Iron gluconate (Ferri gluconas)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Macro and microelements

Stimulators of hematopoiesis

Included in the formulation
АТХ:

B.03.A.A.03   Iron gluconate

Pharmacodynamics:

Pharmacological action - anti-anemic.

It replenishes iron deficiency in the body and stimulates the synthesis of hemoglobin in iron deficiency anemia. It is well absorbed and absorbed. When binding to plasma proteins, transferrin is formed, which enters the red bone marrow and other tissues. It accumulates in the cells of the liver, reticuloendothelial system, muscle tissue.

Pharmacokinetics:

Ingestion iron gluconate has a high degree of absorption and bioavailability (because of the low ionization constant). It is absorbed mainly in the duodenum and the proximal part of the jejunum. The connection with plasma proteins is 90% or more (mainly with hemoglobin). Deposited in the form of ferritin or hemosiderin in hepatocytes and reticuloendothelial system, a small amount - in the form of myoglobin in the muscles.

Norms of physiological loss of iron: for men and women in postmenopause - 1 mg per day, for women in premenopause - 1.5-2 mg per day.

Indications:

Treatment and prevention of iron deficiency anemia of various genesis in adults and children; violations of absorption of iron from the digestive tract.

Conditions accompanied by an increased body requirement in iron (pregnancy, lactation, a period of active growth,donation); inadequate intake of iron from food.

ICD-10

IV.E50-E64.E61.1   Insufficiency of iron

XV.O95-O99.O99.0   Anemia complicating pregnancy, childbirth and the puerperium

III.D50-D53.D50.9   Iron deficiency anemia, unspecified

III.D50-D53.D50   Iron-deficiency anemia

Contraindications:

Hypersensitivity.

Hemochromatosis, hemosiderosis, late porphyria of the skin, chronic hemolysis, sideroblastic anemia (including lead anemia), thalassemia; all kinds of anemia, not related to iron deficiency; hypersensitivity to iron preparations.

Hemolytic (hereditary, acquired) and other anemia, not associated with iron deficiency.

Carefully:

With caution apply for peptic ulcer of stomach and duodenum, inflammatory bowel diseases (enteritis, diverticulitis, ulcerative colitis, Crohn's disease), alcoholism (active or in remission), allergic diseases, bronchial asthma, hepatitis, hepatic or renal insufficiency, rheumatoid arthritis , blood transfusion.

Pregnancy and lactation:

The category of FDA recommendations is not defined. Adequate and well-controlled studies in humans and animals do notwere conducted. When receiving therapeutic doses, no problems were found.

There is no information on the penetration into breast milk. When taken in therapeutic doses, side effects are not documented.

It is possible to use iron gluconate during pregnancy and lactation according to indications.

Dosing and Administration:

Iron deficiency anemia in pregnant women (treatment). Assign 60 mg per day of elemental iron, the course of treatment - 8 weeks. Admission in a dose of 60 mg of elemental iron 3 times a day inferior to intravenous injection iron (III) hydroxide of sucrose complex.

Iron deficiency anemia of the postpartum period is 75-80 mg per day, the course of treatment is 30 days.

Anemia (hemodialysis) - intravenous; course of treatment - 26 months (more effective intake of iron drugs inside and placebo).

Donation - 20-40 mg per day of elemental iron (compensates for loss of iron, but does not restore the concentration of iron in the depot in men).

Inadequate intake of iron from food or a violation of its absorption (chronic diarrhea, achlorhydria, gastrectomy, celiac disease, Crohn's disease, enteritis, malabsorption syndrome) - inside (1 hour before or 2 hours after eating), adults - 1,2-1 , 8 g per day in 2-3 doses; for prophylaxis - 0.6 g per day in 2 divided doses.Therapeutic dose for children is 0.3-0.9 g per day, the preventive dose is 0.3 g per day. The duration of treatment should not exceed 6 months.

Iron deficiency anemia of the elderly - preferably the appointment of low doses (15-50 mg per day of elemental iron as an iron solution of gluconate). The effect on serum iron content is comparable in efficacy for high and low doses.

Side effects:

From the cardiovascular system: hyperemia of the face, a feeling of pressure behind the sternum; rarely - transient decrease in blood pressure, tachycardia.

From the digestive system: nausea; rarely - vomiting, diarrhea, constipation, irritation of the gastrointestinal tract, spasms and abdominal pain. The risk of developing nausea and vomiting when ingestion is higher than with parenteral administration.

From the side of the central nervous system: dizziness, headache, toothache, mild weakness, malaise; rarely - back pain; Encephalopathy with convulsive syndrome is described.

Allergic reactions: rash, itching; in isolated cases - anaphylactic shock.

Contact irritation (pain in the throat, chest), especially when swallowing, irritation in the areas of ulcerative lesions (with prolonged passage of the drug through the gastrointestinal tract).

Overdose:

Excessive fatigue or weakness, hyperthermia, paresthesia, pallor, cold sticky sweat, acrocyanosis, abdominal pain, vomiting and diarrhea with blood, mucosal necrosis of the gastrointestinal tract, weak pulse, lethargy, lowering blood pressure, palpitations, convulsive seizures, coma, peripheral circulatory collapse (within 30 minutes after administration), metabolic acidosis, convulsions, fever, leukocytosis, coma (within 12-24 hours); acute renal and hepatic necrosis (after 2-4 days).

Treatment: gastric lavage. When severe poisoning - intravenous slow administration of deferoxamine: children - at 15 mg / h, adults - 5 mg / kg per hour (up to 80 mg / kg per day). With easy poisoning: children - intramuscular injection of 1 g every 4-6 hours, adults - 50 mg / kg (up to 4 grams per day); symptomatic therapy. Hemodialysis for iron removal is ineffective, but can be used to accelerate elimination complex deferoxamine with iron, as well as with oligo- or anuria. It is possible to use peritoneal dialysis.

Interaction:

It interferes with the absorption of tetracyclines (they should be prescribed at intervals of at least two hours before or after taking iron gluconate).

Coffee, tea, vegetables, milk, cereals, egg yolk, antacids reduce the absorption of iron gluconate (iron preparations should be taken 1 hour before or 2 hours after they are consumed).

Under the influence of ascorbic acid, trivalent iron is converted into bivalent iron, which improves its absorption.

With the simultaneous use of iron gluconate with tetracyclines, D-penicillamine, as well as with antacids containing salts of aluminum, magnesium, a decrease in iron absorption occurs.

With the simultaneous use of calcium preparations, etidron, drugs that reduce the acidity of gastric juice (including cimetidine, preparations containing carbonates, bicarbonates, phosphates, oxalates), pancreatin, pancreolipase reduce the absorption of iron gluconate (iron preparations should be taken 1 hour before or 2 hours after their use).

Iron gluconate reduces the absorption of fluoroquinolones, penicillamine, tetracyclines (they are recommended to be taken 2 hours before or 2 hours after taking iron preparations).

The intake of high doses of iron preparations reduces the intestinal absorption of zinc preparations (the latter is recommended to be taken 2 hours after taking the drugsgland).

Ethanol increases the absorption of iron gluconate and the risk of toxic complications.

A specific antidote for iron gluconate is deferoxamine.

Iron gluconate is pharmaceutically incompatible with other drugs.

Special instructions:

The combination of an iron salt and folic acid more preferably in iron deficiency anemia with a deficiency of folic acid.

Iron preparations stain feces in a dark color and sometimes can mask hidden bleeding.

The form of controlled-release iron preparations is comparable to the conventional tablet form.

Does not affect the anthropometric parameters (height, body weight) of children.

Solution for oral administration is more effective than other liquid (iron protein succinate) and solid forms containing iron (iron sulphate).

Instructions
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