Clinical and pharmacological group: & nbsp

Macro and microelements

Stimulators of hematopoiesis

Included in the formulation
  • Actyferrin
    capsules inwards 
  • АТХ:

    B.03.A.E.10   Iron preparations in combination with other drugs

    Pharmacodynamics:

    The preparation of iron. Iron is the most important microelement of the body. As coenzyme of cytochrome oxidase, catalase and peroxidase, as well as a constituent of hemoglobin, myoglobin and cytochromes, it is involved in a variety of metabolic processes, stimulates erythropoiesis.

    Included in the preparation of α-amino acid serine promotes more efficient absorption of iron and its entry into the systemic bloodstream, which leads to a rapid restoration of the normal iron content in the body. This ensures a better tolerance of the drug and allows to reduce the necessary dose of iron.

    The daily requirement for iron in adults is 1-2 mg, in pregnant women - 2-5 mg, in children under 7 years - 0.5-1.5 mg. On average, 10% is absorbed, therefore, in order to meet the need for iron, the intake dose should exceed the daily requirement by 10 times.

    Pharmacokinetics:

    Suction

    After oral administration, about 10-15% of ferrous iron is absorbed from the duodenum and jejunum. Absorption of iron is also possible through the mechanism of passive diffusion.Absorption of iron significantly increases with its deficiency and with increased erythropoiesis. In patients with a low hemoglobin value and a depleted iron depot, absorption can increase to 50-60% and decrease with normalization of these parameters. Cmax The iron is reached in 2-4 hours after administration.

    Distribution

    In the blood, iron binds to transferrin and in the trivalent form is transported to the sites of hemopoiesis and to specific depots. After binding of iron with apoferritin it is deposited in the liver, spleen and bone marrow in the form of ferritin. Iron penetrates the placental barrier, the minimum amounts are excreted in breast milk.

    Indications:

    Treatment of iron deficiency.

    XV.O20-O29.O25   Malnutrition in pregnancy

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

    IV.E50-E64.E53.9   Insufficiency of B vitamins, unspecified

    III.D50-D53.D50   Iron-deficiency anemia

    Contraindications:

    - violations of iron absorption (sideroahrestic anemia, lead anemia, thalassemia);

    - increased iron content in the body (hemochromatosis, hemolytic anemia);

    - Anemia, not associated with iron deficiency;

    - hereditary intolerance of fructose or galactose, deficiency of lactase, glucose-galactose malabsorption, deficiency of sucrose-isomaltase;

    - Hypersensitivity to the components of the drug.

    Carefully:

    In patients with inflammation and ulcerative lesions of the gastrointestinal mucosa, the relationship between the benefits of treatment and the risk of exacerbations of gastrointestinal diseases should be evaluated against the background of iron therapy. The drug may cause an exacerbation of ulcerative and inflammatory bowel diseases.

    Be wary appoint patients with hepatitis, liver failure, kidney failure. Hepatic or renal insufficiency increases the risk of cumulation of iron.

    Pregnancy and lactation:

    Use during pregnancy and during lactation is possible if the potential benefit of therapy for the mother exceeds the possible risk to the fetus or infant.

    Dosing and Administration:

    The daily dose is set at the rate of 5 drops per 1 kg of body weight, the frequency of reception is 2-3 times a day.

    Breast children: the average dose is 10-15 drops 3 times a day.

    Children of preschool age: the average dose is 25-35 drops 3 times a day.

    Children of school age: the average dose - 50 drops 3 times a day.

    To open the bottle, press the cap down and simultaneously turn in the direction of the arrow. After applying the medicine, the cap should be installed and tightened (prevents access for children).

    The iron deficiency can be approximately calculated by the formula:

    iron (mg) = body weight (kg) × 3.5 × (16 - amount of hemoglobin (g%))

    Side effects:

    Allergic reactions: rarely - cutaneous manifestations.

    From the digestive system: very rarely - constipation, diarrhea, abdominal pain, nausea, vomiting.

    Gastrointestinal disorders can be prevented by gradually increasing the dose at the beginning of treatment or by lowering the dose during treatment.

    Overdose:

    Children have a high risk of intoxication with iron preparations, life-threatening conditions can occur with the intake of 1 g of iron sulfate. Therefore, iron preparations should be stored out of the reach of children

    Symptoms: with a random intake of the drug in very high doses, weakness, fatigue, paresthesia, pallor of the skin, cold sticky sweat, lowering of blood pressure, palpitations, acrocyanosis, abdominal pain,diarrhea with an admixture of blood, cyanosis, confusion, weak pulse, hyperthermia, lethargy, convulsive seizures, symptoms of hyperventilation, coma. Signs of peripheral vascular collapse appear 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: before the specific therapy should be taken to remove from the stomach is not yet absorbed drug (gastric lavage), milk intake, raw eggs. Specific therapy is carried out by the administration of deferoxamine inward and parenterally. In acute poisoning to bind iron, not yet absorbed from the gastrointestinal tract, inwardly 5-10 g deferoxamine (dissolve the contents of 10-20 ampoules in drinking water). To remove absorbed iron deferoxamine administered intramuscularly slowly, to children - 15 mg / h, to adults - 5 mg / kg / h (up to 80 mg / kg per day); with mild poisoning - intramuscularly to children 1 g every 4-6 h, adults - 50 mg / kg (up to 4 g per day). In severe cases, accompanied by the development of shock, intravenously administered drip in a dose of 1 g and conduct symptomatic therapy.

    Hemodialysis is ineffective for excretion of iron, but can be used to accelerate the excretion of iron-deferoxamine complex, and can also be prescribed for oligo- and anuria. Possible peritoneal dialysis.

    In severe intoxication appoint unitiol (sodium dimercaptopropanesulfonate) parenterally. Because of the possible formation of neurotoxic complexes, unitiol should be used with caution.

    Interaction:

    Caution should be used iron preparations with dietary products and supplements containing iron salts (possible risk of overdose).

    Specific antidote - deferoxamine.

    At simultaneous application of an iron salt reduce absorption of such preparations as tetracyclines, inhibitors of gyrase (for example, ciprofloxacin, levofloxacin, norfloxacin, ofloxacin), penicillamine, levodopa, carbidopa and methyldopa.

    In patients receiving substitution therapy with levothyroxine sodium, iron salts reduce its absorption.

    Iron preparations in high doses reduce the renal absorption of zinc preparations (the latter is recommended to be taken 2 hours after taking iron preparations).

    Absorption of iron decreases with the simultaneous administration of colestyramine, antacids (containing aluminum, magnesium, calcium, bismuth) and additives containing calcium and magnesium.

    Simultaneous use of iron salts and non-steroidal anti-inflammatory drugs can enhance the damaging effect of iron on the mucosa of the gastrointestinal tract.

    In children with simultaneous use of iron reduces the effectiveness of vitamin E.

    All of the above funds should be taken 3-4 hours before or after taking the drug. If it is necessary to prescribe drugs simultaneously, systematic clinical and laboratory testing should be carried out.

    Tea, coffee, vegetable food containing iron-chelating substances (such as phosphates, phytates, oxalates), milk, eggs reduce iron absorption.

    Ascorbic acid and citric acid increase the absorption of iron.

    Ethanol increases iron absorption and the risk of toxic complications.

    Special instructions:

    When taking iron-containing preparations, it is possible to stain the feces in a dark (black) color, which has no clinical significance.

    When applying the drug, a persistent darkening of the teeth is possible.

    Instructions
    Up