Generic Name

Junel Fe 24

Mechanism

• Reduces iron deficiency by supplying elemental iron that is absorbed in the duodenum.
• Fe³⁺ is reduced to Fe²⁺ by duodenal ferric reductases (steap3), enabling transport through the divalent metal transporter‑1 (DMT‑1) into enterocytes.
• Inside enterocytes, iron is stored as ferritin or secreted into circulation via ferroportin, bound to transferrin for delivery to erythroid precursors.
• The resulting increase in serum iron supports hemoglobin synthesis and RBC maturation.

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Pharmacokinetics

• Absorption: ~2‑5 % of oral dose reaches systemic circulation; peak plasma levels within *1–2 h* after ingestion.
• Distribution: Binds transferrin; stored mainly in bone marrow, spleen, and liver.
• Metabolism/Elimination: Little hepatic metabolism; iron is incorporated into hemoglobin or ferritin; excess is excreted via the gut lumen. Elimination half‑life ≈ *30 min* for absorbed iron, but iron stores persist and are metabolically turned over over weeks–months.
• Factors affecting absorption:
• Inhibition by calcium, phytates, polyphenols, and high‑fat meals.
• Enhancement by vitamin C (ascorbic acid) and citrate.

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Indications

• Prevention of iron‑deficiency anemia in at-risk populations (e.g., menstruating women, pregnancy, infancy, vegetarians).
• Maintenance therapy for patients with mild iron‑deficiency anemia when higher elemental doses are not required.
• Adjunct in dietary iron supplementation for chronic disease or malabsorption when low-dose iron is preferred to reduce gastrointestinal toxicity.

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Contraindications

Contraindications
• Known hemochromatosis or iron overload disorder.
• Iron‑related hypersensitivity (e.g., allergic reaction to ferrous compounds).
• Acute hemolysis or hemoglobinopathies requiring high-dose iron replacement.

Warnings
• Gastrointestinal irritation (nausea, constipation) – take with a small amount of liquid or food.
• Black or tarry stools – benign side effect but may conceal GI bleeding; evaluate if persistent or accompanied by melena.
• Oxidative stress potential in patients with chronic inflammatory disease; avoid excessive dosing.
• Pregnancy: safe at recommended doses; high doses may increase oxidative stress.

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Dosing

• Adult & adolescent: 1 tablet *once daily*, preferably in the morning with water.
• Infants 6–12 mo.: 1 tablet *every 12 h* (if physician prescribes a low‑dose formulation).
• Patients with iron‑deficiency anemia requiring higher elemental iron: 24 mg per tablet is generally insufficient; consider higher‑dose preparations (e.g., 100–200 mg elemental iron) under supervision.
• Take with vitamin C to enhance absorption; avoid concurrent calcium‑rich foods or supplements at the same time.
• Chewable tablets (if available) can improve taste and tolerance in children.

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Adverse Effects

Common (≥10 %)
• Gastrointestinal: nausea, abdominal discomfort, constipation, diarrhea.
• Darkened stools.
• Headache, mild dizziness.

Serious (rare)
• Severe GI bleeding or ulceration (especially in patients with peptic ulcer disease).
• Hypersensitivity reactions: rash, angioedema.
• Hemolysis in G6PD deficiency if high‑dose formulations are mistakenly taken.

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Monitoring

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Clinical Pearls

• Vitamin C synergy: Combining 50 mg vitamin C with Junel Fe 24 can boost absorption up to 50 % – ideal for patients with marginal compliance or those eating a calcium‑rich diet.
• Timing matters: Taking the tablet *30 min before breakfast* can improve tolerability while avoiding interaction with iron‑blocking foods.
• Steady dose: A low‑dose daily regime (24 mg) reduces GI adverse events compared with intermittent high‑dose protocols, making it a preferable choice for maintenance therapy.
• Taste & compliance: If the tablet’s metallic taste is problematic, administer with a small amount of juice or as chewable (if available) to enhance adherence.
• Screen for hypersensitivity: Prior to therapy, review patient history for reactions to oral iron formulations; if uncertain, perform a skin test before initiating therapy in high‑risk individuals.

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• Key Takeaway – Junel Fe 24 is a low‑dose, well-tolerated oral iron supplement suited for preventive use and mild iron‑deficiency management. Optimize absorption with vitamin C, avoid calcium‑rich meals, and monitor hematologic indices to ensure effective and safe therapy.