Registered Zambia · ZAMRA

Hemoforce Forte Syrup

Ascorbic Acid 20.00 mg,Copper Sulphate Eq. to Elemental Copper 10=2.54 mcg,Cyanocobalamin (Vitamin B12) 5.00 mcg,Folic Acid 0.500 mg,Manganese Sulphate USP Eq. to Manganese 10=3.25 mcg,Sodium Feredetate BP (equivalent to elemental iron) 77.913=11.00 mg,Zinc Sulfate Heptahydrate Eq. to Elemental Zinc 14.66=3.330 mg

075/104 Liquid 0.500 mg,10=2.54 mcg,10=3.25 mcg,14.66=3.330 mg,20.00 mg,5.00 mcg,77.913=11.00 mg alimentary tract and metabolism INN generic

What it does

This medicine is used to treat various health conditions. Please consult your healthcare provider for more specific information.

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Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.

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Registration & product details

Registration no.
075/104
Registration date
2025-12-11
Expiry date
2030-12-10
Status
Registered/Compliant
Active ingredient
Ascorbic Acid 20.00 mg,Copper Sulphate Eq. to Elemental Copper 10=2.54 mcg,Cyanocobalamin (Vitamin B12) 5.00 mcg,Folic Acid 0.500 mg,Manganese Sulphate USP Eq. to Manganese 10=3.25 mcg,Sodium Feredetate BP (equivalent to elemental iron) 77.913=11.00 mg,Zinc Sulfate Heptahydrate Eq. to Elemental Zinc 14.66=3.330 mg
Dosage form
Liquid
Strength
0.500 mg,10=2.54 mcg,10=3.25 mcg,14.66=3.330 mg,20.00 mg,5.00 mcg,77.913=11.00 mg
Pack size
-
Therapeutic class
-
ATC class (WHO)
A11GA - Ascorbic acid (vitamin C), plain
RxNorm RxCUI
1151
Manufacturer / MAH
Shalina Laboratories
Country of origin
India
Manufacturer location
Turbhe MIDC, C 48/3, S Central Rd, MIDC Industrial Area, Turbhe, Navi Mumbai, Maharashtra 400703, India

Source: Zambia Medicines Regulatory Authority · fetched 2026-03-12 00:03:00 · updated 2026-09-28 03:34:31

Disclaimer: This information is sourced from Zambia Medicines Regulatory Authority (Zambia). Always consult a qualified healthcare professional before using any medication.

About 66=

This medicine is used to treat various health conditions. Please consult your healthcare provider for more specific information.

How it works

The exact way this medicine works is specific to the condition it treats. It is important to follow your healthcare provider's instructions for its use.

Who it's for

This medicine may be suitable for different patients depending on their specific health needs.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About 913=

This medication is used to treat various health conditions. Please consult your healthcare provider for specific uses and guidance.

How it works

The exact mechanism of action is not specified, but it generally helps manage certain health conditions effectively.

Who it's for

This medication may be prescribed for individuals with specific health conditions. Consult your doctor to see if it is right for you.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About ascorbic acid

Ascorbic acid, commonly known as Vitamin C, is essential for overall health and helps the body in many ways.

What it treats

  • scurvy
  • immune system support
  • wound healing
  • antioxidant support

How it works

Ascorbic acid helps in the production of collagen, a protein important for skin, blood vessels, and connective tissues, and acts as an antioxidant to protect cells.

Who it's for

It is suitable for people needing vitamin C, such as those with a deficiency or increased requirements due to illness or stress.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About copper

Copper is a mineral that is essential for various bodily functions, playing a role in the formation of red blood cells and maintaining healthy bones and nerves.

What it treats

  • copper deficiency
  • anemia
  • bone health
  • nerve health

How it works

Copper helps the body create red blood cells and supports the proper functioning of nerves and bones.

Who it's for

Copper supplements may be recommended for individuals with low copper levels or certain health conditions that affect copper absorption.

Cautions

  • • Excessive copper intake can be harmful.
  • • People with certain health conditions should consult a healthcare provider before use.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About cyanocobalamin

Cyanocobalamin is a form of vitamin B12 that is important for maintaining healthy nerve cells and producing red blood cells.

What it treats

  • vitamin B12 deficiency
  • pernicious anemia
  • certain types of anemia

How it works

It helps in the production of red blood cells and supports the nervous system.

Who it's for

It is for people who have low levels of vitamin B12, including those with certain dietary restrictions or absorption issues.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About elemental

Elemental is a type of supplement that provides essential nutrients in their simplest form, helping to improve nutrition and support overall health.

What it treats

  • nutritional support
  • malnutrition
  • deficiencies in essential nutrients

How it works

Elemental supplements provide the body with necessary nutrients that may be lacking in the diet, helping to improve health and energy levels.

Who it's for

This supplement is suitable for individuals who need extra nutritional support, such as those recovering from illness or those with specific dietary needs.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About feredetate

Feredetate is a medication used to treat iron deficiency or low iron levels in the body.

What it treats

  • iron deficiency
  • low iron levels (ferropenia)

How it works

Feredetate helps to increase the amount of iron in your body, which is important for making red blood cells and keeping your energy levels up.

Who it's for

This medication is for individuals who have low iron levels, often due to poor diet, certain health conditions, or blood loss.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About folate

Folate is a type of B vitamin that is important for the production of red blood cells and helps prevent certain types of birth defects.

What it treats

  • prevention of neural tube defects in pregnancy
  • treatment of folate deficiency
  • supporting overall health

How it works

Folate helps the body make DNA and is essential for the growth and division of cells.

Who it's for

Folate is suitable for pregnant women, those planning to become pregnant, and individuals with low levels of folate.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About heptahydrate

Heptahydrate is a substance used in various medicinal products.

What it treats

  • treatment of certain conditions related to hydration
  • used in pharmaceutical formulations

How it works

Heptahydrate helps to maintain or restore hydration in the body.

Who it's for

This substance is generally used for individuals needing hydration support.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About manganese

Manganese is a trace mineral important for many bodily functions, including bone formation and metabolism.

What it treats

  • nutritional support
  • bone health

How it works

Manganese helps the body use certain nutrients and is involved in the formation of connective tissue, bones, and blood-clotting factors.

Who it's for

Adults and children who may have low manganese levels due to dietary deficiencies.

Cautions

  • • Excessive intake can lead to toxicity.
  • • Consult a healthcare provider if you have liver problems.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

Clinical monograph: Cyanocobalamin

BNF-referenced

Cyanocobalamin, commonly known as vitamin B12, is a water-soluble vitamin essential for various bodily functions, including DNA synthesis, red blood cell formation, and neurological function. It plays a crucial role in the metabolism of fatty acids and amino acids. Deficiency in vitamin B12 can lead to megaloblastic anemia and neurological disorders.

Mechanism of action

Cyanocobalamin serves as a cofactor for methionine synthase and L-methylmalonyl-CoA mutase enzymes. Methionine synthase is essential for the synthesis of purines and pyrimidines that form DNA. L-methylmalonyl-CoA mutase is involved in the degradation of propionate, crucial for fat and protein metabolism. The lack of vitamin B12 results in the accumulation of methylmalonyl CoA, contributing to neurological manifestations. Additionally, it is vital for the synthesis of methionine from homocysteine, and its deficiency can lead to functional folate deficiency, which impacts red blood cell formation.

Pharmacodynamics

Cyanocobalamin corrects vitamin B12 deficiency and alleviates symptoms and laboratory abnormalities associated with pernicious anemia, such as megaloblastic indices, gastrointestinal lesions, and neurological damage. It is essential for growth, cell reproduction, hematopoiesis, nucleoprotein, and myelin synthesis. The drug significantly impacts fat and carbohydrate metabolism, as well as protein synthesis. Rapidly dividing cells, such as those in the bone marrow, have a high demand for vitamin B12. Parenteral administration of cyanocobalamin can quickly reverse the anemia and gastrointestinal symptoms of vitamin B12 deficiency, while also preventing the progression of related neurological damage.

Pharmacokinetics

Cyanocobalamin is absorbed in the intestine, primarily in the ileum, via specific transport mechanisms that may be impaired in individuals with intrinsic factor deficiency (as seen in pernicious anemia). Once absorbed, it is widely distributed in body tissues, with significant concentrations found in the liver, kidneys, and heart. The vitamin is stored in the liver, where it can be released into circulation as needed. Cyanocobalamin undergoes conversion to its active forms, methylcobalamin and adenosylcobalamin, which are utilized in various metabolic processes. The elimination half-life is variable, but it is generally excreted via urine as metabolites

Adverse effects

  • Abdominal distension
  • Decreased appetite
  • Flatulence
  • Nausea

Interactions

  • Folic acid may interact with cyanocobalamin, especially in cases of megaloblastic anemia caused by folate deficiency.

Precautions

  • Should not be given alone for pernicious anemia.
  • Use caution in patients with Leber's disease, as it may worsen optic atrophy.

Pregnancy

Cyanocobalamin is essential during pregnancy as it helps prevent neural tube defects. It is advised that females of childbearing potential take 5 mg of folic acid daily before conception and throughout pregnancy.

Breast-feeding

Cyanocobalamin is generally considered safe during breastfeeding, but it is advised to monitor the infant for any adverse effects.

Storage

Store in a cool, dry place, away from direct sunlight. Protect from moisture.

Formulations

  • Tablet: 1000 micrograms
  • Tablet: 500 micrograms
  • Tablet: 100 micrograms
  • Oral solution: 50 micrograms per ml
  • Solution for injection: 1000 micrograms per ml
BNF 85 (British National Formulary) p.1153 BNF for Children 2019-2020 p.617 PubChem / pathway

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: Ascorbicacid

BNF-referenced

Ascorbic acid, also known as Vitamin C, is a water-soluble vitamin essential for various bodily functions, including the synthesis of collagen, neurotransmitters, and the immune response. It acts as an antioxidant, protecting cells from damage by free radicals.

Indications

  • Vitamin C deficiency
  • Scurvy
  • Adjunct therapy in iron overload conditions

Dosage

Children: Child 1 month–3 years: 125–250 mg daily in 1–2 divided doses; Child 4–11 years: 250–500 mg daily in 1–2 divided doses; Child 12–17 years: 0.5–1 g daily in 1–2 divided doses.

Adults: 500 mg daily, taken in 1-2 divided doses, depending on the clinical condition and dietary needs.

Mechanism of action

Ascorbic acid functions primarily as a reducing agent, facilitating enzymatic reactions in the body, including the hydroxylation of proline and lysine in collagen synthesis. It also plays a role in the absorption of iron from the gastrointestinal tract and enhances the immune response.

Pharmacodynamics

Ascorbic acid is crucial for the maintenance of connective tissue and is involved in the metabolism of several amino acids. Its antioxidant properties help to mitigate oxidative stress and may play a role in reducing the risk of chronic diseases.

Pharmacokinetics

Ascorbic acid is absorbed in the intestines and is widely distributed throughout the body. The renal clearance of ascorbic acid is dose-dependent, with higher doses leading to increased excretion. The half-life varies but is generally around 15 to 30 minutes in healthy individuals, with tissue saturation levels influencing its retention.

Contra-indications

  • Hypercalcaemia
  • Hyperoxaluria
  • Patients with cardiac dysfunction

Adverse effects

  • Abdominal pain
  • Headache
  • Nausea
  • Vomiting
  • Diarrhoea
  • Constipation
  • Weight loss
  • Polyuria
  • Sweating
  • Thirst
  • Vertigo

Interactions

  • Increases risk of cardiovascular adverse effects with iron chelators
  • Increases risk of cardiovascular adverse effects with deferiprone
  • Increases risk of cardiovascular adverse effects with desferrioxamine

Precautions

  • Use with caution in patients with iron overload
  • Monitor for symptoms of overdose

Pregnancy

High doses teratogenic in animals but therapeutic doses unlikely to be harmful.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

  • Ascorbic acid 50 mg tablets
  • Ascorbic acid 100 mg tablets
  • Ascorbic acid 200 mg tablets
  • Ascorbic acid 250 mg tablets
  • Ascorbic acid 500 mg capsules
BNF for Children 2019-2020 p.674 PubChem / pathway

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: copper

BNF-referenced

Copper is an essential trace element that plays a crucial role in various biological processes, including the functioning of enzymes and the formation of connective tissue. It is an important cofactor for many oxidase enzymes and has antioxidant properties. Copper deficiency can lead to serious health conditions such as Occipital Horn Syndrome and Menke's disease, which are associated with impaired development and neurological impairment. In addition, copper is used in certain contraceptive devices, where it reduces sperm viability and motility, thereby preventing fertilization.

Indications

  • Copper deficiency
  • Occipital Horn Syndrome
  • Menke's disease
  • Contraception (via copper IUD)

Dosage

Children: Refer to the BNF for Children for specific dosing information.

Adults: Refer to the relevant clinical guidelines and BNF for specific dosing information.

Mechanism of action

Copper is absorbed from the gastrointestinal tract via high affinity copper uptake proteins and low affinity copper uptake proteins, likely being reduced to the Cu1+ form prior to transport. Inside enterocytes, it binds to the copper transport protein ATOX1, which facilitates its transport to copper transporting ATPase-1 on the Golgi membrane for incorporation into the Golgi apparatus. Once in systemic circulation, copper binds primarily to ceruloplasmin, albumin, and alpha 2-macroglobulin. It acts as a cofactor in a variety of oxidase enzymes and also influences sperm motility when released from copper IUDs, contributing to its contraceptive effect.

Pharmacodynamics

Copper is essential for the activity of many enzymes and plays a vital role in processes such as iron metabolism, neurotransmitter synthesis, and antioxidant defense. Copper ions, particularly when released from intrauterine devices, have been shown to decrease sperm viability, thereby impacting fertility.

Pharmacokinetics

Copper is absorbed from the gut and is predominantly transported in the plasma bound to proteins such as ceruloplasmin and albumin. The absorption efficiency can vary; however, a significant portion of dietary copper is usually absorbed. The body regulates copper levels through hepatic excretion and storage mechanisms, ensuring homeostasis. Excess copper can lead to toxicity, while deficiency results in various health issues.

Pregnancy

Copper is considered essential during pregnancy, but excessive intake should be avoided due to potential toxicity.

Breast-feeding

Copper is excreted in breast milk, and adequate maternal intake is important for infant development.

Storage

Store in a cool, dry place, away from moisture and heat.

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: elemental

Elemental refers to elemental nutritional formulations that provide essential nutrients in their simplest forms. These formulations are used primarily to treat patients with specific nutritional deficiencies, malabsorption syndromes, or conditions where gastrointestinal function is impaired. Elemental diets are often used in conditions such as Crohn's disease, cystic fibrosis, and short bowel syndrome, and can be administered orally or via enteral feeding.

Indications

  • Malabsorption syndromes
  • Crohn's disease
  • Cystic fibrosis
  • Short bowel syndrome
  • Severe food allergies
  • Inability to meet nutritional needs through standard diets

Dosage

Children: Refer to specific formulations for dosing, as paediatric dosages depend on the product and the child's nutritional needs.

Adults: Refer to specific formulations for dosing, as adult dosages vary based on the product used and the patient's nutritional requirements.

Mechanism of action

Elemental formulations provide nutrients in their simplest forms, which are readily absorbed in the small intestine. This bypasses complex digestive processes, making them suitable for individuals with compromised digestion or absorption capabilities. The nutrients in these formulations include amino acids, simple carbohydrates, and fatty acids, which can be directly utilized by the body's metabolic pathways.

Pharmacodynamics

Elemental formulations help restore nutritional balance by supplying essential macronutrients and micronutrients needed for metabolic processes. They support growth, maintain energy levels, and promote healing in patients with malabsorption or increased nutritional needs. The bioavailability of nutrients in elemental forms is typically high, allowing for efficient uptake and utilization by the body.

Pharmacokinetics

Following administration, elemental nutrients are absorbed in the gastrointestinal tract, primarily in the jejunum and ileum. The rate of absorption can vary based on the specific formulation and the individual's gastrointestinal health. Once absorbed, these nutrients enter systemic circulation and are transported to various tissues for utilization in metabolic processes. The elimination of unabsorbed nutrients occurs primarily through feces.

Adverse effects

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Stomach cramps
  • Dark stools
  • Metallic taste
  • Allergic reactions

Precautions

  • Use with caution in patients with a history of gastrointestinal disorders.
  • Monitor for signs of iron overload in patients receiving multiple iron products.
  • Assess for the need for supplementation in patients with conditions causing malabsorption.

Pregnancy

Iron is essential during pregnancy, but supplementation should be guided by clinical need and under healthcare supervision.

Breast-feeding

Iron is excreted in breast milk; supplementation may be necessary depending on maternal iron status.

Storage

Store in a cool, dry place, away from direct sunlight and moisture. Keep out of reach of children.

Formulations

  • Oral tablets
  • Liquid formulations
  • Injectable solutions

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: feredetate

Feredetate is an iron chelator used primarily in the treatment of iron overload conditions, such as hemochromatosis and secondary iron overload due to repeated blood transfusions. It functions by binding to excess iron in the body, facilitating its excretion and reducing the risk of iron-related organ damage.

Indications

  • Iron overload due to hereditary hemochromatosis
  • Secondary iron overload from repeated blood transfusions
  • Chronic iron overload resulting from ineffective erythropoiesis

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing information.

Adults: Refer to the relevant clinical guidelines and BNF for specific dosing information.

Mechanism of action

Feredetate works by forming stable complexes with ferric ions, thereby reducing free iron levels in the plasma. This process enhances the elimination of excess iron via the kidneys and promotes its safe excretion from the body. The chelation of iron prevents the formation of harmful free radicals, contributing to its protective effects against oxidative stress.

Pharmacodynamics

The pharmacodynamics of feredetate involve its ability to bind iron ions tightly, which decreases the bioavailability of free iron. This action is crucial for preventing iron-induced tissue damage and related complications. The drug's effectiveness is also influenced by the concentration of iron in the body and the presence of other chelating agents.

Pharmacokinetics

Feredetate is administered parenterally, allowing for rapid absorption into the bloodstream. Once in circulation, it distributes to various tissues, but primarily targets areas with iron overload. The elimination half-life is variable, depending on the degree of iron saturation and renal function. Excretion occurs mainly via the kidneys, with a smaller proportion eliminated through the feces.

Contra-indications

  • Hypersensitivity to the active substance or any of the excipients
  • Severe renal impairment
  • Hemochromatosis
  • Hemosiderosis
  • Active infections

Adverse effects

  • Gastrointestinal disturbances (nausea, vomiting, diarrhea)
  • Allergic reactions (rash, itching)
  • Iron overload
  • Headache
  • Dizziness
  • Hypotension
  • Injection site reactions

Interactions

  • Antacids may decrease absorption and efficacy of feredetate
  • Tetracyclines may form insoluble complexes with iron, reducing their efficacy
  • Certain medications that affect iron metabolism or absorption

Precautions

  • Monitor iron levels during therapy to avoid iron overload
  • Caution in patients with a history of gastrointestinal disorders
  • Use with care in patients with liver disease
  • Assess for potential drug interactions

Pregnancy

Feredetate should only be used during pregnancy if the benefits outweigh the risks. Consult relevant guidelines.

Breast-feeding

Feredetate is excreted in breast milk. Caution is advised when administering to nursing mothers.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

  • Injectable solution
  • Oral tablets

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: folate

BNF-referenced

Folate, also known as vitamin B9, is a water-soluble vitamin essential for the synthesis of nucleic acids and amino acids. It plays a crucial role in cellular division and growth, making it particularly important during periods of rapid growth such as pregnancy and infancy. Folate is naturally found in various foods, including leafy green vegetables, fruits, and legumes. It is also available as a dietary supplement and is often used to prevent or treat folate deficiency, which can lead to conditions such as megaloblastic anemia.

Indications

  • Folate deficiency
  • Megaloblastic anemia
  • Prevention of neural tube defects in pregnancy
  • Supplementation in patients on certain medications (e.g., methotrexate)

Dosage

Children: Refer to the BNF for Children for appropriate pa

Adults: Refer to specific guidelines or the BNF for appropriate adult dosing based on the indication.

Mechanism of action

Folate functions as a coenzyme in the conversion of homocysteine to methionine, a process that is vital for DNA synthesis and repair. It is involved in the one-carbon metabolism pathway, where it acts as a carrier of one-carbon units necessary for the synthesis of purines and thymidylate, thus supporting the production of nucleotides and DNA. This mechanism is particularly important in rapidly dividing cells.

Pharmacodynamics

Folate is critical for the formation of red blood cells and the proper functioning of the nervous system. It aids in the production of nucleic acids, which are essential for cell proliferation. Folate deficiency can lead to impaired DNA synthesis, resulting in megaloblastic anemia characterized by the presence of large, immature red blood cells in the bloodstream. Adequate folate levels are also associated with reduced risk of neural tube defects in developing fetuses.

Pharmacokinetics

Folate is absorbed in the proximal part of the small intestine, primarily in the jejunum, and is transported in the bloodstream bound to plasma proteins. It undergoes hepatic metabolism and is stored mainly in the liver. The elimination half-life varies, but dietary folate can be retained in the body for several weeks. Excess folate is excreted through the urine. The bioavailability of folate from food sources is lower compared to synthetic folic acid found in supplements.

Interactions

  • folates+fluorouracil: Severe (increases risk of toxicity)
  • folates+antiepileptics: Moderate (decreases concentration)
  • folates+fosphenytoin: Moderate (decreases concentration)
  • folates+phenobarbital: Moderate (decreases concentration)
  • folates+phenytoin: Moderate (decreases concentration)
  • folates+primidone: Moderate (decreases concentration)
  • sulfasalazine+folates: Unknown (decreases absorption)

Pregnancy

Folate is essential for fetal development and is often recommended to prevent neural tube defects.

Breast-feeding

Folate is generally safe during breastfeeding, as it is important for both maternal and infant health.

Storage

Store in a cool, dry place, away from direct sunlight.

Formulations

  • Tablets
  • Injection

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: hepta

BNF-referenced

Heptachlor is a polychlorinated cyclodiene insecticide, primarily used for pest control. It has been largely discontinued in many countries due to its toxicity and environmental persistence. Heptachlor is known to affect the central nervous system of insects and can have significant implications for human and environmental health.

Dosage

Children: Refer to BNF for Children for specific dosing guidance, as heptachlor usage is largely restricted.

Adults: Refer to BNF for specific dosing information, as heptachlor is not commonly used in clinical settings due to safety concerns.

Mechanism of action

Heptachlor mimics the action of picrotoxin, inhibiting gamma-aminobutyric acid (GABA)-stimulated chloride uptake, which leads to nerve excitation in insects. It competes for binding sites in the brain, causing central nervous system stimulation and resulting in increased transmitter release. This mechanism can lead to increased excitability and potentially toxic effects in target organisms.

Pharmacodynamics

As a neurotoxic agent, heptachlor causes hyperactivity and central nervous system stimulation in insects. Its effects on GABA receptors disrupt normal inhibitory neurotransmission, resulting in uncontrolled neuronal firing. While primarily studied in insects, similar mechanisms may be inferred in higher organisms, including potential neurotoxic effects in humans.

Pharmacokinetics

Heptachlor is lipophilic, leading to significant bioaccumulation in organisms and environmental persistence. It is metabolized in the liver to heptachlor epoxide, which is the more toxic form. The elimination half-life varies but can be prolonged due to its fat solubility and tendency to accumulate in fatty tissues.

Pregnancy

Heptachlor is classified as a category B drug. Animal studies have not shown any harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed.

Breast-feeding

It is not known if heptachlor is excreted in human milk. Caution should be exercised when administering heptachlor to a nursing mother.

Storage

Store in a cool, dry place, away from direct sunlight. Keep container tightly closed and out of reach of children.

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: heptahydrate

Heptahydrate, commonly referred to as heptahydrate salts, refers to a class of compounds that contain seven molecules of water in their crystalline structure. These compounds are used in various pharmaceutical formulations and can influence the solubility and bioavailability of the active ingredients. The presence of water molecules can also impact the stability and shelf-life of the drug formulation.

Dosage

Children: Refer to specific formulation guidelines for pediatric dosing, as heptahydrate is generally used in conjunction with other active ingredients.

Adults: Refer to specific formulation guidelines for dosing, as heptahydrate is typically a component rather than an active agent.

Mechanism of action

Heptahydrate itself does not have a specific pharmacological action as it is generally a structural component in formulations. However, the active ingredients in heptahydrate formulations may exert their effects through various mechanisms depending on their specific pharmacology.

Pharmacodynamics

Pharmacodynamics of heptahydrate salts is largely influenced by the active pharmaceutical ingredients they are combined with. The presence of water molecules can enhance solubility, thereby improving the absorption and overall efficacy of the drug when administered. The hydration state can also play a role in the release profile of the drug from solid dosage forms.

Pharmacokinetics

The pharmacokinetics of heptahydrate formulations depend on the specific active ingredient they harbor. The dissolution rate can be affected by the hydration state, leading to variations in absorption rates. Generally, the pharmacokinetic profile would include absorption, distribution, metabolism, and excretion characteristics of the active pharmaceutical ingredients rather than the heptahydrate component itself.

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: manganese

BNF-referenced

Manganese is a trace mineral that is essential for human health, playing a critical role in various physiological processes. It is involved in the formation of connective tissue, bones, blood clotting factors, and sex hormones. Additionally, manganese is a cofactor for several important enzymes, including those involved in metabolism and antioxidant defense. It is found in foods such as nuts, seeds, whole grains, and leafy vegetables.

Indications

  • Manganese deficiency
  • Bone health and development
  • Antioxidant support
  • Enzyme cofactor in metabolic processes

Dosage

Children: Refer to the BNF for Children for appropriate dosing recommendations.

Adults: Refer to specific clinical guidelines or the BNF for appropriate dosing recommendations.

Mechanism of action

Manganese serves as a cofactor for several enzymes, including manganese superoxide dismutase (MnSOD), which protects cells from oxidative stress by catalyzing the dismutation of superoxide radicals into oxygen and hydrogen peroxide. It also participates in the activation of enzymes involved in carbohydrate, fat, and protein metabolism.

Pharmacodynamics

Manganese plays a role in various biochemical pathways, particularly in the metabolism of amino acids, cholesterol, glucose, and carbohydrates. It is crucial for bone formation and the maintenance of cartilage. Manganese also aids in the synthesis of glycosyltransferases, which are important for the formation of glycoproteins and proteoglycans.

Pharmacokinetics

Manganese is absorbed primarily in the small intestine, with absorption efficiency influenced by dietary factors and the presence of competing minerals. It is transported in the bloodstream bound to proteins such as alpha-2-macroglobulin and transferrin. Manganese is stored in the liver, pancreas, and bones, and is excreted primarily through bile and to a lesser extent in urine. Its half-life in the human body is not well defined due to its trace nature and variable absorption.

Pregnancy

Manganese is classified as a dietary mineral that is essential for human health, but excessive intake should be avoided during pregnancy as it may affect fetal development.

Breast-feeding

Manganese is present in breast milk, and normal dietary intake is considered safe during breastfeeding. However, excessive supplementation should be avoided.

Storage

Store in a cool, dry place, away from direct light and moisture.

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Molecular reference: Cyanocobalamin

PubChem CID 166596686

Molecular formula: C63H88CoN14O14P

Mechanism of action

Vitamin B12 serves as a cofactor for _methionine synthase_ and _L-methylmalonyl-CoA mutase_ enzymes. Methionine synthase is essential for the synthesis of purines and pyrimidines that form DNA. L-methylmalonyl-CoA mutase converts L-methylmalonyl-CoA to _succinyl-CoA_ in the degradation of propionate, an important reaction required for both fat and protein metabolism. It is a lack of vitamin B12 cofactor in the above reaction and the resulting accumulation of methylmalonyl CoA that is believed to be responsible for the neurological manifestations of B12 deficiency. Succinyl-CoA is also necessary for the synthesis of hemoglobin. In tissues, vitamin B12 is required for the synthesis of _methionine_ from homocysteine. Methionine is required for the formation of S-adenosylmethionine, a methyl donor for nearly 100 substrates, comprised of DNA, RNA, hormones, proteins, as well as lipids. Without vitamin B12, tetrahydrofolate cannot be regenerated from 5-methyltetrahydrofolate, and this can lead to functional folate deficiency,. This reaction is dependent on methylcobalamin (vitamin B12) as a co-factor and is also dependent on folate, in which the methyl group of methyltetrahydrofolate is transferred to homocysteine to form _methionine_ and _tetrahydrofolate_. Vitamin B12 incorporates into circulating folic acid into growing red blood cells; retaining the folate in these cells. A deficiency of vitamin B12 and the interruption of this reaction leads to the development of megaloblastic anemia.

Pharmacodynamics

**General effects** Cyanocobalamin corrects vitamin B12 deficiency and improves the symptoms and laboratory abnormalities associated with pernicious anemia (megaloblastic indices, gastrointestinal lesions, and neurologic damage). This drug aids in growth, cell reproduction, hematopoiesis, nucleoprotein, and myelin synthesis. It also plays an important role in fat metabolism, carbohydrate metabolism, as well as protein synthesis. Cells that undergo rapid division (for example, epithelial cells, bone marrow, and myeloid cells) have a high demand for vitamin B12. **Parenteral cyanocobalamin effects** The parenteral administration of vitamin B12 rapidly and completely reverses the megaloblastic anemia and gastrointestinal symptoms of vitamin B12 deficiency. Rapid parenteral administration of vitamin B12 in deficiency related neurological damage prevents the progression of this condition. **Nasal spray effects** In 24 vitamin B12 deficient patients who were already stabilized on intramuscular (IM) vitamin B12 therapy, single daily doses of intranasal cyanocobalamin for 8 weeks lead to serum vitamin B12 concentrations that were within the target therapeutic range (>200 ng/L).

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

Molecular reference: copper

PubChem CID 23978

Molecular formula: Cu

Mechanism of action

Copper is absorbed from the gut via high affinity copper uptake protein and likely through low affinity copper uptake protein and natural resistance-associated macrophage protein-2. It is believed that copper is reduced to the Cu1+ form prior to transport. Once inside the enterocyte, it is bound to copper transport protein ATOX1 which shuttles the ion to copper transporting ATPase-1 on the golgi membrane which take up copper into the golgi apparatus. Once copper has been secreted by enterocytes into the systemic circulation it remain largely bound by ceruloplasmin (65-90%), albumin (18%), and alpha 2-macroglobulin (12%). Copper is an essential element in the body and is incorporated into many oxidase enzymes as a cofactor. It is also a component of zinc/copper super oxide dismutase, giving it an anti-oxidant role. Copper defiency occurs in Occipital Horn Syndrome and Menke's disease both of which are associated with impaired development of connective tissue due to the lack of copper to act as a cofactor in protein-lysine-6-oxidase. Menke's disease is also associated with progressive neurological impairment leading to death in infancy. The precise mechanisms of the effects of copper deficiency are vague due to the wide range of enzymes which use the ion as a cofactor. Copper appears to reduce the viabilty and motility of spermatozoa. This reduces the likelihood of fertilization with a copper IUD, producing copper's contraceptive effect. The exact mechanism of copper's effect on sperm are unknown. The reason for the less severe reaction when the foreign body is at a distance from the retina has been proposed to be ... that near the retina & its blood vessels there is greater oxygen tension than at a distance, which causes metallic copper to oxidize to toxic copper compounds more rapidly close to or in contact with the retina than at a distance. Furthermore, the abscess formation that is characteristic of copper undergoing oxidation close to the retina & choroiod can be attributed to attraction of polymorphonuclear leukocytes from these nearby vascular tissues, which become heavily infiltrated. Liquefaction & disorganization of the vitreous body has been explained on the basis of copper catalysis of oxidation of ascorbic acid, leading to depolymerization of the hyaluronic acid of the vitreous humor. Changes in protein & hexosamine content have also been related to decrease in viscosity of the vitreous humor. Increased content of amino acids in the vitreous humor has been consistent with proteolysis of the vitreous body, but decreased concentration in the aqueous humor has suggested suppression of secretion of amino acids by the ciliary body under the influence of copper.

Pharmacodynamics

Copper is incorporated into many enzymes throughout the body as an essential part of their function. Copper ions are known to reduce fertility when released from copper-containing IUDs.

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

Molecular reference: folate

PubChem CID 135405876

Molecular formula: C19H19N7O6

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

Molecular reference: hepta

PubChem CID 3589

Molecular formula: C10H5Cl7

Mechanism of action

EVIDENCE INDICATES THAT CYCLODIENE-TYPE-INSECTICIDES, EG, HEPTACHLOR EPOXIDE, MIMIC ACTION OF PICROTOXININ. THESE INSECTICIDES INHIBIT THE GAMMA-AMINOBUTYRIC ACID-STIMULATED CHLORIDE UPTAKE IN COXAL MUSCLE OF AMERICAN COCKROACH, & DIRECTLY COMPETE AGAINST LABELED DIHYDROPICROTOXININ FOR BINDING IN THE RAT BRAIN SYNAPTOSOMES. MOREOVER, SEVERAL CYCLODIENE RESISTANT INSECT STRAINS ARE RESISTANT TO PICROTOXININ. THIS CROSS-RESISTANCE IS SPECIFIC TO PICROTOXININ & DOES NOT EXTEND TO OTHER NEUROEXCITANTS. THESE INSECTICIDES, LIKE PICROTOXININ, CAUSE CENTRAL NERVOUS EXCITATION BY STIMULATING TRANSMITTER RELEASE. THESE RESULTS INDICATE THAT SOME OF THE NERVE EXCITATION SYMPTOMS THAT INSECTICIDES CAUSE ARE LIKELY DUE TO THEIR INTERACTION WITH PICROTOXININ RECEPTOR. HEPTACHLOR WAS EVALUATED FOR GENOTOXICITY & EPIGENETIC MEMBRANE EFFECTS. IT WAS NON-GENOTOXIC IN ARLHGPRT MUTAGENESIS ASSAY IN WHICH THE GENOTOXIC CARCINOGENS 7,12-DIMETHYLBENZ(A)ANTHRACENE & BENZO(A)PYRENE INDUCED SIGNIFICANT INCR IN MUTANT INCIDENCE. HEPTACHLOR INHIBITED INTERCELLULAR COMMUNICATION BETWEEN CULTURED LIVER CELLS, A PROPERTY DEMONSTRATED BY MANY TUMOR PROMOTING AGENTS, WHEREAS, BENZO(A)PYRENE DID NOT PRODUCE THIS EPIGENETIC EFFECT. The actions of the polychlorocycloalkane insecticide heptachlor, and its epoxide metabolite, were examined on GABA receptors in insects and vertebrates. Electrophysiological experiments on the cell body of the cockroach (Periplaneta americana) fast coxal depressor motor neuron (Df), and GABA-activated (36) Cl- uptake experiments on microsacs perpared from cockroach ventral nerve cords showed that both heptachlor and heptachlor epoxide blocked functional GABA receptors. The block appeared to be non-competitive and was voltage-independent over the membrane potential range -75 mV to -110 mV. There was no significant difference between the potencies of heptachlor and heptachlor epoxide in the functional assays for insect GABA receptors. Both compounds inhibited (35)S-t-butylbicyclophosphorothionate binding in insects and vertebrates. The findings provide further evidence for block of an insect GABA receptor/Cl- channel by the cyclodiene class of polychlorocycloalkanes, and reveal differences in the insecticide (35)S-t-butylbicyclophosphorothionate binding site interactions of insects and vertebrates. The effects of heptachlor on oxidative phosphorylation and electron transport in male Donryu rat liver mitochondria were investigated. The effects of 50 uM heptachlor on the respiratory activity of isolated liver mitochondria was tested in the presence of added succinate as a substrate. The effects of 100 uM heptachlor was tested in the presence of three kinds of substrates: succinate, beta-hydroxybutylate, and ascorbate plus N,N,N'N'-tetramethylphenylene-diamine. Heptachlor at 50 uM greatly inhibited the state 3 respiration, but inhibited the state 4 respiration hardly at all. The inhibition was released by 2,4-dinitrophenol. The higher dose suppressed state 3 and state 4 respiration almost completely with succinate as substrate. The findings suggest that the function of the electron transport system was also suppressed by the higher heptachlor dose even without oxidative phosphorylation.

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

Molecular reference: manganese

PubChem CID 23930

Molecular formula: Mn

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

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The same active ingredient registered across other registries we cover - including different brands.