Venofer solution 20mg/ml 5ml #5

User manual for Venofer

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Composition

In one milliliter of the preparation Venofer contains: 540 mg of iron (III) hydroxide in the form of a sucrose complex, water purified for injection, sodium hydroxide.

Form of issue

The drug is released as a solution in ampoules of 2 ml, 5 ampoules in a contour pack, 1 package in a cardboard bundle.
The solution is homogeneous, brown.

pharmachologic effect

Anti-anemic.

Pharmacodynamics and pharmacokinetics

The active substance is a multinuclear center of iron atoms, with a valence of 3, surrounded from the outside by a large number of non-covalently bound sucrose molecules. The complex turns out to be quite heavy, about 43 kD, which does not allow it to be quickly excreted from the body with the help of kidneys. The complex is fairly stable, it is not inclined to release iron ions. The iron molecules in the complex are similar to the natural constituent of hemoglobin by ferritin. This complex was developed to provide controlled development of iron, its transport and preservation of ferritin and transferrin in the body.
After the first injection of the drug, the maximum concentration of iron in the blood is reached 10 minutes after the injection.
The half-life is 6 hours. The level of iron distribution in liquid media is rather low.
Iron sugate is unstable, so about 31 mg of iron is transported per day.
In the first 4 hours, about 5% of iron is excreted through the kidneys. After a day, the level of iron in the blood becomes the same, about 75% of sucrose is excreted from the plasma.

Indications for use

The Venofer may designate:
    to quickly restore the level of iron in the body with iron deficiency anemia;
    Persons who do not tolerate and are not able to take iron-containing drugs in the form of tablets;
    if there are injuries, perforations or gastrointestinal diseases, at which the reception of a tablet form is not possible.

Contraindications

The medicine is not prescribed:
    with other types of anemia (hemolytic, megaloblastic, with erythropoiesis or bone marrow hypoplasia);
    if the patient is allergic to any of the components of the remedy;
    in the first trimester of pregnancy;
    with hemosiderosis, hemochromatosis, iron supersaturation;
    when violations of the processes of iron utilization in the body (lead poisoning, thalassemia, sideroachrestic anemia, cutaneous porphyria).

Side effects

The most common side effects of taking the remedy: dysgeusia, chills, lower blood pressure, nausea, redness and inflammation at the injection site. Very rarely anaphylactoid reactions can develop.
Also there were:
    the taste of metal in the mouth, dizziness and headache;
    Myalgia, muscle spasms, vomiting, nausea, diarrhea;
    urticaria and rashes on the skin, erythema;
    tachycardia, dyspnea, bradycardia, palpitations, decreased blood pressure, circulatory collapse, bronchospasm;
    fever, hot flashes, heaviness in the chest, sweating.
Rarely there were paresthesias, arthralgia, arterial hypertension, loss or confusion, back pain, swelling of the joints, itching on the skin, asthenia, a feeling of heat, angioedema and severe fatigue of the patient.
If during the introduction of the drug there is an accidental leakage of the product under the skin, there may be: pain and inflammation at the site of the injection, necrosis of the tissues, the skin will acquire a brown shade.

Instructions for using Venofer (Method and dosage)

The medicine can be administered exclusively intravenously, directly into a vein or drip.
Before you make the first injection, you should enter a test dose. It is necessary to keep a reanimation kit ready. If no undesirable reactions have occurred within 15 minutes, you can enter the remainder of the solution.
The test dose for adults and individuals weighing more than 14 kg is 20 mg iron, for children 1.5 mg per kg body weight.
Typically, the dosage of the drug for adults is 5-10 ml of Venofer, from 1 to 3 times in 7 days.
For children from three years, appoint no more than 0.15 mg of the drug for 1 kg of weight, 1-3 times in 7 days.

Instructions for the use of Venofer, intravenous drip of the agent

This type of injection is safer and more effective, the probability of getting the solution under the skin decreases, the risk of developing arterial hypotension decreases.
Before the infusion, the drug is diluted in the sodium chloride solution (0.9%) in a ratio of 1 to 20. So 1 ml of the drug is diluted in 20 ml of sodium chloride, 5 ml - in 100 ml, 25 ml - in 500 ml.
The rate of introduction of the solution is determined according to the scheme:
    100 mg of iron - 15 minutes;
    200 mg - 30 minutes;
    inject 300 mg of iron is recommended for 90 minutes;
    400 mg - 2.5 hours;
    500 mg - 3.5 hours.
The maximum allowable single dose is 7 mg of iron per kilogram of the patient's weight. Enter it should be no less than 3.5 hours.

Intravenous Injection

The injection is performed by a non-diluted drug at a rate of 1 ml per minute, but the maximum amount of the drug is 10 ml per shot.
With this method of input, it is also necessary to make a test injection. For adults - 1 ml, for children - 1.5 mg of iron per kg, for a minute.
Calculation of dosage is made by the formula: body weight (kg) x Hb (g / l) x 0.24 + deposited iron (mg), where
    Hb (at weight less than 35 kg) = 130 grams per liter; deposited iron = 15 mg per kg;
    with a weight of more than 35 mg, Hb = 150 g / l, deposited iron = 500 mg.
If the therapeutic dose is higher than the calculated daily intake, then the drug should be taken multiple.
Improvements in blood and patient status should occur 7 to 14 days after initiation of treatment. If this did not happen, then the diagnosis should be reviewed.

Calculation of dosage after large blood loss or blood donation (donor)

If you know how much blood was lost, then the required dosage is calculated as the number of units of lost blood multiplied by 200. If Hb was lowered, then the same formula is used, provided that you do not need to replenish the iron depot.

Overdose

As a result of an overdose, symptoms of an acute iron overload - hemosiderosis - appear.
As therapy, the use of symptomatic agents, substances that bind chelates (deferoxamine) intravenously is indicated.

Interaction

It is not recommended to combine Venofer with iron-containing tablets, iron absorption may decrease. Treatment with this kind of drugs should be carried out no sooner than 5 days after the last injection.

Storage conditions

The drug should not be frozen and stored at a temperature above 27 degrees. Keep in original packaging.
Shelf life - 36 months.
Use the solution is recommended immediately after opening the ampoule.
After mixing the substance with fiz. solution it can be stored at a temperature of 18-20 degrees not more than 12 hours.

special instructions

You can take the drug only to patients who have been diagnosed with the results of the tests.
It is not necessary to use expired ampoules, if the medicine has precipitated, clouded, the ampoule is damaged.
Due to the high risk of developing anaphylactoid reactions in patients with polyvalent allergies, folic acid deficiency, bronchial asthma and eczema, this group of patients should be treated with venofert injections carefully.
It is recommended that the dosage and rate of administration of the drug be respected, in order to avoid a strong reduction in pressure in patients or an increase in side effects.

In pregnancy and lactation

The medicine can not be used in the first trimester of pregnancy.
During animal studies, there was no adverse effect on the development of the fetus, embryo, delivery, or postnatal development.
Before prescribing a pregnant woman, the risk / benefit ratio should be closely related.
Iron sugars do not penetrate into breast milk. During breastfeeding, the medication can be taken only after consulting a doctor.

Reviews about Venofer

There are very few reviews about the product. The drug is effective enough in the fight against iron deficiency anemia in a hospital. Of the adverse reactions, most often complain of puffiness in the legs, nausea and dizziness, which pass some time after the injection.