Ferralet 90

Adult (18 - 50 Years) NP NDC 0178-0089-90 Rx Only Storage: Store at 20 degrees C to 25 degrees C (68 degrees F to 77 degrees F), excursions permitted between 15 degrees C and 30 degrees C (between 59 degrees F and 86 degrees F). Brief exposure to temperatures up to 40 degrees C (104 degrees F) may be tolerated provided the mean kinetic temperature does not exceed 25 degrees C (77 degrees F); however, such exposure should be minimized. Clinical Pharmacology: Oral iron is absorbed most efficiently when administered between meals. Dosage and Administration: One tablet daily or as directed by a physician. Do not chew tablet. Precautions: General: Take 2 hours after meals.

90 mg Dual-Iron Delivery Iron is critical for normal hemoglobin synthesis to maintain oxygen transport for energy production and proper function of cells. Adequate amounts of iron are necessary for effective erythropoiesis. Iron also serves as a cofactor of several essential enzymes, including cytochromes, which are involved in electron transport. Folic acid is required for nucleoprotein synthesis and the maintenance of normal erythropoiesis. Folic acid is the precursor of tetrahydrofolic acid, which is involved as a cofactor for transformylation reactions in the biosynthesis of purines and thymidylates of nucleic acids. Deficiency of folic acid may account for the defective deoxyribonucleic acid (DNA) synthesis that leads to megaloblast formation and megaloblastic macrocytic anemias. Vitamin B12 is essential to growth, cell reproduction, hematopoiesis, nucleic acid, and myelin synthesis. Deficiency may result in megaloblastic anemia or pernicious anemia. Notice: Contact with moisture can discolor or erode the tablet. How Supplied: Ferralet 90 (NDC 0178-0089-90) is a green, modified rectangle shaped, film-coated tablet, debossed with "F6" on one side and blank on the other, and packaged in bottles of 90.

Contraindications: Hypersensitivity to any of the ingredients. Hemolytic anemia, hemochromatosis, and hemosiderosis are contraindications to iron therapy. Warning: Folic acid alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient. Do not exceed recommended dose. Discontinue use if symptoms of intolerance appear. The type of anemia and underlying cause or causes should be determined before starting therapy with Ferralet 90 tablets. Ensure Hgb, Hct, and reticulocyte counts are determined before starting therapy and periodically thereafter during prolonged treatment. Periodically review therapy to determine if it needs to be continued without change or if a dose change is indicated. Folic Acid: Folic acid in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurological manifestations remain progressive. pernicious anemia should be excluded before using these products since folic acid may mask the symptoms of pernicious anemia. Geriatric Use: Dosing for elderly patients should be administered with caution. Due to the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy, dosing should start at the lower end of the dosing range. Adverse Reactions: Adverse reactions with iron therapy may include GI irritation, constipation, diarrhea, nausea, vomiting, and dark stools. Adverse reactions with iron therapy are usually transient. Overdosage: Symptoms: abdominal pain, metabolic acidosis, anuria, CNS damage, coma, convulsions, death, dehydration, diffuse vascular congestion, hepatic cirrhosis, hypotension, hypothermia, lethargy, nausea, vomiting, diarrhea, tarry stools, melena, hematemesis, tachycardia, hyperglycemia, drowsiness, pallor, cyanosis, lassitude, seizures, and shock. Rx Only To report a serious adverse event or obtain product information, call (800) 298-1087. Allergic sensitization has been reported following both oral and parenteral administration of folic acid. This product contains FD&C Yellow No. 5 (tartrazine) which may cause allergic-type reactions (including bronchial asthma) in certain susceptible persons. Although the overall incidence of FD&C Yellow No. 5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity. Pediatric Use: Safety and effectiveness in pediatric patients have not been established. Warning: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of the reach of children. In case of accidental overdose, call a doctor or poison control center immediately. Drug Interactions: Prescriber should be aware of a number or iron/drug interactions, including antacids, tetracyclines, or fluoroquinolones. Indications and Usage: Ferralet 90 is indicated for the treatment of all anemias that are responsive to oral iron therapy. These include: hypochromic anemia associated with pregnancy, chronic and/or acute blood loss, metabolic disease, post-surgical convalescence, and dietary needs.