Ferrous Sulphate + Folic Acid + Zinc

Ferrous Sulphate + Folic Acid + Zinc is a iron, folic acid and zinc supplement (anti-anaemic combination) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Ferrous Sulphate + Folic Acid + Zinc is used for:

• Prevention and treatment of anaemia in pregnancy — and to meet the increased need for iron, folic acid and zinc for the growing baby
• Iron-deficiency anaemia in adolescent girls, women with heavy periods, and the malnourished
• Folic acid support — helping prevent neural tube defects when started early in or before pregnancy, as advised
• Zinc deficiency — poor appetite, frequent infections, delayed wound healing
• Recovery after childbirth or blood loss, as the doctor advises

Adults, including pregnant women: the usual dose of Ferrous Sulphate + Folic Acid + Zinc is one tablet/capsule daily, or as the doctor prescribes; in established anaemia the doctor may increase the frequency. In pregnancy it is typically continued through pregnancy and for some months after delivery, in line with antenatal care advice.

• Take it on an empty stomach for best absorption, or after a light meal if it upsets the stomach; bedtime dosing suits many.
• Keep a 2-hour gap from tea, coffee, milk, calcium and antacids; vitamin C-rich foods help iron absorption.
• Children and adolescents: only in doses set by a doctor.
• Do not take extra doses or multiple iron products together.

Ferrous Sulphate + Folic Acid + Zinc is generally well tolerated. Possible effects include:

• Black stools — normal and harmless with iron
• Nausea, mild stomach upset or heartburn
• Constipation or occasionally loose stools
• Metallic taste; zinc on an empty stomach can sometimes cause nausea
• Rarely, allergic reactions such as rash

Taking the tablet after food, drinking plenty of water and eating fibre-rich food usually settles the stomach effects. Seek medical advice if vomiting is persistent, stomach pain is severe, or any allergic symptoms appear.

• Keep strictly away from children — accidental iron overdose is extremely dangerous for young children; treat any ingestion as an emergency.
• Long-term use without a confirmed deficiency is not advisable; anaemia from other causes (thalassaemia, chronic disease, B12 deficiency) needs different treatment.
• Folic acid can mask vitamin B12 deficiency — tell your doctor if you have numbness, tingling or balance problems.
• Tell your doctor about ulcers, bowel disease, thalassaemia, repeated transfusions or liver disease.
• Keep the 2-hour gap from tea, coffee, milk, calcium and antacids.
• In pregnancy, attend regular antenatal check-ups so haemoglobin can be monitored.

Notable interactions of Ferrous Sulphate + Folic Acid + Zinc:

• Tea, coffee, milk, calcium, antacids — markedly reduce iron and zinc absorption; separate by 2 hours.
• Tetracycline and quinolone antibiotics (doxycycline, ciprofloxacin) — both iron and zinc block their absorption; separate by 2–4 hours.
• Levothyroxine — absorption reduced; keep at least a 4-hour gap.
• Penicillamine — absorption reduced by iron and zinc.
• Anti-epileptics (phenytoin) — folic acid may alter their levels; inform your doctor.
• Other multivitamin or mineral products — avoid unplanned doubling of iron or zinc.

• Known allergy to iron, folic acid, zinc or any component
• Iron-overload states — haemochromatosis, haemosiderosis
• Anaemia not caused by iron or folate deficiency, unless a doctor confirms the need
• Untreated vitamin B12 deficiency (pernicious anaemia) — folic acid alone can mask it; needs medical evaluation first
• Patients on repeated blood transfusions — specialist advice required

Ferrous Sulphate + Folic Acid + Zinc is intended for use in pregnancy: iron prevents and treats maternal anaemia, folic acid helps protect the baby from neural tube defects, and zinc supports growth and immunity. Health programmes in Bangladesh recommend iron-folic acid supplementation during pregnancy and after delivery. It is also considered safe during breastfeeding at recommended doses. Take it as part of regular antenatal care, at the dose your doctor or health worker advises, and avoid duplicating iron from other products.

Store Ferrous Sulphate + Folic Acid + Zinc below 30°C in a dry place, away from light and moisture. Keep the container tightly closed and strictly out of the reach of children — iron tablets are dangerous if swallowed by a child. Do not use after the expiry date.