Anemia ?Megaloblastic

A suspected case of Megaloblastic Anemia 40 years old female needs to be given injection Vitcofol-C I/M Chief Complaints Her complaints were weakness,vertigo,breathlessness on exertion Investigations Her Hb is 6.5 and rest parameters like MCV,MCHC etc. are raised Management I would like to know about Vitcofol - C injection How many injections and frequency of administration of it? Like every alternative day or every week uptil ?

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Usually 2cc once a week Depends on severity of anaemia Continue till anemia corrects Find the cause of anemia Do serum iron profile, vitb12, LDH, hb electrophoresis

Rule out cause of anemia 1-Blood transfusion 2-Cobalamin (1000 µg) should be given intramuscularly daily for 2 weeks, then weekly until the hematocrit value is normal, and then monthly for life. A dose of 1000 µg is large, but it may be required in some patients. The reader should be aware that several other protocols for cobalamin therapy have been recommended. It is important to emphasize that patients with mental and neurological impairment due to cobalamin deficiency should be treated more aggressively. 3-The dosage range for folate is 1 to 5 mg daily; 1 mg/d is the usual dosage for adults with megaloblastic anemia, while a higher dosage is indicated in hemolysis, malabsorption, alcoholism, and exfoliative dermatitis. However, there is no harm in giving the higher dosage of folate

INJECTION..VITCOFOL-C .. DOSE..DEPENDS ON .. SEVERITY OF.. ILLNESS.. GENERALLY.. GIVEN..WEEKLY..

Tnx &wc Dr Ajeet Singh
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Folic acid and vitamin B12 deficiency are the leading cause of MEGALOBLASTIC ANEMIA. VIT- B12 deficiency is the pernicious anemia caused by autoimmune destruction of gastric parietal cells. Excess cell turnover, increase demand, malabsorption, Or poor diet may cause folate deficiency. So as you like your treatment of the patient.

Before starting patient on BI2+ Folic acid therapy, need to check B12 levels in serum. This will help to assess severity of deficiency and improvement with treatment. Inj Vitcofol C , 2cc IM once a week till anemia is corrected . After that it is convenient to continue Inj Methycobalamine 1000 mcg once a month life long ,with oral folic acid supplement of 5 mg daily. There are studies to show that oral Methycobalamine is effective as maintenance dose to prevent recurrence of anemia

I agree with Dr Hok Katkade

Why not iron inj. Jectofer or Furose ivy in saline drip

Inj-Trineurosol -H is best painfull but best results in B12 difficiency anemia First wk daily,and then once a wk