Dosing

1) Mighty-Fer Chewable Tablets:
- 1-2 Chewable Tablets daily after meals, or as per physician instructions.
 
2) Mighty-Fer Syrup:
•    Adults    : (100 mg) 2 Teaspoonfuls (10 ml), 2-3 times daily after meals.
•    Children:  (50 mg) 1 Teaspoonful (5 ml), 1-2 times daily after meals.
•    Infants    : (25 mg) ½ Teaspoonful (2.5 ml), 1-2 times daily after meals.
•    Newborn: (2.5 mg Fe) Per kg body-weight daily divided in many drinks.

Mighty-Fer may be mixed with fruit, or vegetable juices or other liquids.
Mighty-Fer should be taken during or immediately after meals.
Best results are obtained by adequate dosage and regular administration.
The therapy should be continued for at least 1 to 2 months.

3) Mighty-Fer I.M Injection:
•    Dosage    : Normal daily dose for adults is 1 ampoule (100 mg) per day.
•    Children are given correspondingly less, depending on their age.

•    Daily Maximum Doses:
Children Up to 5 kg        0.5 ml (1/4 Ampoule)
Children between 5-10 kg        1.0 ml (1/2 Ampoule)
Adults                4.0 ml (2 Ampoules)

* Duration of Treatment:
One injection each 3 to 7 days.
The Intramuscular Injection should be slow and deep.

Use

Tablets & Syrup:
Treatment of latent iron deficiency and iron deficiency anemia (manifest iron deficiency).
* I.M Injection:
All cases of iron deficiency in which rapid and reliable substitution of iron is required, more particularly for the following:
- Severe iron deficiency, e.g. after haemorrhages.
- Disturbances in iron resorption in the gastrointestinal tract.
- Marked incompatibility of oral iron preparations.
-   Iron deficiency during pregnancy.
- Iron deficiency resistant to treatment, when the patient cannot be relied on to take the tablets, and contact between doctor and patient at irregular intervals.

Adverse Reactions

* Tablets & Syrup:
There are no side effects.
* I.M Injection:
- It may cause a darkness of the urine.
- It may cause a pigmentation at the site of injection.

Contraindications

Hypersensitivity to any of the constituents.
- Iron overload (e.g. hemochromatosis, hemosiderosis) or disturbances in iron utilization (e.g. load anemia, sidero-achrestic anemia, thalassemia) and anemia not caused by iron deficiency (e.g. hemolytic anemia).
- All cases of iron surfeit and disturbances in utilization of iron. Crohn’s disease, bronchial asthma, progressive chronic polyarthritis.

Warnings / Precautions Drug

- Patients who are under oral treatment should interrupt the oral treatment 24 hours before the first I.M injection.
- Regular monitoring of the Iron levels should be done to avoid overdosage.

Interactions

The oral form of the Iron should not be given together with the Intramuscular form (Lipothymia): due to the rapid liberation of the iron from its complex form and to the saturation of the siderophiline).

Pregnancy

MIGHTY-Fer could be used safely.

Pharmacodynamics / Kinetics

MIGHTY-Fer provides an ideal preparation for the treatment of all iron deficiency anemias due to its rapid absorption, its high rate of iron utilization, the effective Hb increase and its excellent degree of tolerability.