ascorbic-acid and teferrol

Iron-deficiency anaemia (IDA) is a common nutritional deficiency among pregnant women in India. It has a significant impact on the health of the mother as well as that of the foetus. IDA generally responds well to treatment with oral iron supplementation. However, oral iron supplements are toxic to the gastrointestinal mucosa and intolerance is common, resulting in poor compliance and failure of treatment. The iron salts such as iron hydroxide polymaltose complex (IPC) and ferrous ascorbate (FeA) are claimed to have low gastrointestinal intolerance, therefore better patient compliance than the conventionally used ferrous sulphate (FS). These preparations also claim to increase haemoglobin level faster as well as improve the iron storage better than FS. This study was done to compare the efficacy and safety of FS with IPC and FeA.. It was a randomized, parallel, open label, study among pregnant women of gestational age between 12 to 26 wk with moderate anaemia. Patients were randomly allocated to receive either FS, IPC or FeA. They were then followed up for 90 days to observe for improvement in the haemoglobin levels and other haematological parameters or any adverse drug reaction.. The haemoglobin levels were comparable in the three groups except at day 90 when FeA group had significantly higher haemoglobin level as compared to FS group (P<0.05). The overall adverse effect profiles were also comparable among the study groups except epigastric pain which was more commonly reported in the FS group.. The results of the study showed that FS, IPC and FeA have comparable efficacy and safety profile in the treatment of IDA of pregnancy.

Topics: Adolescent; Adult; Anemia, Iron-Deficiency; Ascorbic Acid; Child; Female; Ferric Compounds; Ferrous Compounds; Humans; Pregnancy; Pregnant Women; Young Adult

To compare the therapeutic efficacy of Ferrous ascorbate (FA) and Iron polymaltose complex (IPC) in Iron deficiency anemia (IDA) in children.. A randomized controlled trial (RCT) was conducted at a tertiary care hospital with 125 (1-12 y) children having clinical symptoms and signs of IDA. Participants were randomized into FA group and IPC group. Both the groups received iron salts (FA or IPC) randomly in a dose of 6 mg/kg elemental iron for 3 mo and followed up on day 3, day 7, at the end of 1 mo and 3 mo for Hemoglobin (Hb), Mean corpuscular volume (MCV), Red cell distribution width (RDW) and reticulocyte count.. Both groups had an improvement in hematological parameters at 3 mo of intervention. The difference in the rise of Hb (g%) at the end of 1 mo in FA group (3.13 ± 1.01) vs. IPC group (2.0 ± 0.85); p = 0.017 and at 3 mo in FA group (4.88 ± 1.28) vs. IPC group (3.33 ± 1.33); p = 0.001 was statistically significant. The difference in the rise of mean Hb was significantly better in FA than the IPC group F [3392] =1.79; p = 0.00 (ANOVA). The difference in the mean increase in MCV (fL) at day 7 in FA group (6.71 ± 8.32) vs. IPC group (2.91 ± 6.16); p = 0.011 and at 1 mo FA group (9.80 ± 8.56) vs. IPC group (5.35 ± 6.11); p = 0.004 was statistically significant. The mean decrease in RDW (%) at 1 mo in FA group (4.23 ± 3.27) vs. IPC group (2.67 ± 1.95); p = 0.005 and at 3 mo in FA group (5.74 ± 3.63) vs. IPC group (4.04 ± 2.17); p = 0.006 was statistically significant. The difference in the rise in mean reticulocyte count at day 3 in FA group (0.88 ± 0.50) vs. IPC group (0.43 ± 1.20); p = 0.017 and at day 7 in FA group (4.00 ± 1.69) vs. IPC group (2.19 ± 1.24); p = 0.001 was statistically significant. F [2294] = 29.2, p = 0.00 (ANOVA). During the study period, the FA group had minor adverse reactions whereas the IPC group had none.. Both the iron salts (FA and IPC) used in the treatment of IDA showed statistically significant improvement in the hematological parameters during the 3 mo of intervention. The improvement in hematological parameters was better in FA supplemented patients as compared to IPC.

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Child; Child, Preschool; Dietary Supplements; Drug Combinations; Erythrocyte Indices; Female; Ferric Compounds; Hemoglobins; Humans; Infant; Iron; Iron Compounds; Male; Reticulocyte Count; Time Factors

The bioavailability of iron on Fe(III)-hydroxide-polymaltose complex was compared intraindividually with that of Fe (II)-ascorbate (iron absorption) and a Fe (II)-sulphate quick release preparation (haemoglobin regeneration test). The study was carried out in a population of 16 healthy male volunteers, phlebotomized in weekly intervals until development of an iron deficiency anaemia in order to establish a test population with only small variations of their individual body iron status. Intestinal iron absorption in fasting state as measured by 59Fe whole body retention and simultaneous estimation from plasma iron tolerance curves was low for the 59Fe (III)-complex (1.2 +/- 0.1% (means +/- SD] as compared to the 59Fe (II)-ascorbate (43.7 +/- 7.1% (means +/- SD]. Iron administration together with a test meal did not affect the absorption from the 59Fe (II)-ascorbate, whereas the 59Fe (III)-complex showed a significant increase in absorption (8.8 +/- 4.7% (means +/- SD]. Haemoglobin (Hb) regeneration after 100 mg of iron as Fe (III)-complex and Fe (II)-sulphate administered during 28 days with meals amounted to a mean of 0.68 +/- 0.2 g/l and 1.1 +/- 0.3 g/l (means +/- SD) of total daily Hb-increase and a net-Hb-increase of 0.31 +/- 0.37 g/l and 0.79 +/- 0.36 g/l (means +/- SD), respectively. There was also a small but significant rise in serum ferritin during the oral treatment in both treatment groups. The results of Hb-regeneration after treatment with the Fe (III)-complex were in the range which could be expected from the absorption measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Anemia, Hypochromic; Ascorbic Acid; Biological Availability; Ferric Compounds; Ferrous Compounds; Food; Humans; Intestinal Absorption; Iron; Iron Radioisotopes; Male

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Child; Ferric Compounds; Humans; Iron

Under physiological conditions, ferric ions are essentially insoluble because of the formation of polynuclear hydroxo-bridged complexes. Ferrous ions are more soluble but may produce hydroxyl radicals on reaction with hydrogen peroxide. Chelation of ferric and ferrous ions with organic ligands may prevent these undesirable reactions. Alternatively, iron(III)-hydroxide/oxide can be stabilized and solubilized by tight interactions with carbohydrates. The data presented in this work show that, because of its physicochemical properties, the iron(III)-hydroxide polymaltose complex (IPC, Maltofer) does not interact with the active ingredients of commonly used drugs such as acetylsalicylic acid (CAS 50-78-2), tetracycline hydrochloride (CAS 64-75-5), calcium hydrogen-phosphate (CAS 7757-93-9), methyl-L-dopa sesquihydrate (CAS 41372-08-1), and magnesium-L-aspartate hydrochloride (CAS 28184-71-6). In contrast, as confirmed by calculations using thermodynamic parameters, FeCl3 x 6H2O (CAS 10025-77-1) can form different types of complexes with these substances. Moreover, the data show that under aerobic conditions high concentrations of ascorbic acid (CAS 50-81-7) can lead to mobilization of iron from IPC and, thus, support the observation that orange juice slightly increases the uptake of iron from IPC.

Topics: Acetaminophen; Anaerobiosis; Ascorbic Acid; Aspartic Acid; Beverages; Calcium Phosphates; Citrus sinensis; Drug Interactions; Ferric Compounds; Food-Drug Interactions; Hydrogen-Ion Concentration; Indicators and Reagents; Methyldopa; Salicylic Acid; Spectrophotometry, Ultraviolet; Tetracycline

The comparative bioavailability from matching quantities of iron in the form of ferrous ascorbate or ferric polymaltose was defined in rats. Studies were carried out in the intact animals under basal conditions and also when requirements for this metal were either increased or decreased by manipulating stores or erythropoietic activity. No significant difference was found in the total quantity of iron absorbed from either salt or complex under any of these circumstances, suggesting that the mucosal mechanism regulating the overall process was common to both. However, the rate of transfer from the lumen into portal blood was distinctive, reaching a maximum with salt at 30 min compared to 24 h for the complex. To explore the possibility that iron from the two sources was initially handled by different subcellular pathways, the radiolabeled compounds were instilled into loops of bowel that had been isolated between ligatures in vivo. Enterocytes were harvested and fractionated, and incorporation into ferritin and transferrin was determined using RIA. From salt, iron appeared rapidly in duodenal but not ileal ferritin, whereas mucosal transferrin increased under conditions of stimulated absorption, suggesting that this protein may act as a shuttle for the metal. In contrast, iron from polymaltose showed a cumulative incorporation into duodenal ferritin over time that correlated with iron absorption, defined by the appearance of radiolabel in the serum and in the carcass; a similar pattern was demonstrable in ileal mucosal cells. Conversely, binding of iron to transferrin was minimal. No iron polymaltose was found within the mucosal cells. It is suggested that the low rate of iron transfer from this ferric complex may reflect its extracellular breakdown in the lumen of the gastrointestinal tract.

Topics: Anemia, Hemolytic; Animals; Ascorbic Acid; Biological Availability; Blood Transfusion; Bloodletting; Cell Fractionation; Centrifugation, Density Gradient; Erythropoiesis; Ferric Compounds; Intestinal Absorption; Intestinal Mucosa; Iron; Iron Radioisotopes; Male; Rats; Transferrin

In both experimental animals and human subjects iron absorption over a wide dosage range was quantitatively equivalent from ferrous salts and a ferric polymaltose complex under basal conditions. The comparable bioavailability was maintained when demand was increased by iron depletion or erythroid stimulation and depressed by expansion of body stores or impaired erythropoiesis. This common pattern for iron retention from both salt and complex supports the interchangeable use of these products in therapy of absolute iron deficiency.

Topics: Animals; Ascorbic Acid; Biological Availability; Ferric Compounds; Ferrous Compounds; Humans; In Vitro Techniques; Intestinal Absorption; Iron; Iron Deficiencies; Male; Rats