Zircon

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 (Zircon) is used to build up the blood in anemia.

Pyridoxine hydrochloride (Zircon) is the 4-methanol form of vitamin B6 and is converted to pyridoxal 5-phosphate in the body. Pyridoxal 5-phosphate is a coenzyme for synthesis of amino acids, neurotransmitters (serotonin, norepinephrine), sphingolipids, aminolevulinic acid. Although Pyridoxine hydrochloride (Zircon) and vitamin B6 are still frequently used as synonyms, especially by medical researchers, this practice is erroneous and sometimes misleading. [PubChem]

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.

* Sideroblastic anaemia

* Treatment and prophylaxis of vitamin B6 deficiency states

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

Ferrous fumarate (Zircon) may also be used for purposes not listed in this medication guide.

Pyridoxine hydrochloride (Zircon) is vitamin B6. Vitamins occur naturally in foods such as meat, poultry, nuts, whole grains, bananas, and avocados. Vitamin B6 is important for many processes in the body.

Pyridoxine hydrochloride (Zircon) is used to treat or prevent vitamin B6 deficiency. It is also used to treat a certain type of anemia (lack of red blood cells). Pyridoxine hydrochloride (Zircon) injection is also used to treat some types of seizure in babies.

Pyridoxine hydrochloride (Zircon) taken by mouth (oral) is available without a prescription. Injectable Pyridoxine hydrochloride (Zircon) must be given by a healthcare professional.

Pyridoxine hydrochloride (Zircon) 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 (Zircon) 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 (Zircon) 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)

Usual Adult Dose for Drug Induced Vitamin/Mineral Deficiency:

Drug Induced Neuritis:

Cycloserine: 100 to 300 mg/day orally in divided doses.

Isoniazid or penicillamine: 100 to 200 mg/day orally for 3 weeks or 25 to 100 mg/day for prophylaxis.

Oral contraceptives: 25 to 30 mg/day orally.

Acute Intoxication:

Hydralazine: 25 mg/kg. One-third of the dose should be administered IM and the remainder administered as an IV infusion over 3 hours.

Isoniazid: 1 to 4 grams IV as a first dose, then 1 g IM every 30 minutes until the total required dose has been administered (given with other anticonvulsants as needed). The total dose administered should equal the amount of isoniazid ingested.

Mushroom ingestion (genus Gyromitra): 25 mg/kg IV infused over 15 to 30 minutes. Repeat as needed to a maximum total daily dose of 15 to 20 g.

Usual Adult Dose for Dietary Supplement:

Pyridoxine hydrochloride (Zircon) Deficiency:

10 to 25 mg/day orally, IM, or IV for 3 weeks followed by 2 to 5 mg/day from a multivitamin product.

Usual Adult Dose for Anemia:

Sideroblastic, hereditary: 200 to 600 mg orally daily. If adequate response obtained, dose may be decreased to 30 to 50 mg orally daily.

If therapeutic response is not obtained after 1 to 2 months of Pyridoxine hydrochloride (Zircon) therapy, a different therapy should be considered.

Usual Adult Dose for Nausea/Vomiting:

Nausea and vomiting of Pregnancy:

25 mg orally every 8 hours.

Usual Pediatric Dose for Drug Induced Vitamin/Mineral Deficiency:

Drug Induced Neuritis (cycloserine, isoniazid, hydralazine, penicillamine) :

Treatment: 10 to 50 mg/day.

Prophylaxis: 1 to 2 mg/kg/day

Acute Intoxication:

Hydralazine: 25 mg/kg: One-third of the dose should be administered IM and the remainder administered as an IV infusion over 3 hours.

Isoniazid: Acute ingestion of known amount: Initial: A total dose of Pyridoxine hydrochloride (Zircon) equal to the amount of isoniazid ingested (maximum dose: 70 mg/kg, up to 5 g); administer at a rate of 0.5 to 1 g/minute until seizures stop or the maximum initial dose has been administered; may repeat every 5 to 10 minutes as needed to control persistent seizure activity and/or CNS toxicity. If seizures stop prior to the administration of the calculated initial dose, infuse the remaining Pyridoxine hydrochloride (Zircon) over 4 to 6 hours. Acute ingestion of unknown amount: Initial: 70 mg/kg (maximum dose: 5 g); administer at a rate of 0.5 to 1 g/minute; may repeat every 5 to 10 minutes as needed to control persistent seizure activity and/or CNS toxicity.

Mushroom ingestion (genus Gyromitra): 25 mg/kg IV. Repeat as needed up to a maximum total dose of 15 to 20 g.

Usual Pediatric Dose for Dietary Supplement:

Pyridoxine hydrochloride (Zircon) Deficiency:

5 to 25 mg/day orally, IM, or IV for 3 weeks followed by 1.5 to 2.5 mg/day from a multivitamin product.

Usual Pediatric Dose for Seizures:

Pyridoxine hydrochloride (Zircon)-dependent seizures:

10 to 100 mg PO, IM, or IV initially, followed by 2 to 100 mg orally daily.

See also:
What is the most important information I should know about Ferrous fumarate (Zircon)?

do not use if:

* you are allergic to any ingredient in Ferrous fumarate (Zircon)/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 Pyridoxine hydrochloride (Zircon)?

Contraindications for Vitamin B6 (Pyridoxine hydrochloride (Zircon))

Vitamin B6 is contraindicated in those hypersensitive to any component of a vitamin B6-containing product.

Use Ferrous fumarate (Zircon) suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Ferrous fumarate (Zircon) suspension 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 (Zircon) suspension, 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 (Zircon) suspension and your other medicines.
• Do not take Ferrous fumarate (Zircon) suspension within 1 hour before or 2 hours after antacids, eggs, whole grain breads or cereal, milk, milk products, coffee, or tea.
• Take Ferrous fumarate (Zircon) suspension with a full glass of water (8 oz/240 mL). Do not lie down for 30 minutes after taking Ferrous fumarate (Zircon) suspension.
• Ferrous fumarate (Zircon) suspension may temporarily stain the teeth. Mixing Ferrous fumarate (Zircon) suspension 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 (Zircon) suspension, 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 (Zircon) suspension.

Use Pyridoxine hydrochloride (Zircon) (vitamin b6) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Pyridoxine hydrochloride (Zircon) (vitamin b6) is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Pyridoxine hydrochloride (Zircon) (vitamin b6) at home, carefully follow the injection procedures taught to you by your health care provider.
• If Pyridoxine hydrochloride (Zircon) (vitamin b6) contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
• Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
• If you miss a dose of Pyridoxine hydrochloride (Zircon) (vitamin b6) and you are taking it regularly, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Pyridoxine hydrochloride (Zircon) (vitamin b6).

Use: Labeled Indications

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

Use: Labeled Indications

Pyridoxine hydrochloride (Zircon) deficiency: Treatment and prevention of Pyridoxine hydrochloride (Zircon) (vitamin B) deficiency.

Off Label Uses

Ethylene glycol poisoning

The American Academy of Clinical Toxicology guidelines recognize the lack of human clinical data for this use and consider Pyridoxine hydrochloride (Zircon) as an adjunctive cofactor therapy in ethylene glycol poisoning without a formal or evidence-based recommendation, especially in patients who may have vitamin deficiencies (eg, patients with alcoholism). Additional data may be necessary to further define the role of Pyridoxine hydrochloride (Zircon) in this condition.

Peripheral neuropathy associated with isoniazid therapy for Mycobacterium tuberculosis (prevention)

Based on the Department of Health and Human Services (DHHS) Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, Pyridoxine hydrochloride (Zircon) is effective and recommended in the prevention of peripheral neuropathy associated with isoniazid therapy for Mycobacterium tuberculosis.

See also:
What other drugs will affect Ferrous fumarate (Zircon)?

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 (Zircon) from the GI tract. May reduce the absorption of penicillamine in the gut when taken concurrently.

See also:
What other drugs will affect Pyridoxine hydrochloride (Zircon)?

Cycloserine, isoniazid, hydralazine, oral contraceptives, penicillamine

Increased need for Pyridoxine hydrochloride (Zircon).

Levodopa

Decreased effect of levodopa. (Interaction does not occur with levodopa/carbidopa in combination with Pyridoxine hydrochloride (Zircon).)

Phenytoin

Phenytoin serum levels may be decreased.

Incompatibility

Incompatible with alkaline solutions, iron salts and oxidizing agents (parenteral).

Laboratory Test Interactions

May result in false-positive urobilinogen in the spot test using Ehrlich reagent.

See also:
What are the possible side effects of Ferrous fumarate (Zircon)?

Applies to Ferrous fumarate (Zircon): 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 (Zircon) (the active ingredient contained in Ferrous fumarate (Zircon))

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 Pyridoxine hydrochloride (Zircon)?

CNS

Neuropathy; unstable gait; drowsiness; somnolence.

EENT

Perioral numbness.

Miscellaneous

Numbness of feet; decreased sensation to touch, temperature or vibration; paresthesia; low serum folic acid levels; burning/stinging at IM injection site; photoallergic reaction; ataxia.