Iron carboxymaltose (Ferinject) is a new intravenous drug for the treatment of iron deficiency anemia. Venofer - official* instructions for use Iron-containing preparations intramuscularly

The use of iron in injection ampoules is justified in cases of iron deficiency anemia. Drugs that are administered parenterally (using injections) begin to act faster and can help cope with anemia in especially severe cases. There are many pros and cons to injecting substances. All features of intramuscular and intravenous administration of iron preparations are described below.

When are injections prescribed?

Indications for parenteral droppers or injections when iron is administered intravenously (intramuscularly) are situations when the patient must urgently receive a dose of a beneficial substance. The use of ampoules is prescribed when the patient, due to injuries, systemic disorders or temporary illnesses, cannot fully absorb iron through the gastrointestinal tract.

Indications for the use of injections of the drug only:

1. Ulcerative colitis in the stomach or intestines in acute form. The use of iron for ulcers does not in itself harm the patient with an ulcer. However, often during oral iron therapy (with tablets taken by mouth), drugs are additionally prescribed to increase the acidity of the gastric environment. The higher the acidity, the better the substance is absorbed. A sharp drug-induced increase in the acidic environment in the stomach can lead to exacerbation of ulcerative formations.
2. Systemic disorders of iron absorption. A person may be genetically predisposed to impaired absorption of iron from the gastrointestinal tract. Sometimes dysfunctions occur due to hormonal imbalance, an intestinal virus, etc. In any case, if the patient’s body does not absorb iron well from the intestines, there is no point in taking the drugs orally. It is necessary to administer the substance intravenously or intramuscularly so that the patient receives the full dose of the element. Problems with absorption occur with pancreatitis, enteritis and similar disorders.
3. Partial removal of the stomach or small intestine. When the natural physiology of the gastrointestinal tract is disrupted, the absorption of certain elements, including iron, is significantly impaired. To increase the effectiveness of therapy, specialists prescribe injections in case of surgical removal of tissue.
4. Complete removal of the stomach. The indications are the same as described above.
5. Intolerance to iron salts. This allergy can be circumvented if the beneficial element is immediately administered intravenously or intramuscularly.
6. Ulcerative type colitis.

Most often, ampoules are used if the patient suffers from traumatic anemia (lost a lot of blood, as a result of which hemoglobin levels have sharply decreased). To quickly restore vital supplies and reduce the risk of death, doctors use the parenteral method of administering the drug.

Important. A doctor must determine the need for injections.

For low degrees of malabsorption (impaired absorption of iron or other substances), oral tablets may still be prescribed rather than injections, simply supplementing the course of tablets with drugs to increase stomach acidity. In case of ulcerative exacerbation, intolerance to components and colitis, they must switch to parenteral administration.

If you suffer from one of the listed disorders, you must inform your doctor in a timely manner. Then he will select the right parenteral drug for you. If you remain silent about the presence of gastrointestinal problems or allergic reactions, the consequences can vary from a decrease in the effectiveness of therapy to death in the case of anaphylactic shock.

Benefits of injections

Iron is better absorbed when given intramuscularly or intravenously. If, when absorbed through the stomach, part of the element is filtered by the liver, then with direct administration the natural filtration is much lower. This is the main advantage of ampoules with the substance, but there are other advantages:

1. Safety for allergy sufferers. When administered directly into the blood, iron does not enter into chemical reactions and iron salts are not formed. But it is iron salts that often cause rashes and other allergic manifestations.
2. Possibility of quickly replenishing microelements. If the patient replaces the tablets with an iron supplement, which is administered intravenously, the rate of receipt of the substances is accelerated tens of times. When taken orally, the substance must travel from the oral cavity to the blood, passing through the esophagus. To achieve the maximum concentration of the drug you have to wait 2-3 hours. When using injections, the absorption rate is 15-20 minutes.
3. Use small dosages. It is enough to make one injection of 1-5 ml (depending on the drug) to give the patient a daily dose of the drug. If you use tablets, you have to drink several capsules with a dosage of 50 mg.
4. No side effects in the oral cavity. If you take the drugs orally, a gray coating often forms on the tongue and on the inside of the teeth. When used parenterally, there are no such side effects, which allows you not to worry about your appearance.
5. Saving. Ampoules with an equal amount of the drug usually cost less than boxes of blister packs. The fact is that the packages themselves cost less, plus more excipients are used in the manufacture of tablets than in the creation of injection solutions.

However, it cannot be said that the use of injections is the most convenient and optimal treatment option. This method of drug administration also has a number of disadvantages. They are presented below.

Disadvantages of parenteral administration

The injections are painful, leave marks on the arms and can be scary in children. These are not all the negative aspects of intravenous (intramuscular) administration. The disadvantages of this method include:

1. Inconvenience in using the drug. It cannot be introduced at work, at school, at university. We have to wait until the patient is home. It is very difficult to give an injection correctly in a public setting, and not everyone understands why the patient resorts to using injections.
2. The need to see a doctor or give injections yourself. Both options are bad. If you get injections from a doctor, you will have to spend time making an appointment, waiting, and traveling to the nearest medical department. If the patient gives injections on his own, the main disadvantage is the need to first learn how to do it correctly. If a person is not trained in basic injection skills, he may not get into a vein or muscle at all, or may give injections that will be accompanied by severe pain and discomfort.
3. Painful sensations. When taken orally, there are no inconveniences: you can only choke on the tablet if you do not wash it down with water. But when the injection procedure is carried out, if the skin is broken, even with a thin needle, unpleasant sensations may occur. They become much stronger if the injection was performed incorrectly and a bruise occurs. The hematoma can remain at the injection site for several days, during which time it causes discomfort.
4. Psychological discomfort. Emotional people and children will negatively perceive the need to constantly inject. For them, one injection is already a test, and if a specialist prescribes a whole course of injections as part of therapy, this can cause complete rejection of the prescribed treatment.
5. Additional costs for syringes. Although disposable tools cost very little, the process of purchasing them, as well as the small additional costs, can be annoying for many.

The main disadvantage of injections is the problems when using syringes. Unprepared patients with no contraindications to oral administration are always prescribed tablets to make the therapy process easier.

How best to administer: intravenously or intramuscularly

Each method of drug administration has its own characteristics. They are taken into account when prescribing the solution.

Intramuscular drugs are most easily absorbed by the body. To saturate the body, 1 ml of solution is enough. But the injections can be too painful. The body absorbs the substance faster than with venous administration.

Intravenous use is less painful, but the effect is achieved 1.5-2 times slower. To carry out one injection, 2.5-3 times more solution is required than when injecting the drug into the muscles. This is a more gentle type of injection.

Duration of therapy and permissible dosages

Treatment is carried out until the content of the substance in the blood is restored. There are several stages of injections:

1. Primary. The patient uses the ampoules according to the dosage.
2. Secondary. The concentration of the substance in the blood has already been achieved; all that remains is to stabilize the reserves and prevent them from being absorbed. Usually the dosage is reduced by 2-3 times according to the doctor’s indications.

Important. One course lasts up to six months in the case of oral administration. However, since injections work better, the period of treatment with their help can be shortened.

Injections during pregnancy

In case of pregnancy, specialists rarely prescribe injection treatment. There are no contraindications to administering the drug orally. Injections can be prescribed only in the following cases:

• serious blood loss as a result of threatened miscarriage;
• severe toxicosis, accompanied by vomiting, due to which the body does not receive the full range of necessary substances.

Even if injections are prescribed, the period of their use does not last long: the patient remains in the hospital and receives injections for several days, after which she can switch to home use of tablets or capsules.

Possible side effects

A small papule or bruise may occur at the injection site. They dissolve quickly, but cause pain when touched.

Other possible problems after injections:

1. A rapidly developing allergic reaction. May lead to anaphylactic shock.
2. DIC syndrome.
3. Exceeding the permissible concentration of iron in the body. Leads to dizziness, nausea and other health problems.
4. The appearance of abscesses in the area where the needle was inserted.

Important. Side effects are less likely to occur when injections are performed professionally.

Possibility of allergic reactions

In the case of intravenous and intramuscular administration, there is a high risk of an allergic reaction. Some patients develop anaphylactic shock within a short time.

You can prevent an allergy attack only by first checking your body for a tendency to it. A specialist should determine the level of sensitivity of the body to iron supplements.

If an allergy is detected, you will have to abandon the specific medicine and find an analogue. Often an allergic reaction develops not to the iron itself, but to an auxiliary substance contained in the solution.

Contraindications to the use of injections

Injections are prohibited for certain body conditions. You will have to refuse to use this method of administration if:

• the body is too sensitive to influences, which is why bruises constantly appear on the surface of the skin after injections;
• the body is oversaturated with iron;
• non-disposable, non-sterilized syringes are used;
• there is a suspicion of an allergic reaction from the body.

It is strictly forbidden to exceed the dosage. If when taking tablets it is calculated as 2 mg of the drug per kg of weight, then when using a solution the calculations are different. The patient should not use more than one ampoule per day.

List of drugs for intravenous and intramuscular administration

List of medications containing iron:

1. "Ferrum Lek" is a drug for intramuscular administration. Ampoules contain 2 ml of solution. Dextran and iron hydroxide are the main and only components of the substance. If you are allergic to dextran, you will have to avoid the drug. Prescribed by weight, one ampoule contains iron content equivalent to 100 mg tablets (maximum dose).
2. "Venofer" is available in 5 ml ampoules. One ampoule is the equivalent of a tablet with a dosage of 100 mg. In addition to iron, the composition includes sucrose compound products. Allergic reactions may occur with sucrose intolerance.
3. "Ferkoven." The ampoule is minimal, with a volume of only 1 ml. The composition contains cobalt compounds and carbohydrate complexes. Easily administered intravenously.
4. "Jectofer." It is considered a combination medicine because it contains citric acid. “Jectofer” is injected into the muscles, the solution is produced in 2 ml containers.
5. "Ferrlecite." Available with sodium and iron gluconate in the composition. It can be in the form of an ampoule of 1 ml for injection into the muscles or 5 ml (injected into a vein).

The drug must be prescribed by a specialist according to the prescription. The ampoule may not be sold without a prescription.

When choosing a drug, the dosage of the substance is taken into account. Ampoules of most of the listed drugs are equivalent to 100 mg of dry drug. This dose is the maximum permissible for a patient per day. If it is exceeded, side effects and ailments may develop.

Conclusion

Iron preparations for parenteral administration are widespread in modern medicine. However, before using them, you must become familiar with the specifics of solutions from ampoules and take into account possible disadvantages and complications. It is prohibited to use the solution without the permission of a specialist.

Patients diagnosed with iron deficiency anemia are prescribed a special medication course, which in most cases includes iron supplements in intramuscular injections and iron supplements in ampoules. Also, the presented medications are prescribed for preventive purposes, for example, to pregnant women. This approach ensures productive saturation of the human body with the microelement it needs – iron. This is necessary, first of all, for people with chronic loss of this element or after extensive operations.

Iron in injections

Almost all medications that are used to eliminate iron deficiency in patients contain a sufficient amount of such an important and valuable trace element - iron. Such methods of therapeutic therapy - vaccination or oral administration - are extremely necessary, since it is impossible to achieve complete restoration of the correct metabolic process with nutrition alone.

Many medical studies have shown that intramuscular administration of iron-containing drugs gives much less effect than taking tablets orally. This is explained by the fact that iron is most effectively absorbed in the intestines. In addition, oral administration of iron supplements leads to the least possible number of side effects.

Iron injections to increase hemoglobin are medications that form the basis of treatment for iron deficiency anemia. Iron ampoules for intramuscular injection are used only in some special cases, since this method of treatment can lead to serious side effects. Iron injections for anemia can be prescribed in order to saturate the body with this element as quickly as possible.

No more than 100 mg of iron per day is injected intramuscularly - this dosage can completely saturate the body with transferrin. Iron preparations in injections often lead to the following complications: allergic reaction, hardening at the injection site, phlebitis, overdose. Also, all patients have one problem - the appearance of bruises from injections.

Therefore, it is important for many patients to know how to treat bruises after iron injections. In this case, heparin ointment will have the most productive effect. Before applying it, it is advisable to warm the hematoma. The most commonly prescribed intramuscular iron preparations in ampoules are:

1. Ferkoven (1 ml ampoules).
2. Ferrum Lek (2 ml ampoules).
3. Venofer (5 ml ampoules).
4. Ferbitol (1 ml ampoules).
5. Ferrlecite (ampoules of 1 and 5 ml).

Iron in injection ampoules is used only in extreme cases and in severe forms of disease. Quite often this is necessary before an upcoming surgery. Also, the appointment occurs if the patient has a disease of the stomach or intestines, damage to the walls of small vessels, after extensive blood loss.

Liquid iron in ampoules

Often, medications that contain iron are recommended to be taken orally. The required dosage of the drug is prescribed strictly individually - calculated based on the patient’s weight. In order for all medications containing iron to be absorbed as efficiently as possible, it is recommended to take them with food.

Taking iron-containing medications does not go away without any side effects. Therefore, the patient most often experiences the following side effects: a feeling of metal in the mouth, attacks of nausea or vomiting, decreased immunity, and upset stool. Also, iron supplements are prescribed under the strict supervision of a doctor, since there are a number of strict contraindications.

The pharmaceutical industry produces a fairly varied amount of liquid iron preparations in ampoules. Separately, I would like to present liquid iron in ampoules - totem. Totem iron preparation in ampoules is a medicinal solution intended for oral administration. Ampoules are available in 10 ml, which is equal to 50 mg of Fe. This antianemic drug is quite popular among other iron-containing drugs.

The iron in Totem ampoules has a dark brown color, a characteristic odor, some excipients - manganese, copper, benzoate and sodium citrate, sucrose, caramel coloring, water, flavoring and citric acid. The use of this drug leads to a gradual regression of all signs of anemic disorder, which is caused by iron deficiency. It should be used with caution: there are a number of contraindications.

You can also highlight other preparations with iron in capsules, which are popular among other similar products: Fenyuls, Heferol, Ranferon, Globiron, Gemsineral. The use of all these drugs presented is allowed only to patients who do not have chronic liver or kidney disease or a blood tumor. There is a strict ban on iron-containing drugs for patients with hemolytic and aplastic types of anemia.

A course of treatment

The treatment course for anemia lasts about six months or slightly longer. All this happens under the strict supervision of a doctor, and every month the patient needs to donate blood to check the results and effectiveness of the selected therapy. Even after the hemoglobin level normalizes, the drugs will have to be taken for about two months.

Some drugs in solution form can irritate the gastric mucosa, so side effects may occur. The effectiveness of iron therapy is determined approximately in the third week after treatment was started - a slight increase in hemoglobin levels in the blood is observed. All measures taken can be considered productive if the required level is achieved within two months. After this, only maintenance therapy is prescribed.

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The drug "Ferrum Lek", ampoules: instructions for use (reviews)

The drug "Ferrum Lek" is used to treat anemia and iron deficiency in adults and children, including infants, and, in addition, during pregnancy and the lactation period. It is an antianemic agent that contains iron in the form of a complex compound of polymaltosate hydroxide.

Description of the drug

The instructions for use for Ferrum Lek ampoules indicate that the molecular weight of this complex is quite large, and its diffusion passing through the mucous membrane of the gastrointestinal system is forty times slower compared to divalent iron. The complex is stable and does not release iron ions under physiological conditions. The active element of the multinuclear zones of the system is included in a structure that is similar to the natural iron compound, the so-called ferritin. Due to the presence of such similarities, the main element of the presented complex can be absorbed only through active absorption.

Iron element binding proteins, which are located on the surface of the intestinal epithelium, completely absorb iron through targeted competitive exchange of ligands. The absorbed type of substance is deposited predominantly in the liver, where further binding to ferritin occurs. Later in the bone marrow area it becomes part of hemoglobin. The polymaltosate hydroxide complex does not have the pro-oxidant properties that are typical of iron layers. Thus, the main active component in this drug is polymaltosate hydroxide along with excipients. This is confirmed by the instructions for use for Ferrum Lek ampoules.

This preparation contains iron in the form of a complex compound polyisomaltose hydroxide. Such a macromolecular type complex does not provoke the release of iron in the form of free ions. The product is structurally similar to a natural compound of the element, namely ferritin. This hydroxide is not characterized by the presence of pro-oxidant characteristics, which are inherent in many salts of this microelement.

This is also confirmed by instructions for use and reviews for Ferrum Lek in ampoules.

Iron, which is included in the composition, is able to quickly compensate for the deficiency of the corresponding element in the human body, including against the background of pronounced iron deficiency anemia, thus restoring the level of hemoglobin necessary for normal life.

When using the product, there is a gradual process of regression of the clinical symptoms of iron deficiency, such as fatigue, weakness and dizziness, along with tachycardia and soreness, as well as dry skin.

Pharmacokinetics of the drug

As the instructions for use indicate for Ferrum Lek ampoules, iron absorption, which is measured by the level of hemoglobin in red blood cells, is inversely proportional to the dose taken, that is, the higher the amount, the lower the corresponding process. There is a statistically negative correlation between the level of deficiency of this substance and its presence, since the greater the lack of iron, the better absorption occurs. The substance is absorbed to the greatest extent in the duodenum and also in the jejunum. The remaining amount of the microelement is excreted in the feces. Its excretion, along with excreted epithelial cells of the gastrointestinal system and skin, as well as sweat, urine and bile, is approximately equal to one milligram of iron per day. In the female body, during the menstrual cycles, there is an additional loss of an important microelement, which, of course, must be taken into account. Analogues of "Ferrum Lek" in ampoules will be presented below.

It should be noted that immediately after intramuscular injection of the drug, it enters the bloodstream very quickly. So, fifteen percent of the dose arrives after fifteen minutes.

Indications for use of Ferrum Lek

The instructions for use for Ferrum Lek ampoules indicate that the drug is prescribed in the following cases:

• therapy for latent iron deficiency;
• treatment of anemia due to iron deficiency;
• prevention of deficiency of this microelement during pregnancy;
• situations against which treatment with iron-containing preparations for internal use is ineffective or impracticable, for example, for the injection form.

Ferrum Lek release form in ampoules

The drug in the form of a solution can be administered exclusively intramuscularly. In no case should intravenous administration of the drug be allowed. This is confirmed by the instructions for Ferrum Lek ampoules.

Before using the first therapeutic dose, a person should administer a test amount of the product, which will be equal to half the contents of one ampoule, which is twenty-five to fifty milligrams of the microelement. Provided there are no adverse reactions from the body, the remainder of the initial daily dose is added within fifteen minutes after administration.

The dosage of Ferrum Lek in ampoules is selected individually depending on the general iron deficiency. Against the background of a known amount of lost blood, intramuscular administration of two ampoules leads to an increase in the level of hemoglobin, which will be equal to the equivalent of one blood unit.

Adults and elderly people are prescribed one hundred to two hundred milligrams, that is, from one to two ampoules, depending on their level of hemoglobin in the blood. The maximum daily dose for children is expressed as seven milligrams per kilogram of the child's weight.

Rules for administering the drug

The drug "Ferrum Lek" in ampoules must be administered deep intramuscularly alternately into the left and right buttock. In order to reduce pain and also avoid skin staining, it is advisable to follow the rules below:

• the product is injected into the upper outer region of the buttock, using a needle five to six centimeters long;
• before the injection process, after disinfecting the skin, it is necessary to move the subcutaneous tissue to the lower part by two centimeters in order to prevent possible leakage of the product;
• immediately after administering the substance, the subcutaneous tissues must be released, and the injection site itself, pressing, must be held in this position for one minute;
• before using a solution intended for intramuscular injection, it is important to carefully inspect the ampoules; it is necessary to use only those that contain a homogeneous solution without any sediment;
• solution for intramuscular injection is always administered immediately after opening the vessel.

Possible side effects

As the instructions for the “Ferrum Lek” product in ampoules indicate, as a result of the body receiving an excess of the substance in general well-being, a feeling of heaviness or fullness may occur, and, in addition, pressure in the epigastric region. Quite often in such situations, nausea, constipation and diarrhea appear, while stool may be dark in color - the phenomenon of black stool, which is explained by the excretion of the unabsorbed part of the iron and is not characterized by clinical significance.

Let us emphasize once again that Ferrum Lek in ampoules is not used intravenously.

Contraindications

Ferrum Lek is contraindicated for use when:

Use during pregnancy and lactation

As the instructions for use for Ferrum Lek in ampoules indicate, it is prescribed intramuscularly to pregnant and lactating women.

In controlled studies using the drug in the second and third trimesters of pregnancy, no negative effects on the body of the mother and her fetus were noted. There were also no harmful effects on the fetus during the use of the drug in the first trimester of pregnancy.

Use in children

Doctors consider it possible to use the drug according to indications and doses that take into account the patient’s age. For children under twelve years of age, due to the need to prescribe the drug in a small dosage amount, it is preferable to use it in the form of syrup.

A prescription is required for Ferrum Lek in ampoules.

Special instructions for use

It should be noted that chewable tablets, as well as syrup, do not stain tooth enamel. The drug, dispensed in injection form, must be used exclusively in a hospital setting. When prescribing Ferrum Lek to patients suffering from diabetes, it is important to consider that one chewable tablet contains a milligram of syrup.

Against the background of anemia caused by infectious or malignant diseases, iron can accumulate in the reticuloendothelial system, from where it can be mobilized and then utilized only after the corresponding disease has been completely cured. Taking a trace element will not affect the results of stool occult blood tests.

Interaction with other drugs and effect on driving ability

This drug does not have any effect on a person’s ability to concentrate, thus allowing him to drive a vehicle without fear.

Ferrum Lek, intended for intramuscular injection, cannot be used in parallel with the same drug for oral administration. Concomitant use with ACE inhibitors can enhance the systemic effects of parenteral drugs containing iron.

"Ferrum Lek" in ampoules: reviews

Among the reviews of the drug “Ferrum Lek” that are found on the Internet, there are very common reports of the occurrence of so-called bruises that form after intramuscular injection of the drug into the body. People write that such formations do not occur for them for quite a long time.

Commenting on these complaints, the developers do not consider the above-mentioned drawback to be a side effect, explaining that the likelihood of such phenomena directly depends on the competent and correct administration of the drug. In order to avoid bruising, you should simply strictly adhere to all the given instructions contained in the annotation.

Reviews about the use of "Ferrum Lek" for children

Approximately eighty percent of reviews of Ferrum Lek for children are positive, which can be explained by the high effectiveness of this product and its easy tolerability by young patients, as well as ease of use.

Parents write that many children really like the taste of the syrup, so they use it for treatment with great pleasure.

As for negative reviews, almost all of them are due to various subjective circumstances that were the reason for the impossibility of using the drug. In most cases, parents were forced to stop giving Ferrum Lek, since their children, unlike the rest, did not like the taste of the syrup. Another reason for dissatisfied parental reviews was the likelihood of constipation in young patients.

Reviews from pregnant women about Ferrum Lek

Most of the reviews about Ferrum Lek during pregnancy in women are also positive. Women write that they like the effectiveness of the drug, the need to take it only once a day, and also enjoy its pleasant taste.

In addition, it is noted that Ferrum Lek increased the level of hemoglobin even against the background of such situations when pregnancy in women was initially accompanied by anemia.

Negative reviews of Ferrum Lek in isolated examples are associated with its ineffective effect. But a predominantly negative aftertaste was manifested due to subjective factors, for example, due to the fact that someone did not like the taste, someone experienced nausea or constipation due to its use. Thus, most negative reviews contain information related to the side effects of this drug.

In conclusion, it should be noted that the medical drug “Ferrum Lek” is today the most frequently prescribed drug by doctors to replenish iron in the body of both children and adult patients, as well as as a preventive measure for the lack of this microelement during pregnancy.

"Ferrum Lek": cheap analogues in ampoules

Similar in composition and therapeutic effect to the Ferrum Lek solution are the preparations “Polymaltose Iron”, “Maltofer”, “Fenuls Complex”, “Ferry”.

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Injections to raise hemoglobin - types of iron-based drugs, benefits and harms

A low level of hemoglobin in the blood is dangerous for the development of iron deficiency anemia. Anemia is a dangerous condition for humans in which body tissues suffer from oxygen starvation.

The lack of B vitamins and heme iron in the body makes the formation of hemoglobin in the blood impossible. Hemoglobin plays an irreplaceable role in human blood, binding free oxygen molecules coming from the lungs and delivering them through the bloodstream to the cells of the body's tissues.

What does the structure of hemoglobin look like?

High levels of iron in the blood can be achieved by prescribing special medications containing iron.

What type of iron does a person need?

Iron is a valuable element for the proper and stable functioning of the human body. Large amounts of iron are found in foods of animal and plant origin. But not all iron is absorbed equally by the body.

Scientists have proven that a person gets the bulk of iron from meat products. The iron contained in the meat of animals and birds is similar in composition to the iron needed by humans and is called heme. In plant tissues, the microelement is found in the unbound free form of divalent and trivalent iron. This type of iron is called non-heme iron and is less easily absorbed, while trivalent iron is not absorbed by the human body.

• oral – tablets and solutions for oral administration, drugs pass through the gastrointestinal tract and are absorbed naturally;
• parenteral - the active substances enter the tissues, bypassing the gastrointestinal tract; these include intravenous injections.

Groups and subgroups of iron-containing medications for hemoglobin correction

Oral iron supplements

Oral iron preparations may contain both organic and inorganic Fe II (ferrous iron) salts and Fe III (ferric iron) salts. The benefits of such drugs for the body are different, the digestibility of FeII drugs reaches 30-40%, the bioavailability of Fe III is much less - up to 10%. It is necessary to take medications in long courses from 30 to 90 days, after which there is a steady increase in hemoglobin content in the blood.

Such drugs have a number of side effects:

• The patient suffers from nausea and vomiting.
• Appetite disappears and the taste perception of food changes.
• When taken for a long time, a person suffers from constipation or diarrhea.
• Iron solutions taken orally have a strong coloring effect and can ruin the color of teeth.

Oral ferrodrugs also have a number of serious contraindications:

• diagnosing a patient with oncology, especially blood cancer;
• stomach ulcer;
• it is impossible to combine taking medications with iron with taking medications of the tetracycline group;
• chronic liver and kidney diseases;
• the patient has enteritis.

Iron supplements are prescribed with extreme caution during pregnancy; women are advised to increase the level of hemoglobin in the blood by consuming foods rich in iron and vitamins.

The selection and prescription of drugs containing iron is carried out by the attending physician, and in no case independently.

Oral medications to stabilize hemoglobin levels

Parenteral ferropreparations

Parenteral ferrodrugs are prescribed in cases of extreme necessity, after a thorough examination of the patient. Here is a list of reasons why adults and children are prescribed injections that increase hemoglobin:

1. Chronic diseases of the digestive system. In pathological diseases: pancreatitis, enteritis, celiac disease, the body’s ability to absorb iron naturally is impaired.
2. Ulcerative colitis, gastric and duodenal ulcers.
3. Allergic reaction to iron salts.
4. Resection of the stomach or part of the small intestine.

Injections to raise hemoglobin are prescribed if it is necessary to saturate the patient’s body with iron in a short period of time before surgery, when there is a possibility of large blood losses.

Iron injections to raise hemoglobin in the blood do not involve the introduction of a microelement in an amount greater than the body's daily requirement - 100 mg at a time.

A patient who receives injections to increase hemoglobin may experience the following consequences:

• seals and abscesses may appear at the injection sites;
• an allergic reaction to the drug, including anaphylactic shock, is possible;
• bleeding disorders may occur;
• An overdose of iron in the body can lead to nausea, vomiting, diarrhea or constipation.

Injections for hemoglobin can be prescribed to both adults and children; the only differences are in the dosage of medications for injection.

Parenteral medications used to correct hemoglobin levels

Injections to raise hemoglobin in the blood and the names of drugs

The list of injections to increase hemoglobin, the names of medications and their brief characteristics are given in the table below.

The use of iron-containing medications by pregnant and lactating women

During pregnancy, many representatives of the fairer sex may be diagnosed with iron deficiency anemia. In particularly severe situations, the attending physician will prescribe iron injections, but in practice they try to avoid such measures.

In most cases, if the hemoglobin level deviates from the norm, pregnant women are prescribed a special diet and preventive use of ferrodrugs. The dose of iron intake per day is prescribed by the doctor for each case individually.

• in the absence of pregnancy pathologies in the 3rd trimester, iron-containing medications are prescribed for preventive purposes;
• for anemia diagnosed before pregnancy, iron medications are used throughout pregnancy and during breastfeeding;
• If anemia develops during pregnancy, ferrodrugs can be prescribed in the early stages of pregnancy.

The nuances of taking ferrodrugs

Iron supplements should be used with extreme caution. These medications will provide invaluable assistance in treating anemia and eliminating the consequences of large blood loss, but can cause irreparable harm to human health if prescribed incorrectly.

Drugs for intravenous injection must be prescribed by an appropriately qualified physician and administered as part of outpatient and inpatient treatment by trained medical personnel.

Do not forget that the cause of a low level of hemoglobin in the blood can be a banal vitamin deficiency. For proper absorption of iron, the body needs a large amount of vitamin C, and for the formation of hemoglobin cells, vitamins B6, B9 and B12. Calcium interferes with the normal absorption of iron, therefore, during the treatment of anemia, eliminate dairy products from the diet, stop smoking, alcohol, coffee and refined foods.

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Iron supplements

Iron deficiency, along with a lack of calcium, is the most common type of vitamin deficiency in women. And this is not surprising, because we lose much more of it than men: About 10-40 mg of iron is lost every month during menstruation.

During pregnancy, the body's depot in the gland is often exhausted, because Fe is spent on the placenta, blood supply and nutrition of the fetus, on expansion of the uterus and blood loss during childbirth.

It is these two factors that determine the increased need for iron in women, especially during pregnancy. Today we will talk about iron supplements, and whether they should be taken without a doctor's prescription.

Where is iron found?

Most of the iron inside the body is contained in hemoglobin, a little less in myoglobin (muscles), and the rest is the body's reserve of iron and is found in the spleen, liver and bone marrow

.

Iron absorption

Regardless of the form of taking the iron supplement, in tablets, capsules, parentally, or simply with food, absorption in a healthy person occurs in the duodenum. However, with iron deficiency, this process can begin in the stomach, and in the rectum and colon, in a word, the body will consume it as much as possible, regardless of the location.

In what form should you take iron?

Modern iron supplements are available in chewable and oral forms. They can contain exclusively forms of iron, or be in combination with folic or ascorbic acid, amino acids. These drugs are usually more expensive, since such supplements enhance the effect of iron absorption. Iron preparations in liquid form are prescribed to patients with anemia after suffering from gastrointestinal diseases, since the coating of the tablets is poorly digested by their stomachs.

In case of poor tolerability of taking drugs orally, or poor absorption of iron in the gastrointestinal tract, patients are prescribed parental iron supplementation, that is, iron supplements in ampoules. There are two varieties here:

• iron hydroxide with dextran and phenol;
• iron hydroxide with dextran and without phenol.

Preparations with phenol can only be administered intramuscularly, and intravenous iron preparations do not contain phenol. Phenol should not be administered intravenously, as there is a risk of developing phlebitis, and the most successful form of treatment for anemia in severe stages is intravenous administration of the entire dose of iron hydroxide with dextran in one dose.

Contraindications and side effects

Despite the fact that intravenous administration is most effective for anemia, this method contains the greatest number of side effects. If fever, enlarged lymph nodes, rashes and distinct weakness occur, it is necessary to stop intravenous administration and switch to another method of treating anemia.

Is taking iron supplements dangerous?

Preparations containing iron are prescribed for the prevention and treatment of anemia of any form, and prevention can only be carried out in connection with the risk of anemia. For example, during pregnancy and lactation. In addition, iron-containing drugs are prescribed for group B hypovitaminosis, frequent bleeding, and also during recovery after surgery. Prescribing medications to yourself is contraindicated, since a healthy person needs enough iron in a balanced diet, and an increased dose of iron has a toxic effect.

Finally, we provide you with a list of iron supplements, both chewable and parental. The list is provided for informational purposes only and is not a prescription for use. Remember, prescribing iron-containing medications to yourself can cause considerable harm to your health.

List of drugs

1. Kaferid tablets
2. Gemostimulin tablets
3. Phytoferrolactol tablets
4. Hemofer tablets
5. Ferrum Lek tablets
6. Ferrocal tablets
7. Syrup "Maltofer"
8. Actiferrin syrup
9. Ferronal syrup
10. Ferrum Lek syrup
11. Ampoules "Venofer"
12. Ampoules "Totem"
13. Ampoules "Maltofer"
14. Ferrum Lek ampoules

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Treatment of iron deficiency anemia in adults. Drugs, injections, diet

In medical interpretation, anemia is a term that does not denote a specific disease, but a group of syndromes characterized by a decrease in the number of red blood cells and hemoglobin in the blood. With iron deficiency anemia, the supply of iron decreases, which interferes with the normal synthesis of hemoglobin.

Ferrotherapy in adults, its features

According to a WHO study, about 30% of women and about 15% of men in the world suffer from iron deficiency anemia. The main reason for its development in adulthood is blood loss of various types. Therefore, treatment of iron deficiency anemia in adults is based, first of all, on finding the source of bleeding and eliminating it.

In young women, the most common cause is heavy menstruation, which, in turn, can be caused by a number of diseases of the reproductive or endocrine system.

Another common source of blood loss is damage to the gastrointestinal tract. Carrying out the necessary research and detecting pathology allows you to eliminate bleeding and begin therapy for the underlying disease.

In women, the most common cause of the disease is heavy periods

Simultaneously with identifying and eliminating the causes of iron deficiency anemia, it is necessary to eliminate the lack of iron in the body and replenish its reserves.

Note! Thoughtless prescription of iron-containing drugs without searching for the root cause in the treatment of iron deficiency anemia in adults is ineffective, costly and can lead to serious consequences (increased bleeding, undetected neoplasms, etc.).

Treatment of iron deficiency anemia in adults. Effective drugs for oral administration

Treatment of iron deficiency anemia in adults is usually carried out with the help of tablets containing iron. For the majority of patients who do not have difficulties with the absorption of pharmacological iron, the use of oral medications is most effective and appropriate.

Reasons for failure of oral drug therapy in adults:

Basic principles of treatment with oral medications

The World Health Organization recommends giving preference to medications containing ferrous iron. The daily dose should be at least 100 mg of the drug. If there are no problems with digestibility, the daily dose is gradually increased to 400 mg.

The drug is usually prescribed in 3-4 doses 1 hour before meals or 2 hours after eating. Experts do not advise taking medications containing iron at intervals of less than 6 hours, since during this time, after using the drug, the absorption capacity of the intestine decreases.

The duration of treatment should not be less than 4 months (in some cases up to 6 months). Approximately 1 month after successful use of the drug, its dose may be reduced.

You should not be afraid of an excess of iron in the body with the correct dosage of the drug: as soon as the body makes up for the lack of the element, its absorption properties drop.

It is important to know! Some substances and medications can significantly affect the rate of iron absorption. Therefore, it is not recommended to take iron-containing preparations with tea or coffee, as tannin and caffeine slow down their absorption.

When choosing a drug, you should pay attention to the price-quality ratio, the number of side effects, and the complexity of the use regimen.

Contraindications for taking drugs orally for iron deficiency anemia

Undesirable effects associated with the use of oral drugs during ferrotherapy in adults are usually expressed in the form of irritation of the gastrointestinal tract. Moreover, if side effects in the intestines (diarrhea, constipation) are practically independent of the dose of the drug, then irritation of the upper gastrointestinal tract (nausea, stomach pain) is directly dependent on the dose taken.

If such symptoms occur, it is recommended to reduce the amount of the drug taken and take it after meals. If this does not help, then it is better to switch to slow-acting drugs. If side effects are severe, you should stop taking iron-containing medications orally.

Treatment of iron deficiency anemia: effective injections

Another option for compensating for microelement deficiency in the treatment of iron deficiency anemia is parenteral administration of drugs, that is, in the form of injections.

Such drugs are usually administered intramuscularly or intravenously. The most commonly used is iron sucrose, although it can cause allergies when administered intravenously.

When treating iron deficiency anemia, drugs are usually administered intramuscularly or intravenously.

Experts advise administering the drug in a dose not exceeding 100 mg over 24 hours. If oversaturated, iron can cause toxic poisoning.

When are injections used to treat iron deficiency anemia?

Iron absorption occurs mainly through the lower gastrointestinal tract, so preference for the treatment of iron deficiency anemia in adults is given to the oral method of taking medications. The effectiveness of parenteral administration is much lower, but in some cases this method must be preferred.

Intramuscular or intravenous administration of a microelement is prescribed in case of difficulties with its absorption by the intestines as a result of certain diseases (inflammatory diseases of the small intestine, enteritis, gastric ulcer in the acute phase, etc.) or previous operations.

It is also advisable to prescribe parenteral administration in case of massive blood loss, when it is necessary to compensate for the deficiency of the element as soon as possible.

Contraindications and side effects of injections for iron deficiency anemia

The most serious complication of taking iron by injection is the possibility of serious anaphylactic reactions. Therefore, before administering the full dose, make a test injection with a small amount of the medicine and wait a while to see if an allergy develops.

Be careful! Although cases of anaphylactic shock are quite rare, parenteral administration of iron supplements should only be carried out in medical facilities designed to provide emergency care.

If allergic reactions occur, you should immediately stop taking the medication. Other possible side effects: fever, myalgia, redness of the skin, rash.

Diet as a way to treat iron deficiency anemia

A mild stage of iron deficiency anemia can be treated with a special diet (in the absence of gastrointestinal diseases).

Mild iron deficiency anemia can be treated with a special diet

• beef liver;
• veal;
• beef tongue;
• turkey meat;
• sea ​​fish;
• buckwheat;
• prunes;
• grenades;
• apples;
• peaches;
• legumes;
• greenery;
• bread.

It should be taken into account that the amount of iron that is absorbed from vegetables and fruits is several times higher than the amount of iron from meat and cereal products.

Also, such a diet is prescribed as an adjunct to drug therapy.

Therapy for iron deficiency anemia in adults includes several important components: identifying and eliminating the root cause of anemia, compensating for iron deficiency with oral or parenteral administration of drugs, following a special diet, and preventing relapses.

Useful videos about iron deficiency anemia in adults and its treatment

Iron deficiency anemia: causes and treatment methods:

Iron-deficiency anemia. Symptoms, signs and treatments:

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Iron supplements are prescribed to the patient provided that he has or there is a need to prevent this condition. Symptoms of anemia in adults appear with an inadequate diet, in the case of lactation, etc. In such situations, iron salts or iron hydroxide are usually prescribed, which compensate for the lack of this element in the body.

Modern drug manufacturers offer a very large number of different iron preparations in different forms. These are chewable tablets, syrup, capsules, dragees, solutions for intravenous and intramuscular administration.

Iron-deficiency anemia develops due to the following reasons:

• Chronic bleeding is the most common cause of anemia (approximately 80% of cases). This condition may be a consequence of bleeding from the gastrointestinal tract due to tumors, etc. In women, this condition develops due to heavy periods, bleeding from the uterus. This is also possible due to pulmonary and nasal bleeding, urolithiasis, malignant tumors of the kidneys and bladder, etc.
• Inflammatory diseases in chronic form - if there is a focus of chronic inflammation in the body, iron is deposited, which is why its hidden deficiency is noted. In this state, iron is in the depot and is absent in order to form.
• An increased need for this microelement is typical during pregnancy, especially after the first trimester, as well as during breastfeeding. Also, high iron requirements are observed with too much physical exertion, active sports, and rapid growth in children.
• Impaired absorption of iron - this condition is observed in some diseases. This occurs with resection of the small intestine, intestinal amyloidosis, chronic enteritis , malabsorption syndrome .
• Poor diet – If a person chooses foods low in iron, the likelihood of anemia increases. This condition is most often diagnosed in young children, often newborns. This is also true for vegetarians.

Daily requirement for iron and its intake from food for people of different ages and gender (table):

Regardless of how much iron is contained in the food consumed, more than 2 mg of the microelement is not absorbed in the intestines during the day (provided that the person is healthy).

Over the course of a day, a healthy adult man loses approximately 1 mg of iron through his hair and epithelium.

A woman during menstruation, provided that they proceed normally, loses about 1.5 mg.

That is, under the condition of normal nutrition, no more than 1 mg enters the depot in men; in women - 0.5 mg. If a person eats poorly or suffers from chronic inflammatory diseases, then the iron in the body is completely consumed. This also happens with heavy periods in women. And if the depot is empty, anemia begins to develop due to provoking factors.

If laboratory tests confirm that a person has Iron-deficiency anemia , it is necessary to find out exactly the cause of this condition. After the bleeding has been stopped or the inflammatory process has been cured, in order to normalize hemoglobin use iron supplements orally. Next, the doctor prescribes the use of a therapeutic dose of the drug for several more months to replenish the depot. Provided that the patient does not tolerate such medications well, he is prescribed half the dose.

For prevention, women of childbearing age are recommended to take any remedy in a therapeutic dose for 7 days a month (in terms of about 200 mg of pure iron per day). You can also use the complex vitamins containing this trace element.

To eliminate anemia, the doctor prescribes medications containing iron, taking into account the results of laboratory tests, age, and tolerability of the drug. The price of iron-containing drugs is also taken into account, because the financial capabilities of patients may vary. The doctor can judge which iron-containing drugs are better based on his experience in using such drugs in children and adults.

If necessary, drugs can also be prescribed in ampoules - for intravenous administration and intramuscular injections. However, they are used only for strict indications, since with such treatment there is a high risk of developing allergic manifestations .

But in no case should you rely on reviews and independently choose the best medications to treat iron deficiency anemia in women or men.

Despite the fact that the list of iron-containing drugs for anemia is very wide, none of them should be used without the approval of a doctor. He prescribes the dosage and evaluates the effect of such drugs over time. After all, an overdose can cause serious poisoning.

Iron supplements are prescribed very carefully for pregnant women. Pregnant women should take iron supplements under the strict supervision of a doctor. Parenteral administration of iron supplements to patients with anemia is indicated in the following cases:

• During surgical interventions on the organs of the digestive system, extensive resection of the intestine, removal of part of the stomach.
• In case of exacerbation of peptic ulcer, when symptoms appear celiac disease , in chronic form, enteritis , nonspecific ulcerative . With the listed diseases, the absorption of iron from the gastrointestinal tract decreases, so it is necessary to receive iron-containing drugs.
• If there is a need to saturate the body with this microelement in a short time - before performing surgery for fibroids, etc.
• For severe iron deficiency anemia.
• If the patient has become intolerant to these medications when taken orally.

Below is a list of iron supplements that are used for anemia. It lists analogues of such products and their approximate cost in pharmacies.

The composition contains iron sulfate (ferrous iron salts). produced in capsules (from 280 rubles), in a solution for internal use (from 320 rubles), syrup (from 250 rubles). Analogues of this medicine are drugs Totema , Ferronal , Ferrlecite , Heferol , . The cost of analogues is from 100 to 500 rubles.

Hemohelper

The composition includes ferrous iron salts and ascorbic Sorbifer acid. It is produced in the form of capsules (from 600 rubles) and children's bars with different flavors (from 300 rubles). Analogues are products (from 300 rubles).

Contains ferric iron ( protein succinylate ). Produced in the form of a solution for oral use. Cost – from 900 rub. (20 bottles of 15 mg). The drug is also produced Ferlatum foul (from 700 rubles), which contains ferric iron and.

Maltofer

This polymaltose complex contains ferric iron. Produced in the form of drops, solution, tablets, ampoules. Cost from 250 rub. The drug is also produced. It is produced in the form of syrup, chewable tablets, and solution for injection. Analogues are drugs Monofer , Ferri .

Also produced:

• sucrose complexes for injections: Argeferr (from 4500 rub.), (from 2500 rub.), (from 2700 rub.);
• dextran complexes: (from 2700 rub.), Dextrafer .

The drug contains iron sulfate and a complex of vitamins (group B, PP, C). It is used for the prevention and treatment of iron deficiency, as well as for hypovitaminosis of group B. The complex is not used for children, but is prescribed if iron is needed for pregnant women. Cost from 170 rub. per pack 10 pcs.

Hematogen

If it is necessary to take iron supplements for children, sometimes the doctor recommends consuming. It is produced from defibrated and purified cattle blood and additional components that add flavor. The composition contains nutrients, microelements and macroelements, including divalent iron, which allows you to overcome its deficiency in the body. Hematogen is indicated for children from 3 years of age.

If medications are needed for children under 1 year of age, iron drops are prescribed.

Ferrous salts

This gluconate , chloride , ferrous sulfate, and iron fumarate . More information about ferrous fumarate - what it is - can be found in the instructions for use. When a patient takes divalent iron, the symptoms of anemia gradually weaken and disappear - fainting, weakness, etc. Laboratory parameters also return to normal. The medicine contains the alpha amino acid serine, which increases iron absorption. This makes it possible to reduce the dose, therefore reducing toxicity during treatment.

Ferrous salts and ascorbic acid

Medicines with this composition are effective, as they improve the efficiency of absorption of the mineral. As a result, the consequences of anemia in women and men can be overcome quickly.

Iron protein succinylate

The composition contains a semi-synthetic protein carrier and trivalent iron. When the carrier dissolves in the duodenum, the trace element is released. At the same time, its absorption improves and the gastric mucosa does not suffer.

Solution Ferlatum protein (“liquid iron”) is taken orally.

Ferric hydroxide

These are preparations that contain polymaltose, dextran or sucrose complexes.

In the digestive tract, the polymaltose complex is stable, so it is absorbed through the mucous membrane much more slowly compared to divalent iron. Its structure closely resembles ferritin, therefore, unlike divalent iron salts, poisoning the body when taking such a medicine is almost impossible. After these complexes are administered intramuscularly or intravenously through the kidneys, they are almost not excreted. They do not have a pro-oxidant effect.

Experts highlight a number of advantages of polymaltose complexes:

• Safe to use due to very low toxicity. No poisoning is observed, even if a person, not knowing how to take this medicine correctly, took too large a dose.
• Well tolerated and highly effective. The product is better tolerated by patients than conventional iron salts and causes fewer side effects.
• When the drug is taken orally, there is no interaction with food. Therefore, treatment does not depend on food intake or diet. The product can be added to drinks for convenience.
• Even if this medicine is taken for a long time, teeth staining does not occur, as happens when taking iron supplements.

How much iron is contained in the medications described above:

Means	Form	Quantity
Maltofer	syrup pills oral solution oral drops injection	10 mg per ml 100 mg per tablet 100 mg per vial 50 mg per ml 100 mg per ampoule
	oral solution	40 mg per vial
Venofer	ampoules with solution for intravenous administration	100 mg per ampoule
Ferrum Lek	for injection chewable tablets syrup	100 mg per ampoule 100 mg per tablet 10 mg vml
	capsules syrup	34.5 mg per capsule 6.87 mg per ml 9.48 mg per ml
Cosmopher	solution for parenteral administration	100 mg per ampoule
Tardiferon	pills	80 mg per tablet
Sorbifer Durules	pills	100 mg per tablet
Totema	intravenous solution	50 mg per ampoule

Often adults and children are prescribed vitamins containing iron. Why such complexes are needed depends on the person’s condition. Iron-containing vitamins are widely represented in modern pharmacology. Due to the fact that women experience frequent blood loss, vitamins with iron for women can be taken for preventive purposes.

For anemia in women, a remedy is often prescribed, also containing, in addition to iron, ascorbic acid. Complexes are often prescribed for pregnant women Gestalis , and etc.

There are also special vitamins with iron for children with improved taste and aroma.

What should you remember when taking iron supplements?

Before treating anemia in adults and children by using oral iron supplements, you need to read the instructions and take into account a number of important principles.

• Do not take such medications simultaneously with drugs that reduce their absorption. These are calcium supplements, antacids, tetracyclines .
• To avoid dyspeptic side effects during treatment, you can use enzyme agents during treatment -,.
• The following can contribute to the absorption of such drugs: ascorbic, succinic, citric acids, sorbitol. Therefore, the treatment regimen sometimes contains substances that activate hemoglobin synthesis. This is copper, cobalt, A , .
• It is optimal to take such medications between meals, because food reduces the concentration of iron. In addition, salts, alkalis and acids from food with iron can form insoluble compounds.
• It is important to individually calculate the patient’s daily iron requirement and determine the duration of the course of treatment. Therefore, the doctor takes into account how much of the microelement is contained in the prescribed medicine and how it is absorbed.
• Be sure to take into account how the drug is tolerated. If negative effects appear, the drug is poorly tolerated, it is replaced with another. Anemia is treated by initially prescribing a minimal dose and then gradually increasing it. As a rule, the treatment process is long. First, the patient receives therapeutic doses of the drug for about 2 months. Then, for another 2-3 months, he takes prophylactic doses.
• The dosage for treatment is calculated based on a dose of 180-200 mg of iron daily.
• The duration of treatment is determined by how quickly the indicators normalize. Iron deficiency anemia is corrected by half in about three weeks. After two months of proper therapy, she is completely cured. But the drug is not discontinued, since over the course of several more months the reserves of this microelement in the body are gradually saturated.
• If a patient is intolerant to a particular drug, then replacing it with another drug may not solve the problem. After all, it is iron that has a negative effect on the gastrointestinal tract. In such a situation, it is recommended to take the drug after meals or reduce the dosage. In this case, the period of saturation of the body will extend to six months.
• It is recommended to take iron supplements for 7-10 days. monthly for girls and women. This can provide primary prevention of anemia.

If you cannot overcome anemia despite taking medications, you should pay attention to the following facts:

• whether the patient took the pills and adhered to the correct dosage;
• whether the person has a malabsorption of iron;
• Perhaps we are talking about anemia of another origin.

Expectant mothers diagnosed with anemia should ask their doctor which drug is best to choose during pregnancy.

Iron deficiency anemia during pregnancy or anemia associated with deficiency is often diagnosed. Treatment of anemia during pregnancy is carried out with the same drugs as in the normal state. Nutrition for anemia in adult women should also be appropriate - complete and include iron-containing foods (legumes, buckwheat, bran, dried fruits, oatmeal, etc.).

Sometimes such medications are prescribed to the expectant mother for preventive purposes. The doctor must take into account the hemoglobin level, as well as when anemia was diagnosed - during pregnancy or earlier.

If the expectant mother does not have anemia, she is prescribed prophylactic medication at a dose of 30-40 mg of iron per day in the third trimester.

If a woman has a tendency to anemia associated with iron deficiency, prophylaxis is carried out at approximately 12-14 and 21-25 weeks. In this case, you need to take 2-3 r. per week 30-40 mg of microelement.

Provided that the woman was diagnosed with this condition during pregnancy, it is recommended to drink 100-200 mg per day.

Pregnant women who suffered from anemia before conception are advised to drink 200 mg of iron throughout the entire period of pregnancy. During lactation, medication should be continued.

Who are contraindicated for iron supplements?

You should not take these medications in the following cases:

• for blood oncology - for different types;
• at hemolytic And aplastic anemia ;
• in case of chronic liver and kidney diseases;
• at the same time with tetracyclines , calcium supplements, antacids ;
• with foods that contain a lot of calcium, fiber or caffeine.

What side effects are possible?

When taken orally

Iron in tablets and other forms for oral administration can cause side effects from the digestive system. This may occur if the patient takes iron vitamins in tablets or preparations with ferrous iron, the name of which can be found above. At the same time, the price of iron tablets does not matter: all these drugs provoke similar side effects. This must be taken into account when choosing a medicine for pregnant women and children.

Most easily tolerated in anemia iron hydroxide polymaltosate , when taken, the frequency of side effects is halved. Reviews indicate that such tablets are best accepted by the body for anemia.

Possible side effects: nausea, vomiting, abdominal pain, loss of appetite,. Allergic manifestations often occur - rash, itching.

It is important to know that darkening of the stool during treatment is normal, because this is how unabsorbed iron is removed from the body.

Application intramuscularly, intravenously

The following manifestations are likely:

• , general weakness, .
• Pain in the back, muscles, joints.
• Metal taste in the mouth, vomiting, abdominal pain, nausea.
• Hypotension , facial hyperemia, tachycardia .
• Swelling and redness at the injection site.
• In rare cases, the temperature may rise, it is possible.

What happens during an overdose

In case of an overdose, most of the side effects that are indicated above can develop - nausea, disturbances of consciousness, decreased blood pressure, vomiting, weakness, signs of hyperventilation, etc. In such a situation, you need to perform gastric lavage, induce vomiting, drink milk and a raw egg. Next, symptomatic treatment is carried out.

If an overdose occurs when administered intramuscularly or intravenously, acute iron overload may occur.

Active substance

Iron (III) hydroxide sucrose complex (iron sucrose)

Release form, composition and packaging

Solution for intravenous administration brown, aquatic.

Excipients: sodium hydroxide, water for injection - up to 1 ml.

5 ml - colorless glass ampoules (5) - contour cell packaging (1) - cardboard packs.

pharmachologic effect

Iron supplement. The polynuclear iron(III) hydroxide centers are surrounded on the outside by many non-covalently bound sucrose molecules. As a result, a complex is formed, the molecular weight of which is approximately 43 kDa, as a result of which it is impossible to excrete it unchanged by the kidneys. This complex is stable and does not release iron ions under physiological conditions. The iron in this complex is bound to structures similar to natural ferritin.

Pharmacokinetics

Distribution

After a single intravenous administration of the drug Venofer containing 100 mg of iron, Cmax of iron, on average 538 μmol, is achieved 10 minutes after injection.

V d of the central chamber almost completely corresponds to the volume of serum - about 3 liters.

Vd at steady state is approximately 8 L (which indicates a low distribution of iron in body fluids). Due to the low stability of iron saccharate compared to transferrin, competitive iron metabolism is observed in favor of transferrin. As a result, about 31 mg of iron (III) is transferred in 24 hours.

Removal

T1/2 - about 6 hours. In the first 4 hours, less than 5% of iron from the total clearance is excreted by the kidneys. After 24 hours, the serum iron level returns to its original (pre-administration) value, and approximately 75% of sucrose leaves the vascular bed.

Indications

Iron deficiency conditions:

- if you need to quickly replenish iron;

- in case of intolerance to oral iron supplements or non-compliance with the treatment regimen;

- in the presence of active inflammatory bowel diseases, when oral iron supplements are ineffective.

Contraindications

- anemia not associated with iron deficiency;

- signs of iron overload (hemosiderosis, hemochromatosis);

— disruption of the iron utilization process;

— I trimester of pregnancy;

- hypersensitivity to the components of the drug.

WITH caution prescribe the drug to patients with eczema, polyvalent allergies, allergic reactions to other parenteral iron preparations; patients with low serum iron-binding capacity and/or deficiency; patients with liver failure, with acute or chronic infectious diseases, with elevated serum ferritin levels due to the fact that parenteral iron may have an adverse effect in the presence of a bacterial or viral infection.

Dosage

Venofer is administered only intravenously (slowly drip or stream) or into the venous section of the dialysis system. Not intended for intramuscular administration. Simultaneous administration of the full therapeutic dose of the drug is unacceptable.

Before administering the first therapeutic dose, a test dose must be prescribed. If during the observation period phenomena of intolerance occur, administration of the drug should be stopped immediately. Before opening the ampoule, you should inspect it for possible sediment and damage. Only brown solution without sediment can be used.

Drip administration: Venofer is preferably administered by drip infusion in order to reduce the risk of a pronounced decrease in blood pressure and the risk of the solution entering the perivenous space. Immediately before infusion, Venofer should be diluted with a 0.9% solution in a ratio of 1:20, for example, 1 ml (20 mg of iron) in 20 ml of 0.9% sodium chloride solution. The resulting solution should be administered at the following speed: 100 mg of iron - no less than 15 minutes; 200 mg of iron - within 30 minutes; 300 mg of iron - within 1.5 hours; 400 mg of iron - within 2.5 hours; 500 mg of iron - over 3.5 hours. The maximum tolerated single dose of 7 mg iron/kg should be administered over a minimum of 3.5 hours, regardless of the total dose of the drug.

Before the first drip administration of a therapeutic dose of the drug Venofer, it is necessary to administer a test dose: 20 mg of iron for adults and children weighing more than 14 kg, and half the daily dose (1.5 mg iron/kg) for children weighing less than 14 kg for 15 min. In the absence of adverse events, the remainder of the solution should be administered at the recommended rate.

Jet introduction: Venofer can also be administered as an undiluted IV solution slowly, at a rate (norm) of 1 ml of Venofer (20 mg iron) per minute; 5 ml of Venofer (100 mg iron) should be administered at least 5 minutes before. The maximum volume of the drug should not exceed 10 ml of Venofer (200 mg iron) per injection.

Before the first jet injection of a therapeutic dose of Venofer, a test dose should be prescribed: 1 ml of Venofer (20 mg iron) for adults and children weighing more than 14 kg and half the daily dose (1.5 mg iron/kg) for children weighing less than 14 kg for 1-2 min. If there are no adverse events during the next 15 minutes of observation, the remaining part of the solution should be administered at the recommended rate. After the injection, the patient is recommended to fix his arm in an extended position for a while.

Introduction to Dialysis System

Venofer can be administered directly into the venous portion of the dialysis system, strictly following the rules described for intravenous injection.

Dose calculation: the dose is calculated individually in accordance with the general iron deficiency in the body using the formula:

General iron deficiency (mg) = body weight (kg) × [normal Hb level - patient's Hb level] (g/l) × 0.24* + deposited iron (mg).

For patients weighing less than 35 kg: normal Hb level = 130 g/l, amount of deposited iron = 15 mg/kg body weight.

For patients weighing more than 35 kg: normal Hb level = 150 g/l, amount of deposited iron = 500 mg.

*Coefficient 0.24 = 0.0034×0.07×1000 (iron content in Hb=0.34%; blood volume = 7% of body weight; coefficient 1000 = conversion from “g” to “mg”).

Total volume (ml) of Venofer that must be administered = total iron deficiency (mg)/20 mg/ml (Tables 1 and 2).

Table 1.

Body mass (kg)
	Hb 60 g/l		Hb 75 g/l
	mg Fe	ml	mg Fe	ml
5	160	8	140	7
10	320	16	280	14
15	480	24	420	21
20	640	32	560	28
25	800	40	700	35
30	960	48	840	42
35	1260	63	1140	57
40	1360	68	1220	61
45	1480	74	1320	66
50	1580	79	1400	70
55	1680	84	1500	75
60	1800	90	1580	79
65	1900	95	1680	84
70	2020	101	1760	88
75	2120	106	1860	93
80	2220	111	1940	97
85	2340	117	2040	102
90	2440	122	2120	106

Table 2.

Body mass (kg)	Cumulative therapeutic dose of Venofer for administration
	Hb 90 g/l		Hb 105 g/l
	mg Fe	ml	mg Fe	ml
5	120	6	100	5
10	240	12	220	11
15	380	19	320	16
20	500	25	420	21
25	620	31	520	26
30	740	37	640	32
35	1000	50	880	44
40	1080	54	940	47
45	1140	57	980	49
50	1220	61	1040	52
55	1300	65	1100	55
60	1360	68	1140	57
65	1440	72	1200	60
70	1500	75	1260	63
75	1580	79	1320	66
80	1660	83	1360	68
85	1720	86	1420	71
90	1800	90	1480	74

In cases where the total therapeutic dose exceeds the maximum permissible single dose, split administration of the drug is recommended. If after 1–2 weeks. after starting treatment with Venofer, there is no improvement in hematological parameters, it is necessary to reconsider the initial diagnosis.

Dose calculation for replenishing iron levels after blood loss or autologous blood donation

The dose of Venofer is calculated using the following formula:

If the amount of blood lost is known: IV administration of 200 mg of iron (10 ml of the drug Venofer) leads to the same increase in Hb concentration as the transfusion of 1 unit of blood (=400 ml with Hb concentration=150 g/l).

Amount of iron to be replaced (mg) = number of units of blood lost × 200
or
Required volume of Venofer (ml) = number of units of blood lost × 10.

When Hb levels decrease: the previous formula should be used provided that the iron depot does not need to be replenished.

The amount of iron (mg) that needs to be replenished = body weight (kg) × 0.24 × [normal Hb level - patient Hb level] (g/l).

For example: body weight 60 kg, Hb deficiency = 10 g/l: the required amount of iron is approximately 150 mg, and the required volume of Venofer = 7.5 ml.

Standard dose

Adults and elderly patients Prescribe 5-10 ml of Venofer (100-200 mg iron) 1-3 times a week, depending on the hemoglobin level.

There are only limited data on the use of the drug in children under 3 years of age. If necessary, it is recommended to administer no more than 0.15 ml of Venofer (3 mg iron) per kg of body weight 1-3 times a week, depending on the hemoglobin level.

Maximum tolerated single dose

Adults and elderly patients: for jet administration - 10 ml of the drug Venofer (200 mg of iron), duration of administration of at least 10 minutes; for drip administration, depending on the indications, a single dose can reach 500 mg of iron. The maximum permissible single dose is 7 mg/kg and is administered once a week, but it should not exceed 500 mg of iron. The time of administration of the drug and the method of dilution are as indicated above.

Side effects

Side effects, possibly related to the administration of the drug Venofer, were observed very rarely (< 0.01% и ≥ 0.001%).

From the nervous system: dizziness, headache, loss of consciousness, paresthesia.

From the cardiovascular system: palpitations, tachycardia, decreased blood pressure, collapsed states, feeling of heat, “flushes” of blood to the face.

From the respiratory system: bronchospasm, shortness of breath.

From the digestive system: spills, pain in the epigastric region, diarrhea, taste disturbance, nausea, vomiting.

From the skin: erythema, itching, rash, pigmentation disorders, increased sweating.

From the musculoskeletal system: arthralgia, joint swelling, myalgia, pain in the extremities.

Allergic reactions: anaphylactoid reactions, facial swelling, laryngeal swelling.

Local reactions: pain and swelling at the injection site (especially if the drug enters extravasally).

General violations: asthenia, chest pain, feeling of heaviness in the chest, weakness, peripheral edema, feeling of malaise, pallor, fever, chills.

Overdose

Symptoms: hemosiderosis due to acute overload.

Drug interactions

The drug should not be prescribed simultaneously with dosage forms of iron for oral administration, because absorption of iron from the gastrointestinal tract decreases. Treatment with oral iron supplements can begin no earlier than 5 days after the last injection.

Pharmaceutical interactions

Venofer can be mixed in one syringe only with saline solution. No other IV solutions or therapeutic agents may be added due to the risk of precipitation and/or other pharmaceutical interactions. Compatibility with containers made of materials other than glass, polyethylene and polyvinyl chloride has not been studied.

special instructions

Venofer should be prescribed only to those patients in whom the diagnosis of anemia is confirmed by appropriate laboratory data (for example, the results of determining serum ferritin or hemoglobin and hematocrit levels, the number of erythrocytes and their parameters - the average volume of an erythrocyte, the average hemoglobin content in an erythrocyte).

IV iron supplements may cause allergic or anaphylactoid reactions, which can be potentially life-threatening.

The rate of administration of Venofer should be strictly observed (with rapid administration of the drug, blood pressure may decrease). A higher incidence of undesirable side effects (especially a decrease in blood pressure), which can also be severe, is associated with an increase in dose. Therefore, the recommended dosing time should be strictly followed, even if the patient is not receiving the drug at the maximum tolerated single dose.

Studies conducted in patients with hypersensitivity reactions to iron dextran showed no complications during treatment with Venofer.

Penetration of the drug into the perivenous space should be avoided, because Venofer entering outside the vessel leads to tissue necrosis and brown discoloration of the skin. If this complication develops, to accelerate the removal of iron and prevent its further penetration into surrounding tissues, it is recommended to apply heparin-containing drugs to the injection site (gel or ointment is applied with light movements, without rubbing).

From a microbiological point of view, the drug should be used immediately.

Shelf life after dilution with saline solution: chemical and physical stability after dilution at room temperature is 12 hours. From a microbiological point of view, the drug should be used immediately. If the drug is not used immediately after dilution, the user is responsible for the conditions and storage time, which in any case should not exceed 3 hours at room temperature if the dilution was carried out under controlled and guaranteed aseptic conditions.

Impact on the ability to drive vehicles and operate machinery

It is unlikely that the drug Venofer may have an undesirable effect on the ability to drive vehicles and operate machinery.

Pregnancy and lactation

Contraindicated in the first trimester of pregnancy.

Limited experience with the use of the drug Venofer in pregnant patients has shown the absence of undesirable effects of iron sucrose on the course of pregnancy and the health of the fetus/newborn. To date, there have been no well-controlled studies in pregnant women. IN experimental studies effects on reproduction in animals; no direct or indirect harmful effects on the development of the embryo/fetus, childbirth or postnatal development have been identified. However, further study of the relationship between the expected benefit of therapy for the mother and the possible risk for the fetus is required.

The drug should be stored out of the reach of children, in its original packaging, at a temperature of 4° to 25°C; do not freeze. Shelf life - 3 years.

Is iron injected intramuscularly or?

How many injections, how long, how often to compensate for iron deficiency?

Is it possible to normalize hemoglobin levels with iron injections only?

You cannot prescribe any treatment for yourself at all. Firstly, there are different types of anemia, and not only iron deficiency. Further, anemia can be due to certain reasons, and until they are eliminated, you can at least inject yourself with iron all the way - it will not do any good. A doctor must understand the causes and prescribe treatment.

If you have iron deficiency anemia, then you can get by with pills; you don’t have to inject iron right away. This may be quite enough, but take the pills for at least 2 months. If there is a need to inject, then Venofer is administered intravenously, not intramuscularly.

There is no particular choice; Ferrum-Lek injections and edema are known. analogue of Ferrolek.

These drugs are in limited demand in the pharmacy of the sleeping region.

You don’t need to prescribe and apply this to yourself.

The instructions contain many side effects and contraindications. You still need to calculate the quantity according to the instructions.

Even in a hospital, if hemoglobin is low, donor blood will be transfused. They will discharge you with indicators above critical. And without any medications, with a normal diet, hemoglobin usually normalizes.

Iron preparations by injection are currently used extremely rarely, and in some anemias there is even more iron in the blood than necessary, and increasing it will only poison the body; iron is a very toxic drug. First you need to find out the cause of low hemoglobin and treat the disease, not the symptom.

Ferrum Lek is best suited for injection. It’s better to inject according to this scheme:

Day 1 - iron injection.

Day 2 - vitamin B12 injection.

Throughout the course of 15 days you need to eat folic acid 10 tablets per day.

Iron supplements for anemia: a review of remedies

Iron is one of the essential elements that ensure stable functioning of the body. Basically, this microelement enters the body with food - there are a number of products in which the level of iron content is very high. But in some cases, even the active consumption of such peculiar foods does not help maintain the balance of iron in the body - in this case, doctors diagnose iron deficiency anemia and prescribe therapy with specific medications.

Basic information about iron supplements

In dosage form, the beneficial microelement in question can be contained in two different forms:

• divalent form– iron preparations are absorbed quickly and completely and are administered orally (orally by ingestion);
• trivalent form– drugs are less easily absorbed and are administered by injection.

A drug containing iron is absorbed in the digestive tract, but this process requires the presence of a sufficient amount of hydrochloric acid in the stomach. Therefore, if a patient is prescribed therapy with iron-containing drugs, but has previously been diagnosed with insufficient production of hydrochloric acid, the patient must simultaneously take medications that increase the acidity of gastric juice.

There is a certain differentiation of substances that increase or decrease the absorption of iron preparations:

• fructose, succinic acid, cysteine ​​and ascorbic acid – increase;
• tannin, phosphoric acid, tetracycline, almagel - reduce.

Naturally, the latter substances should be excluded when taking medications containing iron.

Iron preparations for oral use

Usually, when diagnosing iron deficiency anemia, doctors prescribe medications for oral use. The dosage is set strictly on an individual basis, but there are general recommendations - adults usually need to take 2 mg per kilogram of weight and, as a rule, this amounts to mg of the drug per day, extremely rarely - 300 mg.

If the dose of an iron-containing drug was selected correctly, then after just a few days of therapy the patient begins to feel better; the standard symptoms of iron deficiency anemia practically disappear. In the first 5-7 days of using medications containing iron, the first positive changes appear in the results of laboratory blood tests - the number of reticulocytes begins to increase. And after regular use of iron-containing drugs, a steady increase in hemoglobin is observed.

Note: To restore health, patients will need to take iron supplements orally for quite a long time. Even if hemoglobin levels and general health have already stabilized, you cannot stop therapy - it is necessary to create a reserve of the microelement in the body. But at the moment of “storage” of iron in the body, there is no need to take the prescribed daily dose of medications - the doctor, based on the results of laboratory blood tests, usually adjusts the dosage until it is reduced by half.

Taking iron supplements orally (orally) may be accompanied by the development of side effects:

• nausea and vomiting that occurs regardless of food intake;
• loss of appetite, and in some cases, complete aversion to food;
• pronounced metallic taste in the mouth;
• bowel dysfunction - constipation or diarrhea.

Often, when taking iron-containing drugs orally (orally), a gray coating may appear on the tooth enamel, so doctors recommend either rinsing your mouth thoroughly immediately after taking the medicine, or drinking it through a straw if the product is in liquid form.

• previously diagnosed leukemia – a cancer of the blood;
• diagnosed aplastic and/or hemolytic anemia;
• mandatory use of medications from the group of tetracyclines or antacids;
• diagnosed inflammatory diseases of the kidneys and liver, occurring in a chronic form;
• consuming foods high in calcium, fiber and caffeine.

There are a number of conditional contraindications, that is, iron supplements can be prescribed, but their use must be under constant monitoring of the patient’s condition by medical professionals. Conditional contraindications include:

Doctors do not prescribe iron supplements simultaneously with medications that reduce the acidity of gastric juice, which belong to the group of tetracycline antibiotics. This precaution is necessary to ensure maximum absorption of iron into the body.

Medicines for anemia in tablet form

The following are iron containing medications that are commonly prescribed for treatment of iron deficiency anemia:

1. Actiferrin belongs to the group of combined drugs, available in the form of capsules and drops.
2. Hemofer prolongatum - the main active ingredient is iron, available in tablet form.
3. Tardiferon is a tablet that contains, in addition to iron, ascorbic acid and mucoproteosis.
4. Ferrogradumet is available in the form of coated tablets containing iron sulfate and a plastic matrix.
5. Gemsineral -TD - is available in granules, containing elemental iron, cyanocobalamin and folic acid.
6. Ferronal and Ferrogluconate are 300 mg tablets based on ferrous sulfate.
7. Fenyuls is a combination drug that is available in capsule form. The composition contains riboflavin, ascorbic and folic acids, pyridoxine, fructose, yeast, ferrous sulfate, cyanocobalamin, cysteine.
8. Gyno-tardiferon - tablets in which the dose of elemental iron is 80 mg. The composition contains, in addition to the main active ingredient, folic and ascorbic acids, mucoproteosis.
9. Heferol - capsules containing 100 mg of iron, are made on the basis of fumaric acid.
10. Globiron - gelatin capsules, which contain ferrous sulfate, vitamins B6 and B12, folic acid.
11. Totema – is available in the form of a solution for oral administration (orally) in ampoules of 10 ml. The composition contains sucrose, copper and sodium benzoate/citrate.
12. Ranferon-12 is available in two pharmacological forms: elixir and capsules. In the first case, the iron content in 5 ml is 41 mg, and one capsule contains 100 mg of elemental iron.
13. Sorbifer Durulis - capsules containing 100 mg of iron.

Which of the listed iron medications will be prescribed by a doctor is determined on an individual basis. Therefore, it is strictly not recommended to make a choice on your own.

Iron preparations for parenteral use

We will talk about the injection of iron supplements. You need to know that they are prescribed only under certain circumstances:

• chronic pathologies of the digestive tract, which are accompanied by reduced absorption of iron - for example, pancreatitis (inflammation of the pancreas), malabsorption syndrome, celiac disease, enteritis and others;
• ulcerative colitis of a nonspecific nature;
• intolerance to iron salts or hypersensitivity with allergic manifestations;
• peptic ulcer of the stomach and/or duodenum during periods of exacerbation;
• previous removal of the stomach or part of the small intestine.

Iron preparations in the form of injections are also prescribed if it is necessary to quickly and maximally saturate the patient’s body with iron before scheduled surgical interventions for hemorrhoids, fibroids and other diseases.

Note: It is strictly forbidden to inject more than 100 mg of iron into the body - this dose fully meets the daily requirement for the microelement in question.

If iron-containing drugs are administered to a patient by injection, then side effects can most likely be expected:

• compactions (infiltrates) at the site of administration of the iron preparation;
• phlebitis;
• abscesses at injection sites;
• allergic reaction - sometimes anaphylactic shock immediately develops;
• DIC syndrome;
• overdose of iron in the body.

1. Ferrum Lek - available in ampoules of 2 ml, which is identical to 100 mg of elemental iron, administered intramuscularly. The composition contains iron hydroxide and dextran - they are also the main active ingredients.
2. Venofer - 5 ml ampoules intended for intravenous injection, which is equivalent to 100 mg of iron. The composition contains iron hydroxide sucrose complexes.
3. Ferkoven - contains iron saccharate, carbohydrate solution and cobalt gluconate. Available in 1 ml ampoules, intended for intravenous injection.
4. Jectofer is a combined drug containing an iron-sorbitol-citric acid complex. Available in ampoules of 2 ml, route of administration - intramuscular.
5. Ferrlecite is the main active ingredient in this drug, active sodium – iron gluconate complex. Available as a solution for injection in ampoules of 1 and 5 ml. in the first case, the drug is administered intramuscularly, and 5 ml ampoules are intended for intravenous administration.
6. Ferbitol - the basis of this drug is the iron sorbitol complex, available in 1 ml ampoules for intramuscular administration.

Iron supplements during pregnancy

If iron deficiency anemia was diagnosed in a woman during pregnancy, then all of the above drugs are allowed for use as part of therapy. But prescriptions should only be made by a specialist - often during pregnancy the daily dosage is reduced. Often, during the period of bearing a child, it is necessary to take prophylactic iron supplements - in this case, the dose will also be selected on an individual basis.

• if pregnancy proceeds without any pathologies, then the woman in the third trimester is prescribed iron supplements orally at 30 mg per day;
• if pregnancy proceeds within normal limits, but the woman has a tendency to develop iron deficiency anemia, then prophylaxis is carried out during the week of pregnancy - 30 mg twice a week;
• if iron deficiency anemia is fully diagnosed during pregnancy, then the usual daily dose for a woman is mg, depending on the patient’s weight;
• If iron deficiency anemia was diagnosed in a woman before pregnancy, then she should take iron supplements throughout pregnancy, and during breastfeeding, 200 mg per day.

Iron supplements can and should be taken by people both as a treatment for anemia and as part of preventive measures. But the dosage and duration of the course of treatment should only be determined by a specialist - much depends on the picture of a laboratory blood test, on whether iron deficiency anemia was previously diagnosed, and what pathologies are present in the body.

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category

The information is provided for informational purposes only. Do not self-medicate. At the first sign of disease, consult a doctor. There are contraindications, a doctor's consultation is required. The site may contain content prohibited for viewing by persons under 18 years of age.

Ferrum Lek for injection - official instructions for use

Registration number:

Tradename

International nonproprietary name or generic name

Dosage form

Compound

active substance: Iron (III) in the form of iron (III) hydroxide complex with dextran – 100 mg;

excipient: water for injection.

Note. To adjust the pH value of the solution, use sodium hydroxide in the form of a 6 M solution or concentrated hydrochloric acid.

brown opaque solution with virtually no visible particles

Pharmacological group

Pharmacological properties

The drug contains ferric iron in the form of a complex of ferric hydroxide with dextran. Iron, which is part of the drug, quickly replenishes the lack of this element in the body (in particular, in case of iron deficiency anemia), restores hemoglobin content. When treated with the drug, there is a gradual decrease in both clinical symptoms (weakness, fatigue, dizziness, tachycardia, soreness and dry skin) and laboratory indicators of iron deficiency.

After intramuscular administration of the drug, iron quickly enters the bloodstream: 15% of the dose - after 15 minutes, 44% - after 30 minutes. The biological half-life is 3-4 days.

Iron, in combination with transferrin, is transported to the cells of the body, where it is used for the synthesis of hemoglobin, myoglobin and some enzymes.

The complex of iron (III) hydroxide with dextran is large enough and therefore is not excreted through the kidneys.

Indications

Contraindications

• hypersensitivity to the components of the drug;
• excess iron in the body (hemochromatosis, hemosiderosis);
• anemia not associated with iron deficiency (for example, hemolytic anemia);
• violation of the mechanisms of “utilization” of iron (lead anemia, sideroachrestic anemia, thalassemia);
• first trimester of pregnancy;
• Osler-Rendu-Weber syndrome;
• infectious kidney diseases in the acute stage;
• infectious hepatitis.

Carefully

• bronchial asthma, allergic eczema or other atopic allergies;
• chronic polyarthritis;
• cardiovascular failure;
• low iron binding capacity and/or folic acid deficiency;
• children up to 4 months of age.

Use during pregnancy and lactation

Directions for use and doses

The drug should be administered only in a hospital setting, by specially trained personnel who can recognize the signs of incipient anaphylactic shock, in conditions of availability of resuscitation facilities and the possibility of carrying out a complex of anti-shock measures.

The patient should be observed for at least 30 minutes after each injection.

Before administering the first therapeutic dose of the drug, each patient should be given a test dose of 1/4-1/2 ampoule of Ferrum Lek ® (mg iron) for an adult and half the daily dose for a child. If there are no adverse reactions, the remainder of the daily dose should be administered within 15 minutes.

The dose of Ferrum Lek ® must be selected individually in accordance with the general iron deficiency, which is calculated using the following formula:

Total iron deficiency [mg] = body weight (kg) x (calculated hemoglobin level (g/l) - actual hemoglobin level (g/l)) x 0.24* + deposited iron (mg).

Body weight up to 35 kg: calculated hemoglobin level = 130 g/l and deposited iron = 15 mg/kg body weight.

Body weight over 35 kg: estimated hemoglobin level = 150 g/l and deposited iron = 500 mg.

*Factor 0.24 = 0.0034 x 0.07 x 1000: (Iron content = 0.34%; total blood volume = 7% body weight; factor 1000 = conversion from g/L to mg/L).

Patient body weight: 70 kg

Real hemoglobin concentration: 80 g/l

Total iron deficiency = 70 x () x 0.24 + 500 = 1676 ̴ 1700 mg of iron.

Total number of ampoules of Ferrum Lek ® that must be administered = Total iron deficiency (mg)/100 mg

Table: Calculation of the total number of Ferrum Lek ® ampoules that need to be administered, based on the actual hemoglobin concentration and body weight

If the required dose of Ferrum Lek ® exceeds the maximum daily dose, the drug should be administered in fractional doses (over several days).

If 1-2 weeks after the start of treatment the hematological parameters do not change, an additional examination should be carried out to clarify the diagnosis.

Calculation of the total dose for iron replacement due to blood loss

The required amount of the drug to compensate for post-hemorrhagic iron deficiency is calculated using the following formula: If the amount of lost blood is known: administration of 200 mg intramuscularly (2 ampoules of the drug Ferrum Lek ®) leads to an increase in hemoglobin concentration, which is equivalent to 1 unit of blood (400 ml of blood with a hemoglobin content of 150 g /l).

Iron to be replaced (mg) = number of blood units lost x 200 or

The required number of ampoules of the drug Ferrum Lek ® = the number of lost units of blood x 2.

If the final hemoglobin level is known: use the following formula, taking into account that deposited iron does not need to be replaced.

Iron to be replaced (mg) = body weight (kg) x (estimated hemoglobin level (g/L) - actual hemoglobin level (g/L)) x 0.24.

A patient with a body weight of 60 kg and a hemoglobin deficiency of 10 g/l should be replaced with 150 mg of iron, which is 1 1/2 ampoules of Ferrum Lek ®.

Children: 0.06 ml/kg body weight/day (3 mg iron/kg/day).

Adults: ampoules of the drug Ferrum Lek ® mg iron), depending on the hemoglobin content.

Maximum daily doses

Children: 0.14 ml/kg body weight per day (7 mg iron/kg/day).

Adults: 4 ml (2 ampoules of Ferrum Lek ®) per day.

Side effect

Anaphylactoid reactions, including shortness of breath, urticaria, rash, itching, nausea and trembling, acute severe anaphylactoid reactions (difficulty breathing, circulatory collapse) with death. It is also possible to develop delayed reactions (arthralgia, myalgia, fever).

From the nervous system

Loss of consciousness, convulsions, dizziness, headache, paresthesia, taste perversion.

From the cardiovascular system

Arrhythmia, tachycardia, palpitations, marked decrease/increase in blood pressure.

From the respiratory system

From the digestive system

Dyspeptic symptoms (including nausea, vomiting), abdominal pain, diarrhea.

From the skin and subcutaneous tissue

Itching, urticaria, rash, Quincke's edema, increased sweating.

From the musculoskeletal and connective tissue side

Cramps, myalgia, joint pain.

From the genitourinary system

Chromaturia (change in urine color).

General and administration site disorders

Chills, flushing of the face, chest pain, swollen lymph nodes, increased body temperature, increased fatigue. At the site of intramuscular injection (usually due to a violation of the drug administration technique) - skin staining, bleeding, formation of sterile abscesses, tissue necrosis or atrophy, pain.

Overdose

Treatment is symptomatic; As an antidote, deferoxamine is administered intravenously slowly (15 mg/kg/hour), depending on the severity of the overdose, but not more than 80 mg/kg per day.

Interaction with other drugs

Should not be used concomitantly with oral iron-containing medications.

Concomitant use of ACE inhibitors may increase the systemic effects of parenteral iron preparations.

special instructions

When using the drug Ferrum Lek ®, laboratory tests are required: a general clinical blood test and determination of serum ferritin; it is necessary to exclude impaired iron absorption.

Ferrum Lek ® is intended for intramuscular administration only. Injection technique: it is necessary to insert deeply into the gluteal muscle (a needle 5-6 cm long), as well as shifting the tissue when inserting the needle and squeezing the tissue after removing the needle; injected in turn into the right and left gluteal muscles. An opened ampoule must be used immediately.

Parenterally administered iron supplements can cause hypersensitivity reactions, including anaphylactoid reactions, which can be potentially life-threatening, so appropriate cardiopulmonary resuscitation facilities should be available.

The risk of developing anaphylactoid reactions is increased in patients with a history of allergies (including drug allergies), in patients with a history of severe bronchial asthma, eczema or other allergic manifestations, and in patients with immune-inflammatory diseases (for example, systemic lupus erythematosus, rheumatoid arthritis).

In patients with impaired liver function, the use of parenteral iron should be carried out only after a careful assessment of the benefit/risk ratio. Parenteral administration of iron should be avoided in patients with impaired liver function, where iron overload may be a pathogenetic factor in the development of adverse events (in particular porphyria cutanea tarda). Careful monitoring of iron concentrations is recommended.

The contents of Ferrum Lek ® ampoules should not be mixed with other drugs.

Treatment with oral forms of iron-containing drugs should begin no earlier than 5 days after the last injection of Ferrum Lek ®. If the drug is stored incorrectly, sediment may form; the use of such ampoules is unacceptable.

Release form

5 or 10 ampoules are placed in an open PVC blister or a PVC blister covered with thermo-varnished film.

1 or 2 blisters of 5 ampoules or 1 or 5 blisters of 10 ampoules are placed in a cardboard box along with instructions for use.

Storage conditions

Keep out of the reach of children.

Best before date

Do not use after expiration date.

Conditions for dispensing from pharmacies

Manufacturer

Verovshkova 57, Ljubljana, Slovenia

Consumer complaints should be sent to Sandoz CJSC:

125315, Moscow, Leningradsky Prospekt, 72, bldg. 3.

Ferrum Lek - instructions for use, analogues, reviews, price

Release forms, names and composition

• Syrup for oral administration (glass bottles 100 ml);
• Chewable tablets (packs of 30 and 50 pieces);
• Solution for intramuscular administration (ampoules of 2 ml);
• Solution for intravenous administration (5 ml ampoules).

Solutions for intramuscular and intravenous administration are often called simply ampoules, and syrup - drops.

• Tablets – 100 mg;
• Syrup – 10 mg per 1 ml, that is, 50 mg of iron in one 5 ml measuring spoon;
• Solution for intramuscular administration – 50 mg in 1 ml, that is, 100 mg in one whole ampoule of 2 ml;
• Solution for intravenous administration – 20 mg in 1 ml, that is, 100 mg in one whole ampoule of 5 ml.

Ferrum Lek – INN, photo and recipe

Rp.: Tab. Ferrum Lek No. 30

D.t.s. 1 tablet 2 times a day.

Therapeutic effects of Ferrum Lek

Indications for use

• Latent (hidden) iron deficiency;
• Iron-deficiency anemia;
• Prevention of iron deficiency during pregnancy and lactation, with heavy menstruation, etc.

A solution for intramuscular and intravenous administration Ferrum Lek is indicated for use in cases where it is necessary to quickly replenish iron deficiency in the body, such as:

• Severe anemia after major blood loss;
• Impaired absorption of iron in the intestines (for example, in inflammatory diseases of the intestines, stomach, etc.);
• Ineffectiveness of taking iron supplements orally;
• Inability for any reason to take iron supplements orally.

Ferrum Lek - instructions for use

General provisions

• Prevention of anemia and iron deficiency;
• Treatment of anemia;
• Treatment of latent iron deficiency.

The duration of use and dosage of various dosage forms depend only on the severity of iron deficiency. The duration of the course of treatment does not depend on the form of Ferrum Leka used. That is, to eliminate any condition, you will need to take Ferrum Lek in the form of syrup or tablets, or inject it in the same dosage and for the same period of time. Moreover, the absorption of iron and the rate of normalization of laboratory parameters are the same when using injections, syrup or tablets, so you can choose the type of drug that, for subjective reasons, you like more or is more convenient for use.

Ferrum Lek tablets and syrup – instructions for use

• Children 1 – 12 years old – 25 – 50 mg per day (2.5 – 5 ml of syrup);
• Children and adults over 12 years old – 50–100 mg per day (1 tablet or 5–10 ml of syrup);
• Pregnant women - 100 mg per day (1 tablet or 10 ml of syrup).

Taking Ferrum Leka for prevention continues for the entire period of time as long as a person continues to have insufficient intake of iron from food or its increased consumption (training, intensive growth, pregnancy, etc.). To treat latent anemia, it is necessary to take Ferrum Lek for 1 to 2 months, and ideally until ferritin levels normalize.

• Children from birth to 1 year - 25 - 50 mg per day, which corresponds to 2.5 - 5 ml of syrup (1/2 - 1 measuring spoon);
• Children 1 – 12 years old – 50 – 100 mg per day (5 – 10 ml of syrup or 1 – 2 measuring spoons);
• Children and adults over 12 years old – 100–300 mg per day (1–3 tablets or 10–30 ml of syrup);
• Pregnant women - 200 - 300 mg per day (2 - 3 tablets or 20 - 30 ml of syrup).

The duration of taking Ferrum Lek syrup or tablets for the treatment of anemia is 3 – 5 months (until blood hemoglobin levels normalize). However, after this, it is necessary to continue taking Ferrum Leka in dosages for the treatment of latent anemia (1 tablet or 10 ml of syrup per day) for another 2 - 3 months in order to replenish the depot.

Ferrum Lek injections (injections) – instructions for use

general iron deficiency / 100 mg.

body weight (kg)*(normal hemoglobin level – current hemoglobin level)*0.24 + iron reserves.

In addition to treating anemia, intravenous administration of the solution is carried out to replenish the amount of iron after severe blood loss (more than 400 ml). In this case, the required number of solution ampoules is calculated using special formulas.

one lost unit of blood is equal to 400 ml. For example, a person lost 500 ml of blood, which corresponds to 1.25 units. This means that to replenish iron deficiency he needs 1.25 * 2 = 2.5 ampoules of solution for intravenous administration.

number of ampoules = body weight (kg)*(130 – current hemoglobin level)*0.24/100.

Ferrum Lek - how to administer intramuscularly correctly

Ferrum Lek - how to administer intravenously correctly

• 100 ml – administered over at least 15 minutes;
• 200 ml – 30 minutes;
• 300 ml – 1.5 hours;
• 400 ml – 2.5 hours;
• 500 ml – 3.5 hours.

special instructions

Overdose

To eliminate an overdose, it is necessary to administer deferoxamine intravenously and carry out symptomatic treatment aimed at maintaining the functioning of vital organs and systems.

Interaction with other drugs

Ferrum Lek for children and infants

General provisions

Instructions for Ferrum Lek for children - how to take

• Anemia– 5–10 ml per day until blood hemoglobin levels normalize. After the hemoglobin level has increased to normal, continue taking Ferrum Leka 2.5 - 5 ml per day for 1 - 2 months;
• Hidden iron deficiency– 2.5 – 5 ml per day for 1 – 3 months.

Ferrum Lek during pregnancy

• Anemia– 2 – 3 tablets or 20 – 30 ml of syrup per day until hemoglobin levels normalize. After increasing the hemoglobin concentration to normal, continue to take the drug until delivery, 1 tablet or 10 ml of syrup per day;
• Latent iron deficiency– 1 – 2 tablets or 10 – 20 ml of syrup per day for 1 – 3 months;
• Prevention of anemia– 1 tablet or 10 ml of syrup before birth.

Side effects

With intravenous and intramuscular administration of Ferrum Lek, in addition to the above, the following side effects may also develop:

Side effects of Ferrum Leka usually go away quickly on their own and do not require special treatment.

Contraindications for use

• Non-iron deficiency anemia;
• Impaired absorption and utilization of iron;
• Excess iron in the body (hemochromatosis, hemosiderosis);
• Allergic reactions to the drug.

In addition, injections of solutions are contraindicated in the following conditions:

Ferrum Lek - analogues

• Ferry syrup;
• Maltofer syrup, tablets, drops, solution.

Analogues of Ferrum Lek are preparations containing other chemical iron compounds as active substances. Analogs of Ferrum Leka include the following drugs:

Ferrum Lek (tablets, syrup and injections) – reviews

Reviews about the use of the drug in children

Reviews from pregnant women

Ferrum Lek or Maltofer?

Sorbifer or Ferrum Lek?

Ferrum Lek tablets, syrup and ampoules – price

• Ferrum Lek tablets 30 pieces – 264 – 366 rubles;
• Ferrum Lek tablets 50 pieces – 464 – 528 rubles;
• Ferrum Lek tablets 90 pieces – 803 – 899 rubles;
• Ferrum Lek syrup 100 ml – 135 – 162 rubles;
• Solution for intravenous injection 5 ampoules of 5 ml – 820 – 1045 rubles;
• Solution for intramuscular injections 5 ampoules of 2 ml – 775 – 1078 rubles;
• Solution for intramuscular injections 50 ampoules of 2 ml – 7100 rubles.

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Ferrum Lek - instructions for use, analogs, reviews and release forms (syrup or drops, chewable tablets 100 mg, injections in injection ampoules) medications for the treatment of anemia and iron deficiency in adults, children and pregnancy. Compound

In this article you can read the instructions for use of the drug Ferrum Lek. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Ferrum Lek in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Ferrum Lek in the presence of existing structural analogues. Use for the treatment of anemia and iron deficiency in adults, children (including infants), as well as during pregnancy and breastfeeding. Composition of the drug.

Ferrum Lek is an antianemic drug. Ferrum Lek contains iron in the form of a complex compound of iron (3) hydroxide polymaltosate.

The molecular mass of the complex is so large (about 50 kDa) that its diffusion through the gastrointestinal mucosa is 40 times slower than the diffusion of ferrous iron. The complex is stable and does not release iron ions under physiological conditions. The iron of the multinuclear active zones of the complex is bound into a structure similar to the structure of the natural iron compound - ferritin. Due to this similarity, the iron in this complex is absorbed only through active absorption. Iron-binding proteins located on the surface of the intestinal epithelium absorb iron (3) from the complex through competitive ligand exchange. Absorbed iron is mainly deposited in the liver, where it binds to ferritin. Later in the bone marrow it is incorporated into hemoglobin. Iron complex (3) hydroxide polymaltosate does not have the pro-oxidant properties inherent in iron salts (2).

Iron (3) hydroxide polymaltosate + excipients.

Iron absorption, measured by the level of hemoglobin in red blood cells, is inversely proportional to the dose taken (the higher the dose, the lower the absorption). There is a statistically negative correlation between the degree of iron deficiency and the amount of iron absorbed (the greater the iron deficiency, the better the absorption). Iron is absorbed to the greatest extent in the duodenum and jejunum. The remaining (unabsorbed) iron is excreted in the feces. Its excretion with exfoliating epithelial cells of the gastrointestinal tract and skin, as well as with sweat, bile and urine is approximately 1 mg of iron per day. Women experience additional iron loss during menstruation, which must be taken into account.

After intramuscular administration of the drug, iron quickly enters the bloodstream: 15% of the dose - after 15 minutes, 44% of the dose - after 30 minutes.

• treatment of latent iron deficiency;
• treatment of iron deficiency anemia;
• prevention of iron deficiency during pregnancy;
• conditions in which treatment with oral iron preparations is ineffective or impracticable (for the injection form).

Syrup (sometimes mistakenly called drops).

Chewable tablets 100 mg.

Solution for intramuscular administration (injections in injection ampoules).

Instructions for use and dosage regimen

Doses and duration of treatment depend on the degree of iron deficiency.

The syrup can be mixed with fruit or vegetable juices or added to baby food. The measuring spoon included in the package is used for precise dosing of syrup.

For iron deficiency anemia, the duration of treatment is about 3-5 months. After normalization of hemoglobin levels, you should continue taking the drug for several more weeks to replenish iron reserves in the body.

Children under 1 year of age are prescribed 2.5-5 ml (1/2-1 scoop) of syrup per day.

Children aged 1 to 12 years ml (1-2 scoops) of syrup per day.

For children over 12 years of age, adults and mothers breastfeeding, chewable tablets or ml (2-6 scoops) of syrup per day.

Pregnant women are prescribed 2-3 chewable tablets or ml (4-6 scoops) of syrup until hemoglobin levels normalize. After this, you should continue to take 1 chewable tablet or 10 ml (2 scoops) of syrup per day, at least until the end of pregnancy to replenish iron reserves in the body.

For latent iron deficiency, the duration of treatment is about 1-2 months.

Children aged 1 to 12 years - 2.5-5 ml (1/2-1 measuring spoon) of syrup per day.

Children over 12 years old, adults and mothers breastfeeding - 1 chewable tablet or 5-10 ml (1-2 measuring spoons) of syrup per day.

Pregnant women are prescribed 1 chewable tablet or 5-10 ml (1-2 scoops) of syrup per day.

The drug in solution form can only be administered intramuscularly. Intravenous administration of the drug is not allowed!

Before administering the first therapeutic dose, each patient should be given a test dose of 1/4-1/2 ampoule (25-50 mg of iron) for adults and 1/2 the daily dose for children. If there are no adverse reactions within 15 minutes after administration, the remainder of the initial daily dose is administered.

Doses of the drug Ferrum Lek are selected individually in accordance with the general iron deficiency, calculated using the following formula:

Total iron deficiency (mg) = body weight (kg) × (estimated Hb level (g/l) - detected Hb (g/l)) × 0.24 + deposited iron (mg).

For body weight up to 35 kg: calculated Hb level = 130 g/l, deposited iron = 15 mg/kg body weight.

With a body weight of more than 35 kg: calculated Hb level = 150 g/l, deposited iron = 500 mg.

Factor 0.24 = 0.0034 × 0.07 × 1000 (iron content in Hb = 0.34%, total blood volume = 7% of body weight, factor conversion from g to mg).

Calculation of the total dosage for iron replacement due to blood loss

With a known amount of lost blood, intramuscular administration of 200 mg of iron (2 ampoules) leads to an increase in hemoglobin equivalent to 1 blood unit (400 ml with a hemoglobin content of 150 g/l).

Amount of iron to be replaced (mg) = number of blood units lost x 200 or number of ampoules required = number of blood units lost x 2.

When the final hemoglobin level is known, the above formula is used, taking into account the fact that the deposited iron does not need to be replenished.

Amount of iron to be replaced (mg) = body weight (kg) × (estimated Hb level (g/L) - detected Hb level (g/L)) x 0.24

Usual doses of Ferrum Lek

Adults and elderly patients are prescribed mg (1-2 ampoules) depending on the level of hemoglobin; children - 3 mg/kg per day (0.06 ml/kg body weight per day).

The maximum daily dose for adults is mg (2 ampoules); for children - 7 mg/kg per day (0.14 ml/kg body weight per day).

Rules for administering the drug

The drug is administered deeply intramuscularly alternately into the right and left buttocks.

In order to reduce pain and avoid skin staining, the following rules should be followed:

the drug should be injected into the upper outer quadrant of the buttock using a needle 5-6 cm long;

before injection, after disinfection of the skin, the subcutaneous tissues should be moved down 2 cm to prevent subsequent leakage of the drug;

after administration of the drug, the subcutaneous tissues should be released, and the injection site should be pressed and held in this position for 1 minute.

Before using the solution for intramuscular injection, ampoules should be carefully inspected. Only ampoules containing a homogeneous solution without sediment should be used. The solution for intramuscular injection should be used immediately after opening the ampoule.

• feeling of heaviness;
• feeling of fullness and pressure in the epigastric region;
• nausea;
• constipation;
• diarrhea;
• There is a dark coloration of the stool (black stool), which is due to the excretion of unabsorbed iron and has no clinical significance.

• excess iron in the body (for example, hemochromatosis);
• disorders of iron utilization (for example, anemia caused by lead intoxication, sideroachrestic anemia);
• anemia not associated with iron deficiency (for example, hemolytic anemia, megaloblastic anemia caused by cyanocobalamin deficiency);
• Osler-Rendu-Weber syndrome;
• infectious kidney diseases in the acute stage;
• uncontrolled hyperparathyroidism;
• decompensated cirrhosis of the liver;
• infectious hepatitis;
• 1st trimester of pregnancy;
• hypersensitivity to the components of the drug.

Use during pregnancy and breastfeeding

During controlled studies, when using the drug in the 2nd and 3rd trimesters of pregnancy, no negative effects on the mother or fetus were observed. No harmful effects on the fetus were detected when using the drug in the 1st trimester of pregnancy.

It can be used according to indications and in doses taking into account the patient’s age. For children under 12 years of age, due to the need to prescribe the drug in low doses, it is preferable to use it in syrup form.

Chewable tablets and syrup do not stain tooth enamel.

The drug in injection form should be used only in a hospital setting.

When prescribing Ferrum Lek to patients with diabetes mellitus, it should be taken into account that 1 chewable tablet and 1 ml of syrup contain 0.04 XE.

In cases of anemia caused by an infectious or malignant disease, iron accumulates in the reticuloendothelial system, from which it is mobilized and utilized only after the underlying disease has been cured.

Taking the drug does not affect the results of stool tests for occult blood (selectively for hemoglobin).

Impact on the ability to drive vehicles and operate machinery

Does not affect the ability to concentrate.

Ferrum Lek for intramuscular injection should not be used simultaneously with iron preparations for oral administration.

Concomitant use of Ferrum Lek with ACE inhibitors may increase the systemic effects of parenteral iron preparations.

Analogues of the drug Ferrum Lek

Structural analogues of the active substance:

Analogs by pharmacological group (drugs for the treatment of iron deficiency):

• Actiferrin compositum;
• Aloe syrup with iron;
• Biovital elixir;
• Biofer;
• Venofer;
• Vitrum Superstress;
• Vitrum Circus;
• Hemofer;
• Gyno Tardiferon;
• Likferr 100;
• Maltofer;
• Maltofer Fall;
• Multi tabs Active;
• Pikovit Complex;
• Sorbifer Durules;
• Merz special dragee;
• Stress formula with iron;
• Supradin Kids Junior;
• Tardiferon;
• Totema;
• Ferlatum;
• Ferretab comp.;
• Ferrinate;
• Ferro Folgamma;
• Ferrogrademet;
• Ferronal;
• Ferrum Lek;
• Heferol;
• Enfamil with iron.