Livogen (Ferrous Ascorbate + Folic Acid)
Also sold as: Livogen, Ferium-XT, Iberet-Folic, Fefol-Z, Ferium
Pregnancy
Cat A
Lactation
Safe
Schedule
OTC
Forms
Tablet (typical: 100mg elemental Fe + 1.5mg folate) +3
Indications
- Iron deficiency anemia
- Pregnancy supplementation (mandatory in India)
- Postpartum anemia
- Chronic blood loss (menorrhagia, GI bleed)
- Chronic disease anemia (with other causes ruled out)
Adult Dosing
IDA repletion
100-200 mg elemental Fe PO daily (or alternate-day per recent trials)
3-6 months continued after Hb normal
Pregnancy
100 mg Fe + 500 mcg folate daily from 14 weeks (Govt of India PMSMA)
Continue 3 months postpartum
IV iron (if severe/intolerant)
Iron sucrose 200mg up to 3×/week, OR FCM 500-1000mg single dose
Pediatric Dosing
Infant prophylaxis: 1 mg/kg/day from 4 months exclusive BF
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| No adjustment needed | No CrCl-based dose adjustment required |
Pregnancy & Lactation
Pregnancy: Category A
Required throughout pregnancy and postpartum
Lactation: Safe
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Levothyroxine, fluoroquinolones, tetracyclines, bisphosphonates, levodopa | Reduced absorption — separate by 2-4 hours | Major |
| Antacids, PPIs, H2-blockers | Reduced iron absorption | Moderate |
| Calcium | Reduced absorption — separate by 2 hours | Moderate |
| Vitamin C | Enhances iron absorption — beneficial | Minor |
| Tea, coffee, dairy | Reduced absorption | Moderate |
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Side Effects
Common
- GI upset
- Constipation
- Diarrhea
- Black stools (harmless)
- Metallic taste
- Nausea
Serious / Discontinue If
- Iron overload (in non-deficient patients, hemochromatosis)
- Severe hypersensitivity (parenteral iron)
- Anaphylaxis (parenteral)
Contraindications
- Hemochromatosis
- Iron overload conditions
- Hemolytic anemias not due to iron deficiency
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Livogen Captab | Merck | 10 tab ₹35 |
| Ferium-XT | Emcure | 10 tab ₹45 |
| Iberet-Folic | Abbott | 15 tab ₹95 |
| Govt IFA tablets (free under PMSMA) | GoI | Free |
Monitoring Required
- Hb at 4-8 weeks (expect 1-2 g/dL rise), serum ferritin to confirm repletion
Patient Counseling Points
- Take on empty stomach (1h before food) for best absorption — but if intolerable, take with food
- Take with vitamin C or orange juice
- Avoid tea/coffee within 1 hour
- Black stools are normal — not concerning
- Continue 3-6 months after Hb normalizes
- Increase fluid + fiber to prevent constipation
Stop Googling drug references mid-consultation
EasyClinic auto-flags Livogen interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- Specialty society guidelines (RSSDI/CSI/IAP)