.
• If you miss a dose of Ferrous Fumarate (Trinsicon M), take 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 take 2 doses at once.

Ask your health care provider any questions you may have about how to use Ferrous Fumarate (Trinsicon M).

Use: Labeled Indications

Iron-deficiency anemia: Prevention and treatment of iron-deficiency anemias

See also:
What other drugs will affect Ferrous Fumarate (Trinsicon M)?

Oral absorption of iron may be increased when taken with ascorbic acid. May reduce the absorption of quinolones and tetracyclines when taken concurrently via the oral route. Concurrent admin with antacids may reduce the absorption of Ferrous Fumarate (Trinsicon M) from the GI tract. May reduce the absorption of penicillamine in the gut when taken concurrently.

See also:
What other drugs will affect Vitamin B12 (Trinsicon M)?

In an application of Vitamin B12 (Trinsicon M) Atlantic Laboratories with hormonal contraceptives for oral administration may decrease the concentration of cyanocobalamin in plasma.

In an application with anticonvulsant drugs decreased cyanocobalamin absorption from the gut.

In an Vitamin B12 (Trinsicon M) Atlantic Laboratories application with neomycin, aminosalicylic acid, colchicine, cimetidine, ranitidine, drugs potassium decreased cyanocobalamin absorption from the gut.

Cyanocobalamin may exacerbate allergic reactions caused by thiamine.

When parenteral application of chloramphenicol may decrease the hematopoietic effects of cyanocobalamin with anemia.

See also:
What are the possible side effects of Ferrous Fumarate (Trinsicon M)?

Applies to Ferrous Fumarate (Trinsicon M): chewable tablets, suspension

Other dosage forms:

• capsules, controlled-release tablets, tablets

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

Constipation; darkened or green stools; diarrhea; nausea; stomach upset.

Seek medical attention right away if any of these SEVERE side effects occur while taking Ferrous Fumarate (Trinsicon M) (the active ingredient contained in Ferrous Fumarate (Trinsicon M))

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood or streaks of blood in the stool; fever; vomiting with continuing sharp stomach pain.

See also:
What are the possible side effects of Vitamin B12 (Trinsicon M)?

Applies to cyanocobalamin: intramuscular solution

Other dosage forms:

• nasal gel/jelly, nasal spray

As well as its needed effects, cyanocobalamin (the active ingredient contained in Vitamin B12 (Trinsicon M)) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking cyanocobalamin, check with your doctor or nurse immediately:

Incidence not known:

• Abdominal or stomach pain
• bleeding from the gums or nose
• blue lips and fingernails
• chest pain
• cough
• coughing that sometimes produces a pink frothy sputum
• decreased urine output
• difficult, fast, noisy breathing, sometimes with wheezing
• difficulty with swallowing
• dilated neck veins
• dizziness
• extreme fatigue
• eye pain
• fast heartbeat
• headache
• hives, itching, or skin rash
• increased sweating
• irregular breathing
• irregular heartbeat
• pale skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• ringing in the ears
• swelling of the face, fingers, feet, or lower legs
• tightness in the chest
• unusual tiredness or weakness
• weight gain

Minor Side Effects

Some cyanocobalamin 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:

Incidence not known:

• Diarrhea
• skin rash with a general disease