Pregnancy is a period of increased metabolic demands, with changes in the woman's physiology and the requirements of a growing fetus.
Most of the doctors would recommend every pregnant woman to take folic acid during conception stage and even before the conception stage because it causes numerous advantages for the baby. When the pregnant woman has an adequate amount of ferrous ascorbate folate in the body, it is guaranteed that the baby will achieve the complete development of the brain and spinal column. There is an assurance that the baby will not have any neural tube defects and other inborn defects like harelip and others. On the side of the mother, taking ferrous ascorbate folic acid would help her to avoid having an anemia sickness during pregnancy and in addition to that it also boosts the immune system of the mother and the baby. This is the reason why, it is highly recommended that every pregnant woman should start taking ferrous ascorbate folate especially during the early stages of pregnancy and even before pregnancy. This combination improves fetal growth and develops immune system ensuring expected outcome of pregnancy – "no maternal complication and healthy baby".

Indications:

⇒ Iron-deficiency anemia due to chronic blood loss, hookworm infestation, and inadequate intake of iron
⇒ Megalo-blastic anemia due to deficiency of folic acid
⇒ Dimorphic anemia
⇒ Anemia of nutritional origin, pregnancy, infancy and childhood
⇒ Tonic in general weakness, lack of appetite, rundown conditions and convalescence
⇒ Post-surgery and other debilitating conditions
⇒ Menorrhagia (Heavy bleeding during menstruation)
⇒ Spina bifida

Mechanism of Action:

Ferrous Ascorbate:
Ferrous ascorbate is a synthetic molecule of ascorbic acid and iron. Ascorbic acid enhances the absorption of iron. Iron is critical to a number of synthetic and enzymatic processes. Most of the body iron is part of the haemoglobin molecule where iron serves a key role in oxygen transport. Small amounts of iron are found in myoglobin and in plasma (bound to transferrin). Ascorbic acid reduces ferric iron to ferrous iron which remains soluble even at a neutral pH. Ascorbate is a reducing agent and prevents oxidation.

Folic Acid:
Folic acid acts on megaloblastic bone marrow to produce a normoblastic marrow. In humans, an exogenous source of folate 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. Impairment of thymidylate synthesis in patients with folic acid deficiency is thought to account for the defective deoxyribonucleic acid (DNA) synthesis that leads to megaloblast formation and megaloblastic and macrocytic anemia.

Pharmacokinetics:

Ferrous Ascorbate:
Absorption: Iron absorption occurs predominantly in the duodenum and upper jejunum.
Distribution: 90% of iron is bound to protein.
Metabolism: Iron binds to transferrin and is transported to the spleen, bone marrow and liver, which are the main storage sites for endogenous iron.
Elimination: Because absorption is low and because iron is recycled in the body, less than 1mg/day of endogenous iron is lost through the skin, faeces and urine.

Folic Acid:
Absorption: Folic acid is rapidly absorbed in the proximal portion of the small intestine. After oral administration, the Cmax can be achieved within one hour.
Distribution: As tetrahydrofolic acid derivative, folic acid is well-distributed in all over the body tissues and stored in hepatic tissues.
Metabolism: Folic acid is metabolized in liver into dihydrofolate and tetrahydrofolate forms.
Elimination: About 90% of the administered dose is excreted via the urine.

Side Effects:

⇒ Nausea
⇒ Constipation
⇒ Dark colored stool

Contraindications:

⇒ Patients with hypersensitivity to iron and folic acid.
⇒ Patients who have active bacterial infections.
⇒ Patients with haemosiderosis, haemochromatosis, and haemolytic anemia.