BiferaRx

Generic Name: cyanocobalamin/folic acid/iron (SYE-an-oh-koe-BAL-a-min/FOE-lik AS-id/EYE-urn)
Brand Name: Examples include BiferaRx and Ferrex 150 Forte

Accidental overdose of products that contain iron is a leading cause of fatal poisoning in children younger than 6 years old. Keep this and all medicines out of the reach of children. In case of accidental ingestion, call the poison control center or a doctor at once.


BiferaRx is used for:

Preventing and treating certain types of anemia (eg, caused by low blood iron levels, poor nutrition). It may also be used for other conditions as determined by your doctor.

BiferaRx is a vitamin, folic acid, and iron combination. It works by providing vitamins, folic acid, and iron to the body.

Do NOT use BiferaRx if:

  • you are allergic to any ingredient in BiferaRx
  • you have certain iron metabolism problems (eg, hemosiderosis, hemochromatosis) or you have high levels of iron in your blood

Contact your doctor or health care provider right away if any of these apply to you.

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Before using BiferaRx:

Some medical conditions may interact with BiferaRx. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have bowel problems (eg, colitis, Chron disease, diverticulitis), certain blood disorders (eg, hemolytic or pernicious anemia, porphyria cutanea tarda, thalassemia), or a peptic ulcer
  • if you have had multiple blood transfusions

Some MEDICINES MAY INTERACT with BiferaRx. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Fluorouracil because the risk of its side effects may be increased by BiferaRx
  • Bisphosphonates (eg, alendronate), cephalosporins (eg, cefdinir), hydantoins (eg, phenytoin), levodopa, methyldopa, mycophenolate, penicillamine, quinolones (eg, ciprofloxacin, levofloxacin), tetracyclines (eg, doxycycline), or thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by BiferaRx

This may not be a complete list of all interactions that may occur. Ask your health care provider if BiferaRx may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use BiferaRx:

Use BiferaRx as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take BiferaRx by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Do not take an antacid within 1 hour before or 2 hours after you take BiferaRx.
  • Avoid taking BiferaRx with dairy products; they may interfere with the absorption of the iron in BiferaRx.
  • If you also take a bisphosphonate (eg, alendronate), a cephalosporin (eg, cefdinir), eltrombopag, levodopa, methyldopa, penicillamine, a quinolone (eg, ciprofloxacin), or a tetracycline (eg, doxycycline), ask your doctor or pharmacist how to take it with BiferaRx.
  • If you miss a dose of BiferaRx, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use BiferaRx.

Important safety information:

  • Do NOT take more than the recommended dose without checking with your doctor.
  • Do not take large doses of vitamins (megadoses or megavitamin therapy) while you use BiferaRx unless your doctor tells you to.
  • BiferaRx has folic acid and iron in it. Before you start any new medicine, check the label to see if it also has folic acid or iron in it too. If it does or if you are not sure, check with your doctor or pharmacist.
  • BiferaRx may discolor the stools. This is normal and not a cause for concern.
  • BiferaRx has iron in it. Iron overdose is a leading cause of fatal poisoning in children younger than 6 years of age. In case of an overdose, call a doctor or poison control center right away.
  • BiferaRx may interfere with certain lab tests, including tests used to check for blood in the stool. Be sure your doctor and lab personnel know you are taking BiferaRx.
  • Lab tests, including hematocrit, hemoglobin levels, and blood iron levels, may be performed while you use BiferaRx. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • BiferaRx should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using BiferaRx while you are pregnant. BiferaRx is found in breast milk. If you are or will be breast-feeding while you use BiferaRx, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of BiferaRx:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dark or green stools; diarrhea; nausea; stomach pain; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry, or bloody stools; severe or persistent nausea, vomiting, or stomach pain.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include black, tarry, or bloody stools; blue or unusually pale skin; drowsiness or dizziness; fast heartbeat; increased thirst or urination; seizures; severe or persistent nausea, vomiting, diarrhea, or stomach pain; sluggishness; vomiting blood; weakness.

Proper storage of BiferaRx:

Store BiferaRx at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep BiferaRx out of the reach of children and away from pets.

General information:

  • If you have any questions about BiferaRx, please talk with your doctor, pharmacist, or other health care provider.
  • BiferaRx is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take BiferaRx or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about BiferaRx. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to BiferaRx. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using BiferaRx.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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