Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) is an oral haematinic syrup used to prevent and treat iron deficiency anaemia, megaloblastic anaemia of folate deficiency, and dimorphic anaemia (combined iron and folate deficiency). The active ingredients in Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) are Iron, which provides the mineral substrate for haemoglobin synthesis, and Folic Acid (Vitamin B9), which supports DNA synthesis and red blood cell maturation. Glycerol (glycerine) is the syrup vehicle: it gives the formulation its sweet taste and viscosity, helps preservation, and is gentler on the gastric lining than alcoholic vehicles, making the syrup suitable for children, pregnant women, and adults who cannot swallow tablets.

Iron deficiency is one of the most common nutritional deficiencies, while folate deficiency is one of the most frequent causes of megaloblastic anaemia. The two often coexist, particularly in pregnancy, growing children, women of reproductive age, and people with poor diets or malabsorption. Iron is essential for haemoglobin and myoglobin synthesis, oxygen transport, and several enzymatic reactions. Folic acid is required for the production of purines and thymidylate (the building blocks of DNA), and is critical for cell division, particularly for the rapidly dividing erythroid precursors in the bone marrow. Folic acid is commonly given along with other prenatal supplements to reduce the risk of neural tube defects in the developing foetus.

Glycerol (glycerine) in Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) serves as a sweet-tasting, viscous, water-miscible vehicle that holds the iron salt and folic acid in stable solution, contributes mild humectant and preservative properties, and is well tolerated by the gastric mucosa. The syrup format of Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) proves efficient in kids (paediatrics), pregnancy, and elderly populations who often have difficulty swallowing tablets. The product is intended as a nutritional/therapeutic syrup and not a substitute for evaluation of the underlying cause of anaemia.

Iron deficiency anaemia

To increase the levels of haemoglobin and replenish iron stores.

Folate deficiency anaemia

To correct megaloblastic anaemia caused by inadequate folate.

Dimorphic anaemia

When both iron and folate deficiency coexist.

Anaemia in pregnancy

To meet increased iron and folate requirements and reduce the risk of low birth weight, preterm birth, and neural tube defects.

Anaemia in paediatric patients

As a syrup formulation suitable for children unable to take tablets.

Convalescence and general weakness

Where deficiency-driven anaemia is contributing to fatigue.

• Restores the levels of haemoglobin and iron in people suffering from iron deficiency anaemia.

• Corrects folate deficiency and supports normal red blood cell maturation.

• Glycerol-based syrup is alcohol-free, sweet-tasting, and well-tolerated, supporting adherence in children and pregnant women.

• Folic acid supplementation during early pregnancy lowers the chances of developing neural tube defects in the foetus.

• Flexible liquid dosing for those who cannot swallow tablets.

Common

• Mild nausea, abdominal discomfort, bloating

• Constipation or, less often, diarrhoea

• Dark or black stools (a normal effect of oral iron)

• Metallic aftertaste

• Temporary tooth staining if the syrup is not rinsed away

Uncommon

• Loss of appetite

• Heartburn

• Sleep disturbance with high folic acid doses

Serious side effects requiring immediate attention

• Hypersensitivity reactions, which may present as rash, swelling, and difficulty in breathing

• Severe abdominal pain, vomiting, or blood in stool

• Signs of iron overload, often seen in people with long-term unsupervised use

Shake the bottle of Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) well before use. Take orally as advised by your doctor. It often comes with a measuring cap or spoon. Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) should preferably be taken between meals or one hour before food for best iron absorption. If you experience gastric irritation, take Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) with a light meal. However, avoid taking it together with milk, tea, coffee, antacids, or calcium supplements, as these reduce iron absorption. Rinsing the mouth or brushing teeth after the dose helps prevent temporary staining. You should continue the medication, unless told otherwise.

Iron is absorbed in the upper small intestine, mainly in the duodenum, through a transporter called DMT1 located on the intestinal cells (enterocytes). Once inside the cell, iron either enters the bloodstream via another transporter called ferroportin or is stored within the cell as ferritin. The absorbed iron binds to a plasma protein called transferrin, which carries it to the bone marrow, where it is incorporated into haem inside developing red blood cells. When carried to other tissues, it supports myoglobin (a heam protein) and enzyme production. Iron absorption is tightly regulated by the body's needs and by a hormone called hepcidin, with absorption increasing in deficiency states.

Folic acid is absorbed in the upper small intestine and converted into its active form, tetrahydrofolate, in the body. Tetrahydrofolate carries one-carbon units that are essential for making purines and thymidylate, the building blocks of DNA. Without enough folate, DNA synthesis in rapidly dividing cells (particularly the red blood cell precursors in the bone marrow) is impaired, producing the large, immature "megaloblastic" red cells that are commonly seen in folate deficiency. Adequate folate also supports the conversion of homocysteine to methionine, and is critical during the first trimester of pregnancy to ensure proper neural tube closure in the developing embryo.

Glycerol in Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) dissolves the iron salt and folic acid evenly throughout the syrup, giving the liquid its smooth viscosity and mild sweetness, and provides a non-irritant medium for oral delivery.

• Tea and coffee (CAUTION): Tannins found in both coffee & tea bind iron and lower its absorption. Separate them by at least 2 hours.

• Milk and dairy (CAUTION): Calcium competes with iron. Take the medicines at a different time.

• Whole grains and legumes (CAUTION): Phytates reduce iron absorption. Stop or limit the consumption.

• Vitamin C-rich foods (BENEFICIAL): Citrus foods rich in vitamin C enhance iron uptake.

• Alcohol (CAUTION): May aggravate gastric irritation and impair folate metabolism. Limit or avoid consumption.

• Levothyroxine (SEVERE): Iron binds to levothyroxine in the gut and lowers its absorption, potentially leading to undertreatment of hypothyroidism (low thyroid hormone levels). Separate the medicines by at least 4 hours.

• Tetracyclines and fluoroquinolones (SEVERE): Iron forms insoluble complexes with these antibiotics, reducing their absorption and efficacy. Separate the medicines by 2 to 4 hours.

• Methotrexate (SEVERE): Folic acid can reduce the efficacy of methotrexate when used for cancer treatment. In low-dose methotrexate for autoimmune conditions, folic acid is often co-prescribed by the treating doctor to reduce toxicity. Take only as advised by your physician.

• Methyldopa, levodopa, and penicillamine (CAUTION): Iron chelates these drugs and lowers their bioavailability, reducing therapeutic effect. Separate the doses by at least 2 hours.

• Bisphosphonates (CAUTION): Iron reduces bisphosphonate absorption. It is advised to take the bisphosphonate first thing in the morning and the supplement at least 2 hours later.

• Antacids and proton pump inhibitors (CAUTION): Lower gastric acidity, which hampers the conversion of ferric to ferrous iron and decreases iron absorption. Long-term users may require dose adjustment.

• Phenytoin, carbamazepine, and phenobarbital (CAUTION): Folic acid can reduce serum levels of these antiepileptics, potentially reducing seizure control. Monitor drug levels and clinical response.

• Sulfasalazine and trimethoprim (CAUTION): May reduce folate absorption or activity by interfering with folate metabolism; folate supplementation may need adjustment under medical supervision.

• Haemochromatosis and iron overload states (CONTRAINDICATED): Extra iron from Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) worsens systemic iron deposition in the body and increases the risk of hepatic cirrhosis (liver fibrosis), cardiomyopathy (disease of the heart muscle), endocrine dysfunction, and organ damage.

• Thalassaemia and sideroblastic anaemia (AVOID): Increases the risk of transfusional and dietary iron overload. Use only if advised by your doctor.

• Untreated vitamin B12 deficiency (AVOID): Folic acid alone can correct the megaloblastic anaemia of B12 deficiency haematologically, while neurological damage (subacute combined degeneration of the spinal cord) silently progresses. Confirm B12 status before initiating folate supplementation.

• Active inflammatory bowel disease (CAUTION): Oral iron may worsen mucosal inflammation. IV (intravenous) iron administration is often recommended for those with moderate-to-severe active disease.

• Peptic ulcer disease and gastritis (CAUTION): Oral iron is locally irritant to the gastric mucosa and may aggravate dyspepsia (chronic indigestion), epigastric pain, or bleeding. Either take Elemental Iron + Glycerol (Glycerine) + Vitamin B9 (Folic Acid) with food or consider lower-dose or alternate-day dosing.

Acute iron overdose can result in a medical emergency, particularly in children, and is one of the most common causes of paediatric poisoning. Symptoms of poisoning typically progress in stages, starting with vomiting, abdominal pain, and bloody diarrhoea, followed by an apparent recovery, then metabolic acidosis (acid buildup in the body), shock, hepatotoxicity (liver toxicity), and multi-organ failure. On the other hand, folic acid has a wide safety margin, but excessive doses can mask underlying B12 deficiency. Suspected iron overdose requires emergency care with serum iron measurement, supportive treatment, and chelation therapy (deferoxamine) where indicated. Do not attempt home management and consult a healthcare professional immediately.

Take the missed dose as soon as you remember on the same day. If it is almost time for the next dose, skip the missed one and continue your regular schedule. Do not double the dose. Consistent daily use over weeks to months is what restores iron and folate levels.