Orofer XT

MYELODYSPLASTIC SYNDROMES anemia

Last Updated September 26th, 2019

Therapeutic Indications

OroferXT tablets or syrup are supplements of iron and folic acid. Folic acid is important during periods of cell division resulting in growth and development while the iron is important in the transportation of oxygen to all body cells. Orofer XT tablets are used in the management and treatment of a number of condition that includes:

  • MYELODYSPLASTIC SYNDROMES anemia
    Folic acid deficiency
  • Anemia that is due to iron deficiency caused by either loss of blood or low intake of iron in the diet.
  • Anemia as caused by inadequate vitamin B12 and folic acids( Megaloblastic anemia)
  • Building of immunity
  • Anemia that occurs during lactation and pregnancy
  • Weakness
  • Iron deficiency
  • Poor food absorption
  • Childhood anemia

Since Orofer XT is used to treat anemia, you might want to take up a simple blood test at home to check your hemoglobin levels. This will tell you if you really need to take this medicine and will also help monitor your Hb levels.

A CBC (complete blood count) blood test is a popular test that not only tests your Hb levels, but also other RBC parameters, besides WBC and platelets. Here is our detailed analysis of the CBC blood test that explains the entire procedure along with the pre-test preparations and normal reference ranges.

Do I need a prescription?

Orofer XT can be bought from local pharmacies close to you and from online drug stores too. A doctor’s prescription is mandatory.

Dosage

The dosage recommended for Orofer XT tablets is depended on a number of conditions that include the condition and how severe it is, weight, age, reaction to the initial dose and any other underlying medical conditions. The recommended dose is:

  • One tablet is taken once a day, between meals.
  • If two tablets a day, then they should be distributed through the day with a gap between.

Chemical composition of Orofer XT

Orofer XT contains two active ingredients Folic acid and Iron. The tablet contains:

  • Elemental Iron(Ferrous Ascorbate) – 100 mg
  • Folic acid – 1.1 mg

Orofer XT syrup contains:

  • Elemental Iron(Ferrous Ascorbate) – 30 mg/ 5 ml
  • Folic acid – 550 mcg/ 5 ml

Folic acid is also called folate or vitamin B9.

Mechanism of Action (MOA) of Orofer XT

Genetic Disorder_sickle cell

Orofer XT contains iron that when taken addresses the inadequate supply to the body. Sufficient supply of iron increases production of hemoglobin in blood thus oxygen supply to cells and tissues is sufficient. Iron is also important in the production of myoglobin in muscles thatsupplying muscle cells with enough oxygen. When oxygen supply to all body cells is sufficient, it reduces general weakness, restoring stores of iron in tissues and correcting anemia in the process. Iron is also important in the correct working of neutrophils and in some enzymes as a cofactor.

Folic acid in Orofer XT when ingested in an inactive form. In the body, it is converted by dihydrofolate reductase to methyltetrahydrofolate and tetrahydro folic acid. These derivatives enter the cell through endocytosis that is receptor mediated.

Folic acid is important in the production and development of red blood cells and platelets. It works on megaloblastic bone marrow that ends up producing normoblastic bone marrow that results in normal red blood cells. Folic acid is also utilized during the synthesis of nucleotides and homocysteine remethylation by methionine synthetase to form methionine, the process requires Vitamin B12 as a cofactor. Thus it is needed in adequate amounts during DNA replication when cell division is occurring for growth and in the production of RNA. Use of folic acid is important in expecting and lactating mothers as they supply the growing fetus and breastfeeding child folic acid. Folic acid also improves the absorption of iron in the body.

Facts on Orofer XT

  • Orofer XT is mainly used as an iron supplement.
  • Orofer XT is used together with Vitamin B12 in the management of megaloblastic and pernicious anemia.
  • Diagnosis of pernicious anemia may be interfered with when taking Orofer XT.
  • Orofer XT is not addictive.
  • Orofer XT provides nutrients for the body to utilize but does not cure conditions.
  • Folic acid an active ingredient in Orofer XT is classified by the FDA as pregnancy category A as it brings no harm to the unborn baby.

Contraindications

Orofer XT use is not recommended in a number of conditions. If you have any of these conditions, inform your doctor as it might affect the prescription. The conditions include:

  • Hypersensitive to any of the active ingredients.
  • Liver disease
  • A renal impairment that is severe to moderate or undergoing dialysis
  • Intolerance to the drug
  • Crohn’s disease
  • Hemoglobin disease
  • Bone disease
  • Blood in urine
  • Intestinal inflammation
  • Stomach and intestinal ulcers
  • Decreased amount of protein carrying oxygen(thalassemia)
  • Pernicious anemia and hemolytic anemia
  • Alcoholism

Side effects

Apart from the Orofer XT desired effects, it might also cause some undesirable effects. The side effects do not occur in everyone as they depend on how one’s body reacts to the drug and the duration of using the medication. The side effects can be less common and less serious while others rarely occur but are more serious. Report any side effects to your doctor especially if they do not go away and also to get the doctor’s advice on how to manage the side effects.

Orofer XT side effects include:

  • Indigestion
  • Anxiety
  • Skin rashes that are itchy
  • Nausea
  • Vomiting
  • Bitter taste in the mouth
  • Diarrhea
  • Dark colored stool
  • Gastric reaction
  • Heartburn
  • Stomach cramps
  • Constipation
  • Changes in sleep patterns
  • Upper central abdomen pain
  • Biliousness
  • Discomfort in the intestine
  • Bloating
  • Appetite loss

Immediately consult your doctor if you experience an allergic reaction to the active ingredients in Orofer XT. Signs of an allergic reaction include tingling on the skin or rashes, a fever, difficulty in breathing, swelling of the tongue, lips, and throat.

If you accidentally take an overdose of Orofer XT, consult your doctor immediately or rush to the emergency center of the nearest clinic and carry with you the drug package for identification. An overdose of Orofer XT may cause symptoms such as paleness, nausea, vomiting, heartbeat being weak and fast and green diarrhea.

Drug interactions

Notify your doctor if you on any medication including both over the counter medication or prescription drugs, vitamin supplements and any herbal products before you begin using Orofer XT. Orofer XT is known to interact with a number of medicines and products. Interactions might lower the effectiveness of the medication, increase chances of side effects occurring or worsen an existing condition. The following medications and products interact with Orofer XT:

  • Cetirizine
  • Phenytoin
  • Alcohol
  • Ascorbic corrosive/vitamin C
  • Barbiturates for epileptic seizures
  • Methotrexate
  • Aspirin
  • Cholecalciferol/ vitamin D3
  • Levofloxacin
  • Diphenylhydantoin
  • Cyanocobalamin
  • Montelukast
  • Tetracycline
  • Pyrimethamine
  • Nitrofurantoin
  • Diphenylhydantoin
  • Pregabalin
  • Primidone

What to do if you skip a dose?

If you skip a dose, take it as soon as you remember it. If it is close to the next dose, skip it and take the next dose as scheduled and continue with the normal routine. Do not double the dose to compensate for the missed dose as it may result in adverse effects. If you frequently miss doses, set a reminder or have a family member remind you when it is time for your next dose or you can talk to your doctor for more convenient schedule, frequent dose missing lowers the effectiveness of the medicine.

Precautions

A number of precautions need to be considered when using Orofer XT. The precautions include:

  • Do not take Orofer XT with alcohol as it increases the side effects of drowsiness and calmness.
  • Orofer XT does not interfere with alertness, but in the case that it causes drowsiness or dizziness then one is advised not to take part in activities that require keenness like the operation of heavy machinery or driving.
  • Orofer XT should be kept away from direct sunlight and heat and at room temperature.
  • Orofer XT should be used with caution if you have intestinal inflammation and liver cirrhosis.
  • Allergic reactions to any of the key ingredients.
  • Inform your doctor of any medications and products such as herbal and vitamin supplements you are using to avoid drug interactions.
  • Inform your doctor of any underlying conditions that might affect the functioning of Orofer XT.
  • Do not adjust the prescribed dose of Orofer XT as it may result in side effects if increased.
  • Orofer XT should be taken immediately after food consumption or with food.
  • Do not take Orofer XT that is expired as its effectiveness is reduced. Always check the expiry date on the package.
  • Orofer XT should be used with caution if you have tumours that are folate-dependent.
  • Anti-epileptic drug concentration reduces in the plasma when used concurrently with Orofer XT.
  • When taken together with antibiotics, Orofer XT should be taken two hours prior to the antibiotics to minimize the chances of interactions.
  • You should maintain a gap of two hours between bisphosphonates, Levothyroxine, Methyldopa, Levodopa and Mofetil as Orofer XT reduces their absorption.
  • Avoid the use of caffeinated drinks as they lower absorption of iron and the intake of foods rich in calcium.
  • Orofer XT should be taken for the prescribed duration to ensure it is effective, earliest signs of Orofer XT effectiveness occurs after a period of one month. If your symptoms do not improve while using this medication consult your doctor for reevaluation.

Different Brands and Manufacturing Companies of the Drug

Emcure Pharmaceuticals Ltd is the manufacturer of Orofer XT.

Other products manufactured by Emcure Pharmaceuticals with the same components include:

  • Orofer XT Drop contains 10 mg of elemental iron
  • Orofer XT Plus Syrup contains 30 mg elemental iron, 500 mcg folic acid and 500 mcg mecobalamin in 5 ml.
  • Orofer XT Total contains 100 mg elemental iron,22.5 mg elemental zinc, 1.1 mg folic acid and 1.5 mg of methylcobalamin
  • Ferium XT contains 100 mg elemental iron and 1.5 mg folic acid.

Substitutes of the Drug

Drugs that have the same strength and work as Orofer XT include:

  • Ftwo Tablet – Caplet India Pvt Ltd
  • Aloha XT tablet – Indoco Remedies Ltd
  • Feris 100 mg tablet – Eris Lifesciences Pvt Ltd
  • Ferox XT tablet – Micros Labs Limited
  • Freri XT tablet – Azott Pharmaceuticals Pvt Ltd
  • Ferintas XT tablet – Intas Pharmaceuticals Ltd
  • Cpink tablet – Wanbury Pharmaceuticals
  • Biofer XT tablet – Micro Labs Limited
  • Feon XT – Ayurlife Remedies Ltd
  • Fericip XT – Cipla Pharmaceuticals Ltd
  • Zilof – Micro Labs Limited
  • Zilof XT –Micro Labs Limited
  • Heamifer – Saviyak Life Sciences
  • Hemfol Z – Versatil Pharmaceuticals

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