The iron fumarate (Ferri fumaras)

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.02   The iron fumarate

Pharmacodynamics:

Anti-anemic agent.Iron is a microelement that stimulates erythropoiesis. When iron is used in the form of salts, its deficiency in the body is rapidly replenished, which leads to a gradual regression of clinical (weakness, fatigue, dizziness, tachycardia, tenderness and dry skin) and laboratory symptoms of anemia.

Pharmacokinetics:

Characterized by high bioavailability, since ferrous iron (ferrous) is easily absorbed, and fumaric acid enhances its absorption. Cmax is achieved 4 hours after admission. Half-life - about 12 hours. With iron deficiency anemia, taking 350 mg once a day provides the minimum effective dose of iron. In this case, the level of hemoglobin (and iron) in the blood serum increases, the number of red blood cells increases; All hematologic and clinical symptoms of anemia regress after 3-4 weeks of treatment.

Indications:

Iron deficiency anemia: posthemorrhagic (menorrhagia, chronic blood loss in the digestive tract and others); increased need for iron (pregnancy, lactation, a period of intensive growth and puberty, especially in girls) - treatment and prevention; Inadequate intake of iron from food or impaired absorption (chronic diarrhea,helminthic invasion); iron-deficiency anemia in the elderly and elderly (as a trial treatment).

ICD-10

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

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

III.D50-D53.D50.0   Iron deficiency anemia secondary due to loss of blood (chronic)

III.D50-D53.D50   Iron-deficiency anemia

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

Contraindications:

Hemolytic (hereditary and acquired) and other anemia, not associated with iron deficiency, hemochromatosis, gastric and duodenal ulcer in the exacerbation phase, inflammatory bowel disease (Crohn's disease, ulcerative colitis).

Contraindications for parenteral use: active hepatitis, severe liver dysfunction, acute glomerulonephritis, active pyelonephritis, severe renal dysfunction.

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 - for solutions containing ethanol), bronchial asthma, hepatic or renal insufficiency, rheumatoid arthritis, blood transfusion.

Pregnancy and lactation:

The category of FDA recommendations is not defined. There are no negative effects on the fetus (per child) when the drug is used during pregnancy and breastfeeding. There is no information on the penetration into breast milk.

Possible application for indications.

Dosing and Administration:

Inside, on an empty stomach, 30 minutes before breakfast, adults and children over 12 years - 1 capsule per day or 10 ml of suspension 3-4 times a day for 6-12 weeks. With insufficient effect, the dose can be increased - 1 capsule 2 times a day. Reception continues and after the normalization of the picture of blood. The duration of the saturation course of therapy is not less than 1-1.5 months. Children under 2 years of 5 ml of suspension once a day, 2-6 years - 2 times a day, over 6 years - 3-4 times a day. Suspension is taken in the intervals between meals, washed down with water (but not tea).

Side effects:

Anorexia, metallic taste in the mouth, nausea, vomiting, obstipation, diarrhea.

Overdose:

Symptoms: nausea, epigastric pain, vomiting with blood, diarrhea, dizziness, weakness, confusion, acrocyanosis, lowering of blood pressure, weak pulse.

Treatment: stimulation of vomiting, gastric lavage (at an early stage), administration of milk with egg white; carrying out a specific (prescription inside and parenterally deferoxamine) and symptomatic therapy.

Interaction:

Specific antidote - deferoxamine.

Antacid agents, calcium preparations, ethidron, drugs that reduce the acidity of gastric juice (including histamine H blockers2-receptors, M-cholinolytics, proton pump inhibitors, antacids, preparations containing carbonates, bicarbonates, phosphates, oxalates), pancreatin, pancreolipase reduce absorption (iron preparations should be taken 1 hour before or 2 hours after their use).

Ascorbic acid increases absorption.

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

Large doses of iron drugs reduce intestinal absorption of zinc preparations (the latter is recommended to be taken 2 hours after taking iron preparations). Ethanol increases absorption and the risk of toxic complications.

Pharmaceutically incompatible with other medicines.

With the simultaneous administration of glucocorticosteroids, the stimulation of erythropoiesis is possible.

Special instructions:

Therapy should be performed prior to the normalization of the blood picture. The benzidine test gives a false positive result.

Regular monitoring of hematological parameters is necessary: ​​a sign of the effectiveness of treatment is an increase in the number of reticulocytes on the 7th-10th day from its beginning and normalization of the hemoglobin level in 3-4 (sometimes 6-8) weeks. If the tolerance is poor, the dose reduction, taking the drug during meals, as well as a short break in treatment are indicated.

Capsules and oral solution do not have pharmacokinetic differences. Oral care prevents tooth enamel staining.

Instructions
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