Multi-Vit With Fluoride & Iron (pediatric multivitamin no.75/sodium fluoride/ferrous sulfate)

Dosage of oral iron preparations should be expressed in terms of elemental iron. The elemental iron content of the various preparations is approximately:

Table 1.

Drug Elemental Iron ferric pyrophosphate 120 mg/g ferrous gluconate 120 mg/g ferrous sulfate 200 mg/g ferrous sulfate, dried 300 mg/g ferrous fumarate 330 mg/g ferrous carbonate, anhydrous 480 mg/g carbonyl iron 1000 mg/g

carbonyl iron is elemental iron, not an iron salt.

Fluorides are administered orally as sodium fluoride or topically directly onto teeth as sodium fluoride, acidulated phosphate fluoride, sodium monofluorophosphate, or stannous fluoride.

To minimize the risk of fluorosis and the amount of fluoride swallowed and absorbed systemically, children younger than 12 years of age should be instructed and/or supervised carefully regarding proper techniques for use of topical fluoride preparations. When using fluoride-containing dentifrices in children 3-6 years of age, only a pea-sized amount (approximately 0.25 g) of dentifrice should be applied to the toothbrush twice daily, and the child should be instructed not to swallow the toothpaste. When using fluoride-containing dentifrices in younger children (from eruption of the first tooth up to 3 years of age), only a smear (approximately 0.1 g; about the size of a grain of rice) of dentifrice should be applied to the toothbrush twice daily, and the child should be supervised to ensure that the correct amount of dentrifice is used and to minimize swallowing of the dentifrice. The American Academy of Pediatrics (AAP) states that young children should not rinse with water after brushing their teeth with fluoridated dentifrice because their instinct is to swallow; expectorating without rinsing reduces the amount of fluoride swallowed and leaves some fluoride in saliva, where it is available for uptake into plaque. Unless a fluoride rinsing solution also is being used to provide oral fluoride supplementation, rinsing solutions should not be swallowed after administration but should be expectorated once rinsing is complete.

Patients receiving fluoride powders or concentrated rinsing solutions should be advised that the preparation must be reconstituted and/or diluted as directed prior to use. Patients receiving fluoride treatment gels or rinsing solutions for self-administration should be advised that these preparations are to be used as directed and should not be used as dentifrices or mouthwashes/gargles, respectively.

Oral iron preparations generally should be taken between meals (e.g., 1 hour before or 2 hours after a meal) for maximum absorption but may be taken with or after meals, if necessary, to minimize adverse GI effects. Patients who have difficulty tolerating oral iron supplements also may benefit from smaller, more frequent doses, starting with a lower dose and increasing slowly to the target dose, trying a different form or preparation, or taking the supplement at bedtime.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

During the first and second trimester of pregnancy, iron-deficiency anemia is associated with a twofold increased risk of premature delivery and a threefold increased risk of a low-birthweight delivery. Although iron supplementation during pregnancy has been shown to decrease the incidence of anemia, evidence on the effect of routine iron supplementation during pregnancy on adverse maternal and infant outcomes is inconclusive. Blood volume expands by about 35% during pregnancy, and growth of the fetus, placenta, and other maternal tissues increases the iron requirement threefold during the second and third trimesters of pregnancy to about 5 mg of iron daily. Although menstruation ceases and iron absorption increases during pregnancy, most pregnant women who do not use iron supplements to meet increased iron requirements cannot maintain adequate iron stores, particularly during the last 2 trimesters. Following delivery, iron in the fetus and placenta are lost to the woman, although some of the iron in the expanded blood volume may return to blood stores. Among low-income pregnant women enrolled in health programs in the US, the prevalence of iron-deficiency anemia is 9, 14, and 37% during the first, second, and third trimesters, respectively. While similar data currently are not available for all pregnant women in the US, the low dietary iron intake among US women of childbearing age, the high prevalence of iron deficiency and associated anemia among such women, and the increased iron requirements during pregnancy suggest that anemia during pregnancy may extend beyond low-income women. In addition, use of prenatal multivitamin and mineral supplements among African-Americans, native American and Alaskan Indians, women younger than 20 years of age, and those having less than a high school education is substantially lower than in the general US pregnant population.

The principal reasons for the current lack of widespread adoption of a recommended iron supplementation regimen during pregnancy in US women may include lack of health-care provider and patient perceptions that iron supplements improve maternal and infant outcomes, complicated dose schedules, and adverse effects (e.g., constipation, nausea, vomiting). However, adequate dietary iron intake and iron supplementation generally are recommended for primary prevention of iron deficiency during pregnancy. By employing low-dose (i.e., 30 mg of iron daily) regimens with simplified dose schedules (i.e., once-daily dosing), patient compliance may be improved; low-dose regimens have been shown to increase patient tolerance and are as effective as higher dosages (e.g., 60-120 mg iron daily) in preventing iron-deficiency anemia.

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No enhanced messaging available.