Integra Plus Capsules

Vitamin B Complex components (e.g., B1, B2, B3, B5, B6, B7, B9, B12) act as coenzymes in various metabolic processes, including energy production, DNA synthesis, and red blood cell formation. Iron is an essential mineral component of hemoglobin, myoglobin, and various enzymes; it is crucial for oxygen transport, cellular respiration, and energy metabolism. The combination supports overall nutritional status and addresses deficiencies leading to conditions like iron-deficiency anemia.

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Black, tarry, or bloody stools
Fever
Vomiting blood or coffee ground-like material
Stomach cramps

Other Possible Side Effects

Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor:

Stomach pain or diarrhea
Upset stomach or vomiting
Decreased appetite
Gas
Bad taste in your mouth
Constipation
Green-colored stool

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you are currently taking levodopa, as this may interact with the medication.
If you have an iron overload condition, where your body has excessive levels of iron.
If you have certain types of anemia, including pernicious anemia or hemolytic anemia, as these conditions may be affected by the medication.

This list is not exhaustive, and it is crucial to discuss all your medications, health conditions, and supplements with your doctor. This includes:

All prescription and over-the-counter (OTC) medications
Natural products
* Vitamins

Your doctor and pharmacist need to be aware of all your medications and health conditions to ensure safe treatment. Do not start, stop, or modify the dosage of any medication without first consulting your doctor to confirm it is safe to do so.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This drug may interfere with certain laboratory tests, so be sure to notify your healthcare providers and lab personnel that you are taking it.

If you have a known allergy to tartrazine (also referred to as FD&C Yellow No. 5), consult with your doctor before taking this medication, as some products may contain this ingredient.

Regular blood tests will be necessary to monitor your condition, as directed by your doctor. Discuss any concerns or questions you have with your doctor.

Taking this medication may affect the absorption of other oral medications. If you are taking other drugs by mouth, your doctor may advise you to take them at a different time than this medication to ensure proper absorption.

Not all formulations of this medication are suitable for children, so it is crucial to consult with your doctor before administering it to a child.

If you are pregnant, planning to become pregnant, or are breastfeeding, discuss the potential benefits and risks of this medication with your doctor to determine the best course of action for you and your baby.

• Tetracyclines (e.g., doxycycline, minocycline): Iron can chelate tetracyclines, reducing absorption of both. Separate administration by at least 2-3 hours.
• Fluoroquinolones (e.g., ciprofloxacin, levofloxacin): Iron can chelate fluoroquinolones, reducing absorption. Separate administration by at least 2-4 hours.
• Levothyroxine: Iron can impair levothyroxine absorption. Separate administration by at least 4 hours.

• Antacids (e.g., aluminum hydroxide, magnesium hydroxide): Can reduce iron absorption. Separate administration by 2 hours.
• H2-receptor antagonists (e.g., ranitidine, famotidine) & Proton Pump Inhibitors (e.g., omeprazole, pantoprazole): Reduce gastric acid, which can impair iron absorption. Monitor iron status.
• Bisphosphonates (e.g., alendronate): Iron can interfere with absorption. Separate administration by at least 30 minutes (preferably longer).
• Penicillamine: Iron can reduce penicillamine absorption. Separate administration by at least 2 hours.
• Chloramphenicol: May delay response to iron therapy in iron deficiency anemia.
• Vitamin E: High doses may impair iron absorption.
• Alcohol: Chronic heavy alcohol use can impair absorption and utilization of B vitamins (especially folate, B1, B6, B12).

• Calcium supplements: Can reduce iron absorption. Take iron at a different time of day.
• Dietary fiber (e.g., bran): Can reduce iron absorption.
• Tea/Coffee: Tannins can reduce iron absorption. Avoid taking with meals containing iron.

• Gastrointestinal upset (nausea, constipation, diarrhea, dark stools)
• Fatigue, weakness, pallor (signs of anemia)
• Neurological symptoms (e.g., tingling, numbness, gait instability - if B12 deficiency is severe and unaddressed)
• Allergic reactions (rare: rash, itching, swelling, severe dizziness, trouble breathing)

Iron and B vitamins (especially folate) are crucial during pregnancy for maternal health and fetal development. This combination is often recommended to prevent or treat iron-deficiency anemia and neural tube defects. Dosing should be guided by a healthcare provider.

Iron and B vitamins are important for lactating mothers and are generally considered safe and beneficial. They are excreted in breast milk in small amounts, providing essential nutrients to the infant. Dosing should be guided by a healthcare provider.

Use with extreme caution in children due to the high risk of accidental iron overdose, which can be fatal. Keep out of reach of children. Dosing must be precise and determined by a pediatrician based on age, weight, and specific deficiency.

Older adults may have increased risk of iron deficiency due to reduced absorption or chronic conditions. They may also have B vitamin deficiencies (especially B12 due to malabsorption). This combination can be beneficial, but monitor for potential drug interactions and underlying conditions. Start with lower doses if sensitive to GI upset.

• Advise patients that iron supplements can cause dark or black stools, which is a normal and harmless side effect.
• To minimize GI upset, advise patients to take the supplement with food, but be mindful of food interactions that reduce iron absorption.
• Emphasize the importance of consistent daily dosing for effective repletion of iron and vitamin stores.
• Educate patients on the critical danger of iron overdose in children and the need for secure storage.
• For patients with ongoing blood loss (e.g., heavy menstruation), continuous supplementation may be necessary.

• Oral iron supplements (e.g., ferrous sulfate, ferrous gluconate, ferrous fumarate) as single agents
• Individual B vitamin supplements (e.g., folic acid, vitamin B12, B complex)
• Dietary modifications (iron-rich foods, folate-rich foods)
• Intravenous iron (for severe iron deficiency or malabsorption)
• Parenteral B12 (for severe B12 deficiency or malabsorption)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.