Zenifor
Generic Name
Ferrous Fumarate + Folic Acid + Zinc Sulphate Monohydrate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zenifor 500 mg tablet | ৳ 45.00 | ৳ 180.00 |
Description
Overview of the medicine
Zenifor is a combination of Ferrous Fumarate, Folic Acid, and Zinc Sulphate Monohydrate, used to prevent and treat iron deficiency anemia, megaloblastic anemia due to folic acid deficiency, and zinc deficiency.
Uses & Indications
Dosage
Adults
One capsule daily, or as directed by the physician. It is usually taken after meals to minimize gastrointestinal discomfort.
Elderly
Same as adult dosage, or as advised by the physician. No specific dose adjustment is generally required.
Renal_impairment
Use with caution in patients with severe renal impairment due to potential accumulation of zinc. Consult physician for appropriate dosage adjustment.
How to Take
Orally, preferably after meals to reduce gastrointestinal upset. Should be swallowed whole with water.
Mechanism of Action
Ferrous Fumarate provides elemental iron, essential for hemoglobin synthesis and oxygen transport. Folic acid is vital for DNA synthesis, cell division, and red blood cell maturation. Zinc is crucial for numerous enzymatic functions, immune system health, and cell growth.
Pharmacokinetics
Onset
Gradual, with hematological effects usually observed after several weeks of consistent therapy. Symptomatic improvement may precede laboratory changes.
Excretion
Iron is primarily excreted via feces, with minor losses through urine, skin, and bile. Folic acid is excreted mainly via urine. Zinc is primarily excreted through feces (endogenous fecal excretion) and to a lesser extent via urine and sweat.
Half life
Iron has no true biological half-life as it is conserved and recycled within the body. Folic acid has an elimination half-life of approximately 3-9 hours. Zinc's half-life is variable and depends on various physiological factors.
Absorption
Iron (as Ferrous Fumarate) is absorbed primarily in the duodenum and upper jejunum, influenced by gastric acidity and dietary factors. Folic acid is absorbed throughout the small intestine, mainly in the jejunum. Zinc absorption is also mainly in the small intestine, with absorption rates varying.
Metabolism
Iron is largely conserved and recycled, with minimal loss. Folic acid is metabolized in the liver to its active form, tetrahydrofolate. Zinc is not extensively metabolized; it is utilized in various metalloenzymes and stored.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation
- Haemochromatosis and other iron overload syndromes
- Non-iron deficiency anemias (e.g., pernicious anemia, unless combined with appropriate vitamin B12 therapy)
- Active peptic ulcer, regional enteritis, ulcerative colitis
Drug Interactions
Antacids
May decrease iron absorption. Avoid co-administration.
Levothyroxine
Iron may reduce levothyroxine absorption, leading to reduced thyroid hormone efficacy. Separate administration by several hours.
Penicillamine
Zinc absorption may be reduced by penicillamine. Separate administration by at least 2 hours.
Bisphosphonates
Iron may interfere with bisphosphonate absorption. Administer at least 30 minutes apart.
Calcium supplements
High doses of calcium can reduce iron and zinc absorption.
Tetracyclines & Quinolones
Iron and zinc can reduce the absorption of these antibiotics. Administer at least 2 hours before or 4-6 hours after.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, abdominal pain, diarrhea, and in severe cases, shock, metabolic acidosis, liver damage, and cardiovascular collapse. Management involves immediate gastric lavage, symptomatic and supportive care. Chelation therapy (e.g., deferoxamine) may be necessary for severe iron toxicity.
Pregnancy & Lactation
Zenifor is generally considered safe and beneficial during pregnancy and lactation for preventing and treating deficiencies, but should only be used as directed by a physician.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation
- Haemochromatosis and other iron overload syndromes
- Non-iron deficiency anemias (e.g., pernicious anemia, unless combined with appropriate vitamin B12 therapy)
- Active peptic ulcer, regional enteritis, ulcerative colitis
Drug Interactions
Antacids
May decrease iron absorption. Avoid co-administration.
Levothyroxine
Iron may reduce levothyroxine absorption, leading to reduced thyroid hormone efficacy. Separate administration by several hours.
Penicillamine
Zinc absorption may be reduced by penicillamine. Separate administration by at least 2 hours.
Bisphosphonates
Iron may interfere with bisphosphonate absorption. Administer at least 30 minutes apart.
Calcium supplements
High doses of calcium can reduce iron and zinc absorption.
Tetracyclines & Quinolones
Iron and zinc can reduce the absorption of these antibiotics. Administer at least 2 hours before or 4-6 hours after.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, abdominal pain, diarrhea, and in severe cases, shock, metabolic acidosis, liver damage, and cardiovascular collapse. Management involves immediate gastric lavage, symptomatic and supportive care. Chelation therapy (e.g., deferoxamine) may be necessary for severe iron toxicity.
Pregnancy & Lactation
Zenifor is generally considered safe and beneficial during pregnancy and lactation for preventing and treating deficiencies, but should only be used as directed by a physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
The active components (Ferrous Fumarate, Folic Acid, Zinc Sulphate Monohydrate) have undergone extensive clinical trials individually and in various combinations to establish their efficacy and safety. Specific trials for the 'Zenifor' brand typically focus on bioequivalence and local market approval.
Lab Monitoring
- Complete blood count (CBC) including hemoglobin, hematocrit, and red blood cell indices
- Serum ferritin
- Serum iron and total iron-binding capacity (TIBC)
Doctor Notes
- Counsel patients on proper administration to enhance absorption and minimize GI side effects.
- Emphasize the importance of dietary management alongside supplementation.
- Advise patients about potential drug and food interactions.
- Monitor hemoglobin, ferritin, and clinical symptoms periodically.
Patient Guidelines
- Take the capsule whole with water, do not chew or crush it.
- Take after meals to minimize stomach upset.
- Avoid taking with milk, tea, or coffee as they can reduce absorption.
- Store in a cool, dry place away from children.
Missed Dose Advice
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Zenifor is generally not expected to impair the ability to drive or operate machinery. However, if you experience dizziness or significant side effects, avoid such activities.
Lifestyle Advice
- Maintain a balanced diet rich in iron, folic acid, and zinc.
- Include foods high in Vitamin C to enhance iron absorption.
- Regular exercise can improve overall health and energy levels.
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