Timed release capsule
META-Z TR is a preparation of iron, folic acid and zinc, Iron and zinc are specially formulated for timed-release over several hours.
META-Z TR is indicated for the treatment and prophylaxis of iron, folic acid and zinc deficiency especially during pregnancy and lactation.
Dosage and administration:
Adults : 1 capsule a day. In more severe cases, 2 capsules a day may be required.
Do not use in patients hypersensitive to the product or those with iron overload.
Care should be taken in patients who may develop iron overload, such as those with haemochromatosis, haemolytic anaemia or red cell aplasia. Failure to respond to treatment may indicate other causes of anaemia and should be further investigated. Iron and zinc chelate with tetracyclines and absorption of all three agents may be impaired. The absorption of zinc may be reduced in the presence of iron. Absorption of iron may be impaired by penicillamine and by antacids. Such potential interactions can be reduced by separating administration of each product by several hours. In patients with renal failure, a risk of zinc accumulation could exist.
Use in pregnancy:
Use of any drug during the first trimester of pregnancy should be avoided if possible. Thus administration of iron during the first trimester requires definite evidence of iron deficiency. Prophylaxsis of iron deficiency where inadequate diet calls for supplementary zinc and folic acid is justified during the remainder of pregnancy.
Dark stools are usual during iron therapy, and nausea and other symptoms of gastrointestinal irritation, such as anorexia, vomiting, discomfort, constipation and diarrhoea are sometimes encountered. Zinc may also produce gastrointestinal upset. These timed release capsules are designed to reduce the possibility of gastrointestinal irritation. There have been rare reports of allergic reactions.
Iron overdosage is dangerous, particularly in children, and requires immediate attention. Gastric lavage should be carried out in the early stages, or if this is not possible, vomiting should be induced. These procedures should not be undertaken where signs of the corrosive effects of zinc are present. Give oral desferrioxamine (2g for a child or 5g for an adult) and demulcents. If serum iron levels at 4 hours or more post-ingestion are over 5mg/I in a child or 8 mg/I in an adult, or if the patients is in shock of coma, intravenous desferrioximine should be used. Zinc sulphate in gross overdosage is corrosive. Symptoms are those of gastrointestinal irritation, leading in severe cases to haemorrhage, corrosion of the mucosa and possible later stricture formation. Gastric lavage or emesis should be avoided. Demulcents such as milk should be given. Chelating agents such as dimercaprol, penicillamine or edetic acid have been recommended.
Symptomatic and supportive measures should be given as required. The timed release capsule presentation may delay excessive absorption of iron and zinc and allow more time for initiation of appropriate countermeasures.
Store in a dry place below 250C and protect from light. Keep out of children's reach to avoid accidental iron poisoning.
META-Z TR Capsule : Box containing 3 strips of 10 timed release capsules each. Each capsule contains dried ferrous sulphate BP 150 mg (equivalent to 47 mg iron), zinc sulphate monohydrate BP 61.8 mg (equivalent to 22.5 mg zinc), both in timed release form, and folic acid BP 500 mcg.