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Q. Can I take Iron supplements along with asthma medications?

Answered by
Dr. Zubayeralam
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Jul 24, 2021

Hi doctor,

I have allergic issues for the past 15 years. Initially, it started as allergic rhinitis, and then I got bronchial asthma. Currently, I am taking medications for asthma and sacroiliitis. I was having some issues and flare-ups for the past three months. So I did a blood test today to know whether I have an infection with COVID-19 as my parents were infected with COVID-19 even after getting vaccinated. I consulted a doctor and he gave me some medicines. Kindly check my attached reports and guide me further with treatment. Is it fine to take iron supplements? I am also taking Budamate forte.

#

Hi,

Welcome to icliniq.com.

I understand your concern. According to your statement, you are suffering from bronchial asthma and sacroiliitis. According to your attached investigation reports, (attachment removed to protect patient identity), your CRP (C-reactive protein) levels are above normal, total IgE (immunoglobulin E) and LDH (lactic dehydrogenase) remains high, Hb (hemoglobin) level remains below normal and Hba1c (hemoglobina1c) is around 5.8%.

Raised CRP levels can indicate the presence of inflammation in the body. Raised LDH indicates the presence of anemia or severe asthma. Total IgE remains raised due to the presence of atopy, allergies, or asthma. Having an Hba1c of 5.8% indicates a prediabetic condition. Your blood sugar can remain high due to intake of steroid medication like Budamate forte. Your hemoglobin levels remain below normal and it indicates the presence of anemia. Some parameters remain above normal or below normal and it does not confirm anything.

All the blood parameters may vary from laboratories to laboratories due to methods of investigation procedures, reagents, instruments, techniques of sample collection, and faulty techniques. You can take iron supplements along with your current medications. Asthma can get flared up due to seasonal changes. Some patients can feel better during summer, while some patients can feel better during winter. You can continue taking medications prescribed by your doctor for 15 to 30 days to have best results. Your doctor has given you the best treatment protocol.

Thank you doctor,

I have constipation for the past 20 days. Can I take Naturolax or Duphalac along with these medicines? Kindly suggest some medicines. I am taking Saaz 500 mg and Pregaba. I forgot to mention that my vitamin B12 levels remain above 1000 ng/mL. I am also taking iron supplements. Can I take them safely with constipation? Does Pregaba cause drowsiness? Does intake of Loratadine cause any allergic reactions? My doctor told me to change my inhaler from Budamate forte to Forglyn. Is it a good inhaler for asthma?

#

Hi,

Welcome back to icliniq.com.

I understand your concern. According to your statement, you are suffering from constipation for 20 days. Having bowel movements less than three times a week is referred to as constipation. Naturolax contains a powdered form of natural isabgol husk and Duphalac contains laxatives. Both Naturolax and Duphalac can be used in the treatment of constipation. You can use any one of them safely along with your current asthma medications and other medications. Pregaba (Pregabalin) and Saaz (Sulfasalazine) can cause constipation. Pregaba can cause drowsiness.

If your bowel movements become regular, then your gastric problems will get subsided. You can also take some medicines like Domperidone, Rabeprazole, and syrup Gaviscon to subside your gastric issues along with Naturolax or Duphalac. Having vitamin B12 levels above 900 ng/mL is considered high and it occurs as a result of intake of huge amounts of B12 for a prolonged time, liver disease, kidney problems, diabetes, and leukemia. But test results can vary from laboratory to laboratory.

Having a single value of high vitamin B12 levels does not confirm anything. In these abnormal situations, your doctor can suggest you check the levels of methylmalonic acid (MMA). You can take iron supplements without vitamin B12. Loratadine is a non-sedative second generation antihistamine. It is a safe and effective medication for asthma. It does not interact with asthma medications.

Forglyn contains Formeterol and Glycopyrrolate. Formoterol is a long-lasting bronchodilator and Glycopyrrolate is an anticholinergic drug that reduces secretion in the airways. Your doctor has suggested you to take Forglyn instead of Budamate forte as it can cause raised blood sugar level that results in diabetes mellitus.

Thank you doctor,

With the continuation of my previous chat, I want to update and ask certain queries. Please guide me. I have consulted an ENT doctor since I was not getting relief from the treatment taken and the doctor gave me the following treatment. I took Hetrazan 100 mg twice daily for 14 days, Montair LC, Flomist, and Ab-flo. Now, I do not have high eosinophils count but the IgE level always remains high for the last 15 years. Am I on the right line of treatment? Will intake of Hetrazan help me? Is it a habit-forming drug? What are the adverse reaction?

It is the fourth day of taking this drug and I am facing a little bit of discomfort in my eyes. I have a little bit of swelling on the face with a bit of mucus development in my eyes on the left side. Is it common while taking the drugs? My doctor told me to visit after seven days. Can I wait till that time or should this be consulted immediately? In the initial two to three days, I felt extremely relaxed that happened after so many years after taking this line of treatment. I was tired of frequent infections of cough, cold and asthma flare. I am attaching my allergy comprehensive profile also.

I am a female of 38 years old with a blood pressure of 110/70 mmHg, a weight of 70 kilograms, and SpO2 of 98 to 99. My medical issues started at the age of 16 years. I use to have digestive issues, constipation, and excess gas. Then, after two years, I started having allergic issues that included urticaria rashes and allergic rhinitis sometimes. Over the years, it got converted to bronchitis and asthma with iron deficiency anemia many times. Then I had viral keratitis after undergoing LASIK after eight years. I also developed GERD, piles, panniculitis, and abdominal tuberculosis after undergoing a C-section after four years.

On taking ATT twice, I started to have vulva swelling and it lasted for a period of time. I got herpes in my arms while taking ATT and later on sacroiliitis. I also developed warts on the body and foot corns in the last three years. I do not know whether these are connected. Kindly guide. Please let me know whether these two drugs have any reaction with Hetrazan treatment. When I had keratitis, I used Systane ultra eyedrop and Iflomax eye ointment. Can I use it now with Hetrazan treatment?

My previous physician gave me a multivitamin Absolute 3G which is a multivitamin with some herbal content. Can you please specifically look at them? I am attaching a picture. I feel a bit energetic with them and I did not take it for the last four days. Can I take Absolute 3G multivitamins with Hetrazan? Can I also take my Vitamin C 500 mg daily, Limcee, and Vitamin D once a week too with Hetrazan treatment? Please guide.

#

Hi,

Welcome back to icliniq.com.

Thank you for the query. I can understand your concern. According to your statement, you have been suffering from allergic rhinitis, bronchial asthma, bronchitis, digestive problems, sacroiliitis, keratitis, repeated Infections, and raised IgE levels. In the case of allergic asthma, both IgE and eosinophils are engaged in a complex process. In that, they have their own roles. It is considered that IgE is the main reason for allergic asthma, while raised eosinophil count is a consequence of the whole process, so eosinophilia or raised eosinophil count will be always found in case of allergic asthma that is not mandatory.

Again, on the initiation of the IgE response, it can be further amplified by basophils, mast cells, and eosinophils. This process can also drive more IgE production, although eosinophils only become expressed when activated. Elevated serum IgE may result from allergies, infections, immune conditions like hyper IgE syndrome, tuberculosis, parasitic infestations, EBV (Epstein Barr virus), CMV (cytomegalovirus), HIV (human immunodeficiency virus), gammopathies, Churg Strauss syndrome, some primary immunodeficiency disorders and many more.

Hyper IgE is a rare primary immunodeficiency disease characterized by recurrent eczema, recurrent staphylococcal skin abscess, other skin problems like viral Infections such as herpes simplex, herpes zoster, molluscum contagiosum, warts, fungal Infections like vaginal or vulvar candidiasis, thrush, fungal nail infections, repeated respiratory tract infections like pneumonia, bronchitis, tuberculosis, ear, eye or sinus infections, skeletal and connective tissue disorders like sacroiliitis, bone fractures, anemia like hemolytic anemia, high serum levels of IgE, eosinophilia as well as other disorders like digestive problems, neurological manifestations and many more.

Eosinophilia can be found in 90 percent of cases, but in the rest of 10 percent cases, the number of eosinophils in the blood might be normal like yours. It is an autosomal dominant or recessive form of the disease. Diagnosis of hyper IgE syndrome is suspected based on symptoms and measurement of serum IgE levels. Genetic testing can identify gene mutations. It is done mainly to confirm the diagnosis or to help predict inheritance patterns. Lifelong prophylactic antistaphylococcal Antibiotics like Trimethoprim or Sulphamethoxazole are the main treatment for hyper IgE syndrome. Skin problems are treated with hydration, emollient creams, and antihistamines.

If there are infections, even after taking antibiotics and other associated problems, then they should be treated according to their clinical features. Hetrazan contains diethylcarbamazine that belongs to the group of medications known as antihelminthic which is used in the treatment of worm infections and filariasis. Your high IgE levels may result from parasitic infestations and it is your assumption. For that, he has been prescribed this medication.

It is not a habit-forming drug. It is a safe drug. So, you can use your eye drops and herbal multivitamins, vitamin C as well as your currently using medications with this medication without any tension. The side effects that you have already mentioned are the common side effects of this medication. Usually, this medication has no serious side effects. But, if you have facial swelling, then you should consult your doctor promptly. Take care. Hope I have answered your question. Let me know if I can assist you further.

Thank you doctor,

Can my diagnosis be simple eosinophilia or parasite etiology or hyper IgE syndrome? How does Hetrazan work? Am I on the correct line of treatment? If I am taking a dose of 100 mg twice daily, then how long will it help to clear up my infection? How long do I need to take this drug? How to know whether my infection got cleared?

It has been six days since taking this medicine. Initially, I felt extremely good for three days. For the last two days, I am having sacroiliitis pain, breathlessness, and mucus production with a headache. I am using nasal spray and eye floaters. After using Systane ultra eye drop and Iflomax eye ointment, I have a little bit of reduction of symptoms in my condition.

My parents were COVID positive last month and they are taking medications for blood pressure and diabetes. Can they also take Absolute 3G multivitamins for two to three months? My dad has low hemoglobin and so I am asking whether it is good to take Absolute 3G multivitamin as it contains a ginkgo blob with trace elements.

I think that this does not have any interaction with their medicines and Hetrazan. Apologies for asking this again and I am afraid of a drug interaction. While having body ache, can I take Zerodol SP safely as prescribed for three days? Can I take Ab-flo for few days and Tiova inhaler that I used to take earlier with Hetrazan? Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again. When eosinophil count is high above normal, then it is known as eosinophilia. According to your statement, your eosinophils count is always normal, so it is not eosinophilia. So, parasitic etiology or hyper IgE syndrome may be the cause. Without investigation, it is difficult to predict. Hetrazan contains diethylcarbamazine that works by killing the worms. You are in the correct treatment as your doctor has suspected parasitic infestations. It has to be taken for four to seven days to kill the worms. But, as you are suffering from chronic allergy due to many causes, so your doctor has advised Hetrazan for 14 days.

You are suffering from diethylcarbamazine-induced side effects. If these side effects persist for a longer time or bother you then you should inform your prescribing doctor promptly for medical help. There is no known interaction found between diethylcarbamazine and 3G multivitamin forte despite containing Ginkgo Biloba. So, you can take a 3G multivitamin forte with Hetrazan without any tension that I have already mentioned. There is no known interaction found between diethylcarbamazine and Zerodol or Aceclofenac as Zerodol contains aceclofenac. So, you can also take Zerodol with diethylcarbamazine or Hetrazan without any tension. Take care. In case of any other query ask me.


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