Ferrum Lek tabs 100mg #50

Ferrum Lek instruction for use

Reed more about Ferrum Lek

Composition

1 chewable tablet consists of such components as:
    polymataltate of trivalent iron hydroxide - 400 mg (the mass part is indicated in terms of pure iron - 100 mg);
    dextrates - 730 mg;
    macrogol 6000 - 37 mg;
    talcum - 21 mg;
    aspartame - 1.5 mg;
    chocolate flavor - 0.6 mg.

Form of issue

Iron preparations are very popular in the pharmaceutical market, since the problem of the deficiency of this microelement is extremely widespread, because Ferrum Lek is supplied to pharmacy kiosks in several pharmaceutical forms:
    Tablets Ferrum Lek for chewing 100 mg - flat tablets of dark brown color (possible light brown inclusions) of round shape with characteristic facet on one of the surfaces. Fastened to 10 pieces in blisters of aluminum or polyethylene foil. The cardboard package contains 3 or 5 strips.

pharmachologic effect

Ferrum Lek (International non-proprietary name or INN - Iron [III] hydroxide polymaltosate) is a pharmaceutical preparation, the main active ingredient of which is the complex iron salt. This microelement is an important component of such protein structures as hemoglobin and myoglobin. Its physiological role is in the transport of oxygen, since hemoglobin is a key part of the erythrocyte (another name for cells is red blood cells, they are responsible for transferring oxygen and carbon dioxide in the respiratory cycle). In the process of cellular respiration, iron promotes the transport of electrons through the membrane in the oxidative metabolism that occurs during the growth and proliferation of young emerging tissues.
Also, iron is an integral part of many enzymes normally found in the human body. In the composition of biological catalysts, the microelement accelerates the course of vital oxidation and hydroxylation processes at the subcellular level. Due to these chemical reactions, most metabolic pathways proceed in such a way as to maintain the further normal functioning of the living organism.

Pharmacodynamics and pharmacokinetics

Chewable tablets and syrup are used for oral administration, so their pharmacokinetic abilities are similar in many respects. The drug is slowly absorbed from the cavity of the gastrointestinal tract only by active absorption (iron binding proteins located on the surface of the digestive tube absorb the microelement through competitive ligand exchange) for two reasons:
    the molecular weight of ferric iron is much higher than that of divalent iron;
    a complex compound that is used in a pharmaceutical preparation, similar in structure to a physiological iron carrier ferritin.
It is interesting that the absorption of iron, measured by hemoglobin level (to obtain this information, the double isotope method was used in clinical studies) is inversely proportional to the dose taken. That is, a negative correlation literally says that the higher the deficiency state, the better the absorption capacity of iron in the duodenum and jejunum.
Most of the iron that enters the body from the organs of the gastrointestinal tract settles in the liver (it is linked to the already known carrier protein by ferritin), whence it is delivered to the bone marrow and is included in the hemoglobin synthesis cycle during the active phase of hematopoiesis.
The remaining (not absorbed iron) is excreted together with exfoliating cells of the intestinal epithelium and skin, and also with sweat, bile and urine in the amount of about 1 mg per day. When calculating the dosage of the drug, it should be taken into account that in women during the menstrual period, additional losses of an important trace element occur.
Reduction of clinical manifestations of the underlying disease is observed gradually, since for the development of a full-fledged pharmacological action, the drug must undergo a complete cycle of hemoglobin synthesis, which does not take place simultaneously.
The solution for intramuscular administration has other pharmacokinetic abilities. First of all, the complex with dextran allows us to quickly fill the micronutrient deficiency in various kinds of anemia, in this form the active component is delivered not only to the bone marrow, bypassing the stage of deposition in the liver, but also other peripheral tissues (for example, containing myoglobin) through another carrier - transferrin (one molecule of beta-globulin binds to two iron atoms). So 15 percent of the used dose enters the main bloodstream after 15 minutes, and the next 44 percent - in half an hour. The half-life period is 3-4 days, since the ferrule complex with dextran is too large to be excreted through the kidneys.

Indications for use

Tablets and syrup for oral administration develop their action gradually, because they are used in the following pathological situations:
    latent iron deficiency;
    Iron-deficiency anemia;
    prevention of micronutrient deficiency during pregnancy.
The solution for intramuscular infusions acts somewhat faster than the oral forms of the pharmaceutical preparation, therefore indications for its use also include the following nosological units:
    severe iron deficiency due to bleeding (eg, hemorrhagic anemia);
    a violation of the ability of the microelement to be absorbed through the gastrointestinal tract;
    impossibility to treat a patient with iron preparations for oral administration (operations on the digestive tube, cancer of the esophagus or stomach, various mechanical barriers, etc.).

Contraindications

    increased individual sensitivity or intolerance of the acquired or hereditary character to the component components of the drug;
    hemosiderosis - pigmentary dystrophy characterized by deposition of hemosiderin;
    hemochromatosis is a hereditary disease in which iron accumulates in the body everywhere in excess;
    violation of iron utilization mechanisms;
    anemia, which are not accompanied by a deficiency of this trace element (thalassemia or hemolytic anemia).
All pharmaceutical forms of the drug should be used with caution (recommended treatment in a hospital under round the clock supervision of qualified medical personnel) with the following concomitant pathologies:
    bronchial asthma;
    chronic polyarthritis;
    heart failure;
    deficiency of folate or a low ability to bind iron of another etiological origin;
    the drug is not used in pediatric practice until the child reaches the age of 4 months.

Side effects

The undesirable consequences of conservative treatment with oral forms of the drug tend to be weak and pass on their own in a short time, however in clinical practice the following side effects can be observed:
    gastrointestinal disturbances (dyspeptic indigestion);
    a feeling of overflow, heaviness, or pain in the epigastric region (in the projection of the stomach and duodenum);
    constipation or diarrhea;
    dark staining of the stool, which has no clinical significance, since it indicates the excretion of unabsorbed iron.
Since the solution for intramuscular administration in ampoules is somewhat more active, therefore the side effects of drug therapy with this pharmaceutical form of the drug are somewhat better expressed and can manifest themselves as:
    arterial hypotension;
    muscle and joint pain;
    enlarged lymph nodes;
    hyperthermia - a slight increase in body temperature;
    headache and dizziness;
    malaise;
    allergic reactions up to anaphylactic shock (very rare).
The violation of the technique of drug administration can lead to such consequences:
    staining the injection site;
    local soreness;
    the development of the inflammatory process at the injection site.

Instructions for use (Method and dosage)

The instruction for the Ferrum Lek is divided into several parts - general provisions that are valid for all types of pharmaceutical preparations, the therapy regimen and dosages for each individual pathology for different forms of the drug.
Oral forms are taken with meals or immediately after meals. Tablets can be both chewed and swallowed whole. If the taste of the syrup causes unpleasant sensations, then it can be mixed with fruit or vegetable juices (with baby food, if it is pediatric practice for children of younger age). The daily dose can be divided into several receptions or used at a time (if a solution is used for intramuscular injections, then it is better to inject injections in the morning hours, introducing all the daily amount of the drug immediately).
With iron deficiency anemia, the duration of conservative therapy is 3-5 months, depending on the severity of the microelement deficiency. After the normalization of the hemoglobin level, drug treatment should be continued for a few more weeks, in order to replenish all the physiological stores of iron.
Several by other scheme used tablets. Instructions for the use of tablets Ferrum Lek prescribes the following dosage of a pharmaceutical preparation - the first 2-3 months are prescribed 1 tablet 2-3 times a day, depending on the degree of microelement deficiency and the severity of the accompanying symptoms. After reaching the physiological level of iron, the dosage is reduced to 1 tablet 1 time per day for the next several months, until the attending physician considers it necessary to stop the conservative course of treatment.
Latent iron deficiency - the course, as a rule, lasts 1-2 months, in order to eliminate all the symptoms and make up the natural depot of the microelement in the human body. The following treatment regimen is used:
    in the age category from 1 to 12 years - syrup in a dosage of 2.5-5 ml (half or whole measuring spoon) daily;
    children over 12 years and adults (including mothers who are breastfeeding and women during pregnancy) - 5-10 ml of syrup (1-2 units) of the drug Ferrum Lek;
    the number of chewable tablets taken can range from 1 to 2 per day, but this pharmaceutical form is only used when the patient reaches 12 years of age.
For pregnant women, the dosage and dosage regimen varies slightly. So, with iron deficiency anemia 2-3 chewable tablets or 20-30 ml of syrup are used until laboratory tests testify about the normalization of the level of hemoglobin and serum iron. Next, maintenance therapy is used for 1 tablet or 10 ml of syrup until the end of the pregnancy period (as anemia or micronutrient deficiency can resume again).

Overdose

Symptoms of iron intoxication with oral administration of the drug Ferrum Lek in the form of chewable tablets or syrup is not observed, since an excessive amount of the active ingredient is not absorbed from the gastrointestinal tract. If the dose exceeds the required, the constituents pass through the digestive tube in a bound form and are not absorbed by passive diffusion.

Interaction

From clinically meaningful pharmaceutical interactions, only the reinforcement of the systemic action of the injectable solution was revealed, while using it with angiotensin-converting enzyme inhibitors (a group of cardiac drugs for lowering the systemic blood pressure). It should not be in conservative therapy to combine oral dosage forms with a solution for intramuscular injection.

Storage conditions

Keep out of reach of children at a temperature of no higher than 25 degrees Celsius.

Shelf life

3 years.

special instructions

In pure form, iron can affect the normal color of teeth, but in oral pharmaceutical forms, special salts of this trace element are used, so that when the drug is applied through the gastrointestinal tract, the teeth will not darken.
If anemia is caused by an infectious agent or malignant neoplasm, then Ferrum Lek will not act immediately. First of all, the acting components accumulate in the reticuloendothelial system and only after effective therapy of the underlying pathology are mobilized from this depot and show all the breadth of their pharmacological action.
For patients with diabetes, it should be remembered that 1 chewable tablet and 1 ml of Ferrum Lek syrup contain 0.4 XE (bread units), which must be taken into account when calculating the daily ration and taking anti-diabetic medications.
The drug does not affect the fine motor skills, the ability to concentrate, because driving or other potentially dangerous mechanisms during the course of conservative treatment is permitted.

Synonyms

Monofer

Children

In pediatric practice, the drug is used only after the age of 4 months.

With alcohol

Drinking alcoholic drinks does not affect the pharmacology of this medication, however, as with other medications, taking large amounts of alcohol is not recommended during the course of conservative drug therapy.

During pregnancy (and lactation)

Oral forms of the drug do not have a negative effect on the body of the future mother and child when applied during pregnancy (clinical trials were conducted in all trimesters of this critical period for women).
Solution for parenteral use should not be used during pregnancy, especially in the first trimester. In the next two, its inclusion in complex conservative therapy is justified only if the intended benefit for the mother significantly exceeds the potential harm to the fetus or the baby during breastfeeding.

Reviews about Ferrum Lek

Reviews of the tablets of Ferrum Lek are, as a rule, positive. The drug not only allows you to successfully adjust laboratory blood indicators such as hemoglobin and balance of serum iron, but also feel better. After passing the course of conservative treatment, people note an unprecedented ease and, as they say, "breathe in full breast," because the replenishment of iron deficiency saturates the body with oxygen.
Reviews during pregnancy are also filled with thankful words. The injections of the solution for intramuscular injections are painless, and the manifestation of pharmacological effects does not take long to wait. Owing to iron deficiency, the main and peripheral blood flow improves, which gives the haggard organism additional forces. The woman's skin regains a healthy color, the appetite becomes more moderate and habitual, and the gestation period is much easier.
Medical references about Ferrum Lek from the point of view of qualified specialists confirm these recommendations. The oxidation and hydroxylation processes occurring under the action of iron-containing enzymes pass more intensively. Tissue breath increases the intake of useful nutrients to cells and its internal organelles, allowing you to work in the physiological regime, which affects the entire body.