home Thyroid Iron preparations intravenously drip. Intravenous and intramuscular administration of iron: rules for the use of injections. Duration of therapy and acceptable dosages

Iron preparations intravenously drip. Intravenous and intramuscular administration of iron: rules for the use of injections. Duration of therapy and acceptable dosages

Patients diagnosed with iron deficiency anemia are prescribed a special medication course, which in most cases includes iron preparations in intramuscular injections and an iron preparation in ampoules. Also, the presented medicines are prescribed for preventive purposes, for example, to pregnant women. This approach ensures the productive saturation of the human body with the necessary trace element - iron. This is necessary, first of all, for people with chronic loss of this element or after extensive operations.

iron in injections

Almost all drugs that are used to eliminate the iron deficiency state in patients contain a sufficient amount of such an important and valuable trace element - iron. Such methods of therapeutic therapy - vaccination or oral administration - are extremely necessary, since it is impossible to achieve a complete restoration of the correct metabolic process with nutrition alone.

Many medical studies have shown that intramuscular administration of iron-containing preparations gives a much smaller effect than taking oral tablets. This is due to the fact that iron is most effectively absorbed in the intestines. In addition, oral iron preparations lead to the fewest possible side effects.

Iron injections to increase hemoglobin are drugs that form the basis of therapeutic therapy for iron deficiency anemia. Iron in intramuscular injection ampoules is used only in some special cases, since this method of treatment can lead to serious side effects. Iron injections for anemia can be prescribed in order to saturate the body with this element as quickly as possible.

Iron in injections intramuscularly is administered no more than 100 mg per day - this dosage can completely saturate the body with transferrin. Iron preparations in injections often lead to the appearance of such complications: an allergic reaction, induration at the injection site, phlebitis, overdose. Also, for all patients, one problem is characteristic - the appearance of bruises from injections.

Therefore, it is important for many patients to know how to treat bruises after iron injections. In this case, heparin ointment will have the most productive effect. Before applying it, it is desirable to warm the hematoma. The following iron preparations in ampoules intramuscularly are most often prescribed:

Ferkoven (1 ml ampoules).
Ferrum Lek (2 ml ampoules).
Venofer (5 ml ampoules).
Ferbitol (1 ml ampoules).
Ferrlecit (ampoules of 1 and 5 ml).

Iron in ampoules for injection is used only in extreme cases and in severe forms of diseases. Quite often, this is necessary before the upcoming surgery. Also, the appointment occurs if the patient has a disease of the stomach or intestines, damage to the wall of small vessels, after extensive blood loss.

Liquid iron in ampoules

Often, preparations that contain iron are recommended to be taken by mouth. The required dosage of the drug is prescribed strictly individually - it is calculated from the calculation of the patient's weight. In order for all iron-containing medications to be absorbed as efficiently as possible, it is recommended that they be taken with food.

Reception of iron-containing preparations does not pass without any manifestations. Therefore, the following side effects are most often observed in the patient: a feeling of metal in the mouth, bouts of nausea or vomiting, reduced immunity, upset stools. Also, iron preparations are prescribed under the strict supervision of a doctor, since there are a number of strict contraindications.

The pharmaceutical industry produces a fairly diverse amount of liquid iron preparations in ampoules. Separately, I would like to present liquid iron in ampoules - a totem. The preparation of iron totem in ampoules is a medicinal solution that is intended for oral administration. Ampoules are available in 10 ml, which is equal to 50 mg of Fe. This anti-anemic drug is quite popular among other iron-containing drugs.

Iron in Totem's ampoules has a dark brown color, a characteristic smell, some excipients - manganese, copper, sodium benzoate and citrate, sucrose, caramel coloring, water, flavoring and citric acid. The use of this drug leads to a gradual regression of all signs of an anemic disorder, which is caused by a lack of iron. Use with caution: there are a number of contraindications.

You can also highlight other preparations with iron in capsules, which are popular among other similar products: Fenyuls, Heferol, Ranferon, Globiron, Gemsineral. The use of all these presented drugs is allowed only for patients who do not have a chronic liver or kidney disease, a blood tumor. A strict ban on iron-containing preparations exists for patients with hemolytic and aplastic varieties of anemia.

A course of treatment

The treatment course of anemia lasts about six months or a little longer. All this happens under the strict supervision of a doctor, and every month the patient needs to donate blood to check the results and effectiveness of the selected therapy. Even after the hemoglobin level returns to normal, the drugs will have to be taken for about two months.

Some drugs in the form of a solution can irritate the gastric mucosa, so side effects may occur. The effectiveness of therapeutic iron therapy is determined approximately in the third week after the treatment was started - a slight increase in the level of hemoglobin in the blood is observed. All measures taken can be considered productive if the required level is reached after two months. After that, only maintenance therapy is prescribed.

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The drug "Ferrum Lek", ampoules: instructions for use (reviews)

The drug "Ferrum Lek" is used to treat anemia and iron deficiency in adults and children, including infants, and, in addition, during pregnancy and lactation. It is an antianemic agent in which iron is contained in the form of a complex compound of polymaltose hydroxide.

Description of the drug

For Ferrum Lek ampoules, the instructions for use indicate that the molecular weight of this complex is quite large, and its diffusion passing through the mucous membrane of the gastrointestinal system is forty times slower compared to ferrous iron. The complex is stable without releasing iron ions under physiological conditions. The active element of the multinuclear zones of the system is included in a structure that is similar to the natural iron compound, the so-called ferritin. Due to the presence of this similarity, the main element of the presented complex can only be absorbed through active absorption.

Iron-binding proteins, which are located on the surface of the intestinal epithelium, completely absorb iron through targeted competitive ligand exchange. The absorbed type of substance is deposited mainly in the liver, where further binding with ferritin occurs. Later, in the bone marrow, it becomes part of hemoglobin. The polymaltose hydroxide complex does not have the pro-oxidant properties that are typical of iron layers. Thus, the main active ingredient in this preparation is polymaltose hydroxide along with excipients. This confirms the instructions for use for Ferrum Lek ampoules.

In this preparation, iron is contained in the form of a complex compound of polyisomaltose hydroxide. Such a macromolecular type complex does not provoke the release of iron in the form of free ions. The product is similar in its structural structure to the natural compound of the element, namely ferritin. This hydroxide is not characterized by the presence of pro-oxidant characteristics, which are inherent in many salts of this microelement.

This is also confirmed by the Ferrum Lek remedy in ampoules, instructions for use and reviews.

Iron, which is included in the composition, is able to quickly compensate for the lack of the corresponding element in the human body, including against the background of pronounced iron deficiency anemia, thus restoring the level of hemoglobin necessary for normal life.

When using the remedy, a gradual process of regression of the clinical symptoms of iron deficiency is carried out, such as fatigue, weakness and dizziness along with tachycardia and soreness, as well as dry skin.

Pharmacokinetics of the drug

As the instructions for use indicate to Ferrum Lek ampoules, iron absorption, which is measured by the level of hemoglobin in erythrocytes, is inversely proportional to the dose taken, that is, the higher the amount, the lower the corresponding process. There is a statistically negative correlation between the level of deficiency of a given substance and its presence, since the greater the lack of iron, the better absorption occurs. To the greatest extent, the substance is absorbed in the duodenum, as well as the jejunum. The remaining amount of the microelement is excreted with feces. Its excretion, along with the separating cells of the epithelium of the gastrointestinal system and skin, as well as together with sweat, urine and bile, is approximately equal to one milligram of iron per day. In the female body during the menstrual cycles, an additional loss of an important trace element occurs, which, of course, must be taken into account. Analogues "Ferrum Lek" in ampoules will be presented below.

It should be noted that immediately after intramuscular injection of the drug, it enters the bloodstream very quickly. So, fifteen percent of the dose hits after fifteen minutes.

Indications for use of Ferrum Lek

For Ferrum Lek ampoules, the instructions for use indicate that the drug is prescribed in the following cases:

latent type iron deficiency therapy;
treatment of anemia due to iron deficiency;
prevention of deficiency of this trace element during pregnancy;
situations against the background of which treatment with iron-containing preparations for oral administration is ineffective or impracticable, for example, for an injectable form.

Graduation form "Ferrum Lek" in ampoules

The drug in the form of a solution can be administered exclusively by intramuscular route. In no case should intravenous administration of the drug be allowed. This confirms the instructions for Ferrum Lek ampoules.

Before using the first therapeutic dose, a person should enter a test amount of the product, which will be equal to half the contents of one ampoule, which is twenty-five to fifty milligrams of a trace element. Provided that there are no adverse reactions from the body within fifteen minutes after administration, the remainder of the initial daily dose is added.

The dosage of "Ferrum Lek" in ampoules is selected individually, depending on the general iron deficiency. Against the background of a known amount of lost blood, intramuscular injection of two ampoules leads to an increase in the level of hemoglobin, which will be equal to the equivalent of one blood unit.

Adults and the elderly are prescribed one hundred to two hundred milligrams, that is, from one to two ampoules, depending on their level of hemoglobin in the blood. The maximum daily dose for children is expressed as seven milligrams per kilogram of the child's weight.

Rules for the administration of the drug

The drug "Ferrum Lek" in ampoules must be injected deep intramuscularly alternately into the left and right buttocks. In order to reduce pain, as well as avoid staining the skin, it is advisable to follow the rules below:

the agent is injected into the upper outer region of the buttock, using a needle five to six centimeters long;
before the injection process, after disinfection of the skin, it is necessary to move the subcutaneous tissues to the lower part by two centimeters in order to prevent possible leakage of the agent;
immediately after the injection of the substance, the subcutaneous tissues must be released, and directly the injection site, pressing, hold in this position for one minute;
before using a solution intended for intramuscular injection, it is important to carefully examine the ampoules, it is required to use only those that contain a homogeneous solution without any sediment;
solution for intramuscular injection is always administered immediately after opening the vessel.

Possible Side Effects

As the instructions indicate to the Ferrum Lek remedy in ampoules, as a result of the body receiving an excess content of a substance in general well-being, a feeling of heaviness or overflow may occur, and, in addition, pressure in the epigastric region. Quite often, in such situations, nausea, constipation and diarrhea appear, while staining of feces in a dark color can be noted - the phenomenon of black stools, which is explained by the removal of the non-absorbed part of the iron and is not characterized by clinical significance.

We emphasize once again that Ferrum Lek is not used intravenously in ampoules.

Contraindications

"Ferrum Lek" is contraindicated in:

Use during pregnancy and lactation

As the instructions for use for "Ferrum Lek" in ampoules indicate, intramuscularly it is prescribed to pregnant and lactating women.

In the process of controlled studies in the framework of the use of the drug in the second and third trimesters of pregnancy, there was no negative effect on the body of the mother and her fetus. There were also no harmful effects on the fetus during the use of the drug in the first trimester of pregnancy.

Use in children

Doctors consider it possible to use the drug according to indications and doses that take into account the age of the patient. For children under twelve years of age, due to the need to prescribe the drug in a small amount of dosing, it is preferable to use it in the form of a syrup.

For "Ferrum Lek" in ampoules, a prescription is required.

Special instructions for use

It should be noted that chewable tablets, as well as syrup, do not stain tooth enamel. The drug, which is dispensed in an injection form, must be used exclusively in a hospital setting. In the case of the appointment of "Ferrum Lek" for patients with diabetes, it is important to consider that one chewable tablet contains a milligram of syrup.

Against the background of anemia caused by infectious or malignant diseases, iron can accumulate in the reticuloendothelial system, from where it can be mobilized, and then utilized only after the complete cure of the corresponding disease. Taking the trace element will not affect the results of fecal occult blood tests.

Interactions with other drugs and effects on driving ability

This drug does not have any effect on the ability of a person to the necessary concentration of attention, thus allowing, without fear, to drive a vehicle.

Ferrum Lek, intended for intramuscular injection, cannot be used in parallel with the same drug for oral administration. Simultaneous use with ACE inhibitors can enhance the systemic effects of parenteral agents containing iron.

"Ferrum Lek" in ampoules: reviews

Among the reviews about the drug "Ferrum Lek", which are found on the Internet, there are very common reports of the occurrence of so-called bruises that form after intramuscular injection of the drug into the body. People write that such formations do not pass from them for quite a long time.

Commenting on these complaints, the developers do not consider the aforementioned disadvantage to be a side effect, explaining that the likelihood of such phenomena directly depends on the competent and correct administration of the drug. In order to avoid bruising, you should simply strictly follow all the instructions given in the annotation.

Feedback on the use of "Ferrum Lek" for children

Approximately eighty percent of the reviews about Ferrum Lek for children are positive, which can be explained by the high efficiency of this product and its easy tolerance by young patients, as well as ease of use.

Parents write that many children really like the taste of syrup, so they use it for treatment purposes with great pleasure.

As for the negative reviews, almost all of them are due to all sorts of subjective circumstances that caused the impossibility of using the drug. In most cases, parents were forced to stop giving Ferrum Lek, because their children, unlike the rest, on the contrary, did not like the taste of the syrup. Another reason for dissatisfied parental feedback was the likelihood of constipation in young patients.

Reviews of pregnant women about "Ferrum Lek"

Most of the reviews about Ferrum Lek against the background of pregnancy in women are also positive. Women write that they like the effectiveness of the drug, the need to take it only once a day, and also pleases with its pleasant taste.

In addition, it is noted that Ferrum Lek increased the level of hemoglobin even against the background of such situations when initially pregnancy in women was accompanied by anemia.

Negative reviews about "Ferrum Lek" in single examples are associated with its ineffective impact. But a predominantly negative sediment was manifested due to subjective factors, for example, due to the fact that someone did not like the taste, someone had nausea or constipation due to its use. Thus, most negative reviews contain information related to the side effects of this drug.

In conclusion, it should be noted that the medical preparation "Ferrum Lek" is by far the most commonly prescribed by doctors remedy for replenishing iron in the body of both children and adult patients, as well as preventing the deficiency of this microelement during pregnancy.

"Ferrum Lek": analogues are cheap in ampoules

Similar in composition and therapeutic effect to the solution "Ferrum Lek" are the preparations "Iron polymaltose", "Maltofer", "Fenyuls complex", "Ferry".

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Injections to raise hemoglobin - types of iron-based drugs, benefits and harms

A low level of hemoglobin in the blood is dangerous for the development of iron deficiency anemia. Anemia is a dangerous condition for a person in which the tissues of the body suffer from oxygen starvation.

The lack of B vitamins, heme iron in the body makes the formation of hemoglobin in the blood impossible. Hemoglobin plays an indispensable role in human blood, binding free oxygen molecules coming from the lungs and delivering them through the bloodstream to body tissue cells.

What is the structure of hemoglobin

High levels of iron in the blood can be achieved by prescribing special medications containing iron.

What is the iron necessary for a person

Iron is a valuable element for the proper and stable functioning of the human body. A large amount of iron is found in food of animal and vegetable origin. But not all iron is equally absorbed by the body.

Scientists have proven that a person receives the main amount of iron from meat products. The iron contained in the meat of animals and birds is similar in composition to the iron needed by humans and is called heme. In plant tissues, the trace element is in the unbound free form of ferrous and ferric iron. Such iron is called non-heme iron and is absorbed worse, while ferric iron is not absorbed by the human body.

oral - tablets and solutions for oral administration, drugs pass through the gastrointestinal tract system and are absorbed naturally;
parenteral - active substances enter the tissues, bypassing the gastrointestinal tract, they include intravenous injections.

Groups and subgroups of iron-containing medicines for hemoglobin correction

Oral iron preparations

Oral iron preparations may contain both organic and inorganic salts of Fe II (ferrous iron) and salts of Fe III (ferric iron). The benefits of such drugs for the body are different, the digestibility of FeII drugs reaches 30-40%, the bioavailability of Fe III is much less - up to 10%. It is necessary to take medicines in long courses from 30 to 90 days, after which there is a steady increase in hemoglobin in the blood.

Such drugs have a number of side effects:

The patient suffers from nausea and vomiting.
Loss of appetite, there is a change in the taste perception of food.
With prolonged use, a person suffers from constipation or diarrhea.
Oral iron solutions have a strong staining effect and can spoil the color of the teeth.

Oral ferropreparations also have a number of serious contraindications:

diagnosing a patient with oncology, especially blood cancer;
stomach ulcer;
it is impossible to combine taking medications with iron with taking drugs of the tetracycline group;
chronic diseases of the liver, kidneys;
the patient has enteritis.

Iron preparations are prescribed with extreme caution during pregnancy, women are advised to increase the level of hemoglobin in the blood by consuming food rich in iron and vitamins.

The choice and prescription of drugs containing iron is carried out by the attending physician, and in no case independently.

Oral drugs to stabilize hemoglobin levels

Parenteral ferropreparations

Parenteral ferropreparations are prescribed in cases of emergency, after a thorough examination of the patient. Here is a list of reasons why an adult and a child are prescribed injections that increase hemoglobin:

Chronic diseases of the digestive system. In pathological diseases: pancreatitis, enteritis, celiac disease - the body's ability to absorb iron naturally is impaired.
Ulcerative colitis, gastric and duodenal ulcers.
Allergic reaction to iron salts.
Resection of the stomach or part of the small intestine.

Injections to raise hemoglobin are prescribed, if necessary, to saturate the patient's body with iron in a short period of time before surgery, when there is a possibility of large blood loss.

Iron injections to raise hemoglobin in the blood do not provide for the introduction of a trace element in an amount greater than the daily requirement of the body - 100 mg at a time.

A patient who is given injections to increase hemoglobin may experience the following consequences:

seals and abscesses may appear at the injection sites;
an allergic reaction to the drug is possible, up to anaphylactic shock;
blood clotting disorders may occur;
an overdose of iron in the body threatens with the appearance of nausea, vomiting, diarrhea or constipation.

Injections for hemoglobin can be prescribed for both adults and children, the differences are only in the dosage of medicines for injection.

Parenteral drugs used to correct hemoglobin values

Injections to raise hemoglobin in the blood and the name of the drugs

A list of injections to increase hemoglobin, the names of medicines and their brief description are given in the table below.

The use of iron-containing medicines by pregnant and lactating women

During pregnancy, many women can be diagnosed with iron deficiency anemia. In especially difficult situations, the attending physician will prescribe iron injections, but in practice they try to avoid such measures.

In most cases, when the hemoglobin level deviates from the norm, pregnant women are prescribed a special diet and prophylactic use of ferropreparations. The dose of iron intake per day is prescribed by the doctor for each case individually.

in the absence of pregnancy pathologies in the 3rd trimester, iron-containing medicines are prescribed for prophylactic purposes;
with anemia diagnosed before pregnancy, iron medications are used throughout pregnancy and during breastfeeding;
with the development of anemia during pregnancy, ferropreparations can be prescribed in the early stages of pregnancy.

The nuances of taking ferropreparations

Iron preparations should be used with extreme caution. These medicines will provide invaluable assistance in the treatment of anemia and eliminate the consequences of large blood loss, but they can cause irreparable harm to human health if used incorrectly.

Drugs for intravenous injection should be prescribed by a qualified physician and administered as part of outpatient and inpatient care by trained medical personnel.

Do not forget that the cause of a low level of hemoglobin in the blood can be a banal beriberi. For the proper absorption of iron, the body needs a large amount of vitamin C, and for the formation of hemoglobin cells, vitamins B6, B9 and B12. Calcium interferes with the normal absorption of iron, therefore, for the duration of the treatment of anemia, exclude dairy products from the diet, stop smoking, alcohol, coffee and refined foods.

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Iron preparations

Iron deficiency, along with calcium deficiency, is the most common type of beriberi in women. And this is not surprising, because we lose it much more than men: Every month, about 10-40 mg of iron is lost during menstruation.

During pregnancy, the body's depot in the gland is often exhausted, because Fe will be used up for the placenta, blood supply and nutrition of the fetus, for the expansion of the uterus and blood loss during childbirth.

It is these two factors that determine the increased need for iron in women, especially during pregnancy. Today we will talk about iron preparations, as well as whether it is worth taking them without a doctor's prescription.

Where is iron found?

Most of the iron inside the body is found in hemoglobin, a little less in myoglobin (muscles), and the rest is the body's supply of iron and is located in the spleen, liver and bone marrow

iron absorption

Regardless of the form of taking the iron preparation, in tablets, capsules, parentally, or simply with food, absorption in a healthy person occurs in the duodenum. However, with iron deficiency, this process can begin in the stomach, and in the rectum and colon, in a word, the body will consume it as much as possible, regardless of the place.

In what form to take iron?

Modern iron preparations are available in chewable and oral form. They may contain exclusively forms of iron, or be in combination with folic or ascorbic acid, amino acids. These preparations are usually more expensive, since such supplements increase the effect of iron absorption. Iron preparations in liquid form are prescribed to patients with anemia after suffering gastrointestinal diseases, since the shell of the tablets is poorly digested by their stomachs.

In case of poor tolerance of taking drugs orally, or poor absorption of iron in the gastrointestinal tract, patients are prescribed parental iron intake, that is, iron preparations in ampoules. There are two varieties here:

iron hydroxide with dextran and phenol;
iron hydroxide with dextran and without phenol.

Preparations with phenol can only be administered intramuscularly, and intravenous iron preparations do not contain phenol. Phenol should not be administered intravenously, as there is a risk of developing phlebitis, and the most successful form of treatment for anemia in severe stages is the intravenous administration of the entire dose of iron hydroxide with dextran in one dose.

Contraindications and side effects

Despite the fact that intravenous administration is most effective for anemia, it is this method that contains the greatest number of side effects. If fever, swollen lymph nodes, rashes, and marked weakness occur, intravenous administration should be stopped and another method of treating anemia should be switched.

Is taking iron supplements dangerous?

Preparations containing iron are prescribed for the prevention and treatment of anemia of any form, and prevention can be carried out only in connection with the risk of anemia. For example, during pregnancy and lactation. In addition, iron-containing drugs are prescribed for group B hypovitaminosis, frequent bleeding, and also during recovery after surgery. Prescribing medications to yourself is contraindicated, since a healthy person has enough iron in a balanced diet, and an increased dose of iron has a toxic effect.

Finally, we provide you with a list of iron preparations, both chewable and parenteral. The list is provided for guidance only and not for prescription. Remember, prescribing iron-containing preparations to yourself can cause considerable harm to health.

List of drugs

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Treatment of iron deficiency anemia in adults. Drugs, injections, diet

In a medical interpretation, anemia is a term that refers not to a specific disease, but to a group of syndromes, which are characterized by a decrease in the number of red blood cells and hemoglobin in the blood. With iron deficiency anemia, the supply of iron falls, which prevents the normal synthesis of hemoglobin.

Ferrotherapy in adults, its features

According to a WHO study, about 30% of women and about 15% of men in the world suffer from iron deficiency anemia. The main reason for its development in adulthood is blood loss of a different nature. Therefore, the treatment of iron deficiency anemia in adults is based, first of all, on finding the source of bleeding and eliminating it.

In young women, the most common cause is heavy menstruation, which, in turn, can be caused by a number of diseases of the reproductive or endocrine system.

Another common source of blood loss is damage to the organs of the gastrointestinal tract. Conducting the necessary research and detection of pathology allows you to eliminate bleeding and begin therapy for the underlying disease.

In women, the most common cause of the disease is heavy menstruation.

Simultaneously with the identification and elimination of the causes of iron deficiency anemia, it is necessary to eliminate the lack of iron in the body and replenish its reserves.

Note! The thoughtless prescription of iron-containing drugs without looking for the root cause in the treatment of iron deficiency anemia in adults is ineffective, costly and can lead to serious consequences (increased bleeding, undiagnosed neoplasms, etc.).

Treatment of iron deficiency anemia in adults. Effective drugs for oral administration

Iron deficiency anemia in adults is usually treated with iron tablets. For the majority of patients who do not have difficulties with the absorption of pharmacological iron, the use of oral preparations is most effective and appropriate.

Reasons for the ineffectiveness of oral therapy in adults:

Basic principles of treatment with drugs for oral administration

The World Health Organization recommends giving preference to preparations containing ferrous iron. The daily rate should be at least 100 mg of the drug. In the absence of problems with digestibility, the daily dose is gradually adjusted to 400 mg.

The drug is usually prescribed in 3-4 doses 1 hour before meals or 2 hours after eating. Experts do not advise using drugs containing iron with an interval of less than 6 hours, since during this time after the use of the drug, the absorption capacity of the intestine decreases.

The duration of treatment should not be less than 4 months (in some cases up to 6 months). Approximately 1 month after the successful use of the drug, its dose can be reduced.

You should not be afraid of an excess of iron in the body with the correct dosage of the drug: as soon as the body makes up for the lack of an element, its absorbing properties fall.

It is important to know! Some substances and drugs can significantly affect the rate of absorption of iron. Therefore, it is not recommended to drink iron-containing preparations with tea or coffee, since tannin and caffeine slow down their absorption.

When choosing a drug, you should pay attention to the ratio of price and quality, the number of side effects, the complexity of the regimen of use.

Contraindications for taking oral drugs for iron deficiency anemia

Undesirable effects associated with the use of oral drugs in ferrotherapy in adults, as a rule, are expressed in irritation of the gastrointestinal tract. Moreover, if side effects in the intestines (diarrhea, constipation) practically do not depend on the dose of the drug, then irritation of the upper gastrointestinal tract (nausea, pain in the stomach) is directly dependent on the dose taken.

With the manifestation of such symptoms, it is recommended to reduce the amount of the drug taken and use it after meals. If this does not help, then it is better to switch to slow-acting drugs. With severe side effects, oral iron supplements should be discontinued.

Treatment of iron deficiency anemia: effective injections

Another option to compensate for the lack of a microelement in the treatment of iron deficiency anemia is the parenteral administration of drugs, that is, in the form of injections.

These drugs are usually administered intramuscularly or intravenously. Ferrous sucrose is the most commonly used, although it can cause allergies when administered intravenously.

In the treatment of iron deficiency anemia, drugs are usually administered intramuscularly or intravenously.

Experts advise to administer the drug at a dose not exceeding 100 mg for 24 hours. With excessive saturation, iron can cause toxic poisoning.

When are injections used to treat iron deficiency anemia?

The absorption of iron occurs mainly through the lower gastrointestinal tract, so the preference for the treatment of iron deficiency anemia in adults is given to the oral route of medication. The effectiveness of parenteral administration is much lower, but in some cases it is necessary to give preference to this method.

Intramuscular or intravenous administration of a microelement is prescribed for difficulties with its absorption by the intestines as a result of certain diseases (inflammatory diseases of the small intestine, enteritis, gastric ulcer in the acute phase, etc.) or surgeries.

It is also advisable to prescribe parenteral administration for massive blood loss, when it is necessary to compensate for the lack of an element as soon as possible.

Contraindications and side effects of injections for iron deficiency anemia

The most serious complication of iron injections is the possibility of serious anaphylactic reactions. Therefore, before the introduction of a full dose, a test injection is made with a small amount of medicine and they wait for a while to see if an allergy appears.

Be careful! Although cases of anaphylactic shock are quite rare, parenteral administration of iron-containing preparations should be carried out only in medical institutions adapted for emergency care.

In case of allergic reactions, you should immediately stop taking the medicine. Other possible side effects: fever, myalgia, skin redness, rash.

Diet as a treatment for iron deficiency anemia

A mild stage of iron deficiency anemia can be treated with a special diet (in the absence of gastrointestinal diseases).

Mild iron deficiency anemia can be treated with a special diet

It should be borne in mind that the amount of iron that is absorbed from vegetables and fruits is several times higher than the amount of iron from meat and cereal products.

Also, such a diet is prescribed as an adjunct in drug therapy.

Therapy for iron deficiency anemia in adults includes several important components: identifying and eliminating the root cause of anemia, compensating for iron deficiency with oral or parenteral administration of drugs, following a special diet, and preventing relapses.

Useful videos about iron deficiency anemia in adults and its treatment

Iron deficiency anemia: causes and treatments:

Iron-deficiency anemia. Symptoms, signs and treatments:

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Iron is one of the indispensable elements that ensure the stable functioning of the body. Basically, this trace element enters the body with food - there are a number of products in which the level of iron content is very high. But in some cases, even the active use of such peculiar foods does not help to maintain the balance of iron in the body - in this case, doctors diagnose the type and prescribe therapy with specific drugs.

Table of contents:

Key facts about iron preparations

In the dosage form, the useful trace element in question can be contained in two different forms:

divalent form- iron preparations are absorbed quickly and fully, are administered orally (orally by swallowing);
trivalent form- drugs are absorbed worse, are administered by injection.

The iron-containing drug is absorbed in the digestive tract, but this process requires the presence of a sufficient amount of hydrochloric acid in the stomach. Therefore, if a patient is prescribed therapy with iron-containing drugs, but he has previously been diagnosed with insufficient production of hydrochloric acid, the patient must take medications that increase the acidity of gastric juice in parallel.

There is a certain differentiation of substances that enhance or reduce the absorption of iron preparations:

fructose, succinic acid, cysteine and ascorbic acid - increase;
tannin, phosphoric acid, tetracycline, almagel - lower.

Naturally, the latter substances should be excluded when using drugs containing iron.

Iron preparations for oral use

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When diagnosing iron deficiency anemia, doctors usually prescribe medications to be taken by mouth. The dosage is set strictly on an individual basis, but there are also general recommendations - adults usually need to consume 2 mg per kilogram of weight and, as a rule, this is 100-200 mg of the drug per day, extremely rarely - 300 mg.

If the dose of the iron-containing preparation was chosen correctly, then after a few days of therapy the patient begins to feel better, the standard symptoms of iron deficiency anemia practically disappear. In the first 5-7 days of taking drugs with iron content, the first positive changes in the results of laboratory blood tests appear - the number of reticulocytes begins to grow. And after 60-90 days of regular use of iron-containing preparations, a steady increase in hemoglobin is noted.

Note:patients will need to take oral iron supplements for quite a long time to restore health. Even if the hemoglobin indicators and the general state of health have already stabilized, it is impossible to stop therapy - it is necessary to create a supply of the microelement in the body. But at the time of "storage" of iron in the body, you do not need to take the prescribed daily dose of drugs - the doctor, based on the results of laboratory blood tests, usually adjusts the dosage to reduce it by 2 times.

Taking iron supplements orally (by mouth) may be accompanied by the development of side effects:

and vomiting, appearing regardless of the use of food;
loss of appetite, and in some cases a complete aversion to food;
pronounced metallic taste in the mouth;
disruption of the intestines - or.

Often, against the background of the use of iron-containing drugs orally (orally), a gray coating on tooth enamel may appear, so doctors recommend either rinsing your mouth thoroughly immediately after taking the medication, or drinking it through a straw if the remedy is in liquid form.

There are a number of conditional contraindications, that is, iron preparations can be prescribed, but their use should be under constant monitoring of the patient's condition by medical professionals. Conditional contraindications include:

and/or duodenum;
enteritis of various etiologies.

Doctors do not prescribe iron supplements at the same time as drugs that reduce the level of gastric acidity, belong to the group of tetracycline antibiotics. This precaution is necessary to ensure maximum absorption of iron into the body.

Medicines for anemia in tablet form

The following are iron-containing drugs that are commonly prescribed for treatment of iron deficiency anemia:

Aktiferrin - belongs to the group of combined drugs, is available in the form of capsules and drops.
Hemofer prolongatum - the main active ingredient is iron, is available in tablet form.
Tardiferon - tablets, which contain, in addition to iron, ascorbic acid and mucoproteose.
Ferrogradumet - is available in the form of tablets with a shell, the composition contains ferrous sulfate and a plastic matrix.
Gemsineral -TD - is available in granules, it contains elemental iron, cyanocobalamin and folic acid.
Ferronal and Ferrogluconate - 300 mg tablets, based on ferrous sulfate.
Fenyuls is a combination drug that is available in the form of capsules. The composition contains riboflavin, ascorbic and folic acids, pyridoxine, fructose, yeast, ferrous sulfate, cyanocobalamin, cysteine.
Gino-tardiferon - tablets in which the dose of elemental iron is 80 mg. The composition contains, in addition to the main active substance, folic and ascorbic acids, mucoproteosis.
Heferol - capsules, which contain 100 mg of iron, are made on the basis of fumaric acid.
Globiron - gelatin capsules, which contain ferrous sulfate, vitamins B6 and B12,.
Totem - is available as a solution for oral administration (inside) in 10 ml ampoules. Contains sucrose, copper and sodium benzoate/citrate.
Ranferon-12 - is available in two pharmacological forms: elixir and capsules. In the first case, the iron content in 5 ml is 41 mg, and one capsule contains 100 mg of elemental iron.
Sorbifer Durulis - capsules containing 100 mg of iron.

Which of the listed iron preparations will be prescribed by a doctor is determined on an individual basis. Therefore, it is strongly not recommended to make a choice on your own.

Iron preparations for parenteral use

We will talk about the injection of iron preparations. You need to know that they are assigned only under certain circumstances:

Iron preparations in the form of injections are also prescribed if it is necessary to quickly and maximally saturate the patient's body with iron before the prescribed surgical interventions for hemorrhoids, fibroids and other diseases.

Note:it is strictly forbidden to inject into the body more than 100 mg of an iron preparation - this dose fully provides the daily requirement for the microelement in question.

If iron-containing preparations are injected into the patient, then with a high probability the appearance of side effects can be expected:

seals (infiltrates) at the injection site of the iron preparation;
phlebitis;
abscesses at injection sites;
allergic reaction - sometimes anaphylactic shock develops immediately;
DIC;
an overdose of iron in the body.

Ferrum Lek - is available in ampoules of 2 ml, which is identical to 100 mg of elemental iron, is administered intramuscularly. The composition contains iron hydroxide and dextran - they are also the main active ingredients.
Venofer - ampoules of 5 ml, intended for intravenous injection, which is equivalent to 100 mg of iron. The composition contains iron hydroxide sucrose complexes.
Ferkoven - the composition contains iron sucrose, a solution of carbohydrates and cobalt gluconate. Produced in ampoules of 1 ml, intended for intravenous injection.
Zhektofer is a combined preparation, the composition contains an iron-sorbitol-citric-acid complex. Produced in ampoules of 2 ml, the route of administration is intramuscular.
Ferrlecit - the main active ingredient in this preparation is active sodium - an iron gluconate complex. Produced as a solution for injection in ampoules of 1 and 5 ml. in the first case, the drug is administered intramuscularly, and 5 ml ampoules are intended for intravenous administration.
Ferbitol - the basis of this drug is the iron sorbitol complex, is available in 1 ml ampoules for intramuscular injection.

Iron supplements during pregnancy

If iron deficiency anemia was diagnosed in a woman during the period of bearing a child, then all of the above drugs are allowed for use as part of therapy. But only a specialist should make appointments - it is often during pregnancy that the daily dosage is reduced. Often, during the period of bearing a child, it is required to take prophylactic iron preparations - in this case, the dose will also be selected individually.

if the pregnancy proceeds without any pathologies, then a woman in the third trimester is prescribed iron preparations orally at 30 mg per day;
if the pregnancy proceeds within the normal range, but the woman has a tendency to develop iron deficiency anemia, then prophylaxis is carried out during the period of 21-25 weeks of pregnancy - 30 mg twice a week;
if iron deficiency anemia is fully diagnosed during pregnancy, then the usual daily dose for a woman is 100-200 mg, depending on the weight of the patient;
if iron deficiency anemia was diagnosed in a woman before pregnancy, then she should take iron supplements throughout the pregnancy, and during breastfeeding, 200 mg per day.

Iron preparations can and should be taken by people both as a treatment for anemia and as part of preventive measures. But the dosage and duration of the course of administration should be determined only by a specialist - a lot depends on the picture of a laboratory blood test, on whether iron deficiency anemia was previously diagnosed, what pathologies are present in the body.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category

The use of iron in injection ampoules is justified in cases of iron deficiency anemia. Preparations that are administered parenterally (with the help of injections) begin to act faster, allow you to cope with anemia in especially severe cases. Substance injections have many pros and cons. All features of intramuscular and intravenous administration of iron preparations are described below.

When are injections given?

Indications for parenteral droppers or injections when iron is administered intravenously (intramuscularly) are situations when the patient must urgently receive a dose of a useful substance. The use of ampoules is prescribed when the patient, due to injuries, systemic disorders or temporary illnesses, cannot fully absorb iron through the gastrointestinal tract.

Indications for the use of exclusively injections of the drug:

Ulcerative colitis in the stomach or intestines in an acute form. The use of iron for an ulcer does not in itself harm the patient with an ulcer. However, often with oral iron therapy (taking tablets by mouth), additional drugs are prescribed to increase the acidity of the gastric environment. The higher the acidity, the better the substance is absorbed. A sharp drug increase in the acidic environment in the stomach can lead to an exacerbation of ulcerative formations.
Systemic disorders of iron absorption. A person may be genetically predisposed to malabsorption of iron from the gastrointestinal tract. Sometimes dysfunctions occur against the background of hormonal failure, an intestinal virus, etc. In any case, if the patient's body does not absorb iron well from the intestines, there is no point in taking oral medications. It is necessary to inject the substance intravenously or intramuscularly so that the patient receives the full dose of the element. Absorption problems occur with pancreatitis, enteritis and similar disorders.
Partial removal of the stomach or small intestine. In violation of the natural physiology of the gastrointestinal tract, the absorption of certain elements, including iron, is significantly impaired. To increase the effectiveness of therapy, specialists in the case of surgical removal of tissues prescribe injections.
Complete removal of the stomach. The indications are the same as described above.
Intolerance to iron salts. This allergy can be circumvented by immediately injecting a useful element intravenously or intramuscularly.
Ulcerative colitis.

Most often, ampoules are used if the patient suffers from traumatic anemia (he has lost a lot of blood, as a result of which hemoglobin levels have dropped sharply). To quickly restore vital supplies and reduce the risk of death, doctors use the parenteral method of administering the drug.

Important. The doctor should determine the need for injections.

With small degrees of malabsorption (impaired absorption of iron or other substances), oral tablets can still be prescribed, and not injections, simply by supplementing the course of tablets with drugs to increase the acidity of the stomach. In the case of ulcerative exacerbation, intolerance to components and colitis, they must switch to parenteral administration.

If you suffer from one of these disorders, you must inform your doctor in a timely manner. Then he will select the right parenteral drug for you. If we keep silent about the presence of gastrointestinal problems or allergic reactions, the consequences can vary from a decrease in the effectiveness of therapy to death in the case of anaphylactic shock.

Benefits of injections

Iron with injections intramuscularly or intravenously is absorbed better. If during absorption through the stomach, part of the element is filtered by the liver, then with direct administration, natural filtration is much lower. This is the main advantage of ampoules with a substance, but there are other advantages:

Safety for allergy sufferers. In the case of introduction directly into the blood, iron does not enter into chemical reactions, iron salts are not formed. But it is iron salts that often cause rashes and other allergic manifestations.
Possibility of fast replenishment of stocks of microelements. If the patient replaces the tablets with an intravenous iron preparation, the rate of obtaining substances is accelerated tenfold. When taken orally, the substance must pass from the mouth to the blood, while passing through the esophagus. To achieve the maximum concentration of the drug, you have to wait 2-3 hours. When using injections, the absorption rate is 15-20 minutes.
Use of small dosages. It is enough to make one injection of 1-5 ml (depending on the drug) to give the patient a daily dose of the drug. If tablets are used, then you have to drink several capsules with a dosage of 50 mg.
No side effects in the oral cavity. If drugs are taken orally, a gray coating often forms on the tongue and on the inside of the teeth. With parenteral use, there are no such side effects, which allows you not to worry about your appearance.
Saving. Ampoules with an equivalent amount of the drug usually cost less than blister boxes. The fact is that the packages themselves cost less, plus a larger amount of excipients is used in the manufacture of tablets than in the creation of injection solutions.

However, it cannot be said that the use of injections is the most convenient, optimal option for treatment. This method of drug administration has a number of disadvantages. They are presented below.

Disadvantages of parenteral administration

The injections are painful, leave marks on the hands, and can cause fear in children. These are not all the negative aspects of intravenous (intramuscular) administration. The disadvantages of the method include:

Inconvenience in using the drug. It cannot be introduced at work, at school, at the university. We have to wait until the patient is at home. It is very difficult to inject correctly in public conditions, and besides, not everyone understands why the patient resorts to the use of injections.
The need to see a doctor or do injections yourself. Both of these options are bad. If you get injections from a doctor, you will have to spend time on an appointment, waiting, a trip to the nearest medical department. If the patient gives injections on his own, the main drawback is the need to first learn how to do it correctly. If a person is not trained in basic injection skills, he may not enter a vein or muscle at all, or he may give injections that will be accompanied by severe pain and discomfort.
Pain sensations. When taken orally, there are no inconveniences: you can only choke on a tablet if you do not drink it with water. But when the injection procedure is carried out, if the skin is broken, even with a thin needle, discomfort can occur. They intensify at times if the injection was carried out incorrectly, and a bruise occurred. The hematoma can stay at the injection site for several days, all this time it causes discomfort.
Psychological discomfort. Emotional people, children will negatively perceive the need to constantly inject. For them, one injection is already a test, and if a specialist prescribes a whole course of injections as part of therapy, this can cause a complete rejection of the prescribed treatment.
Additional costs for syringes. Although disposable instruments cost very little, the process of buying them, as well as the fact of small additional expenses, can be annoying for many.

The main disadvantage of injections is the problems when using syringes. Unprepared patients with no contraindications to oral administration are always prescribed tablets to make the therapy process easier.

How best to administer: intravenously or intramuscularly

Each of the methods of drug administration has its own characteristics. They are taken into account when prescribing a solution.

Intramuscular preparations are most easily absorbed by the body. To saturate the body, 1 ml of solution is enough. But injections can be too painful. The body absorbs the substance faster than with venous administration.

Intravenous use is less painful, but the effect is achieved 1.5-2 times slower. For one injection, 2.5-3 times more solution is required than when the drug is injected into the muscles. This is a more gentle type of injection.

Duration of therapy and acceptable dosages

Treatment is carried out until the content of the substance in the blood is restored. There are several injection steps:

Primary. The patient uses the ampoules according to the dosage.
Secondary. The concentration of the substance in the blood has already been reached, it remains only to stabilize the reserves and prevent them from dissolving. Usually the dosage is reduced by 2-3 times according to the doctor's indications.

Important. One course lasts up to six months in the case of oral administration. Since the injections work better, the treatment period with their help can be shortened.

Injections during pregnancy

In the case of pregnancy, specialists rarely prescribe treatment with injections. There are no contraindications to oral administration of the drug. Injections can be prescribed only in the following cases:

severe blood loss as a result of a threatened miscarriage;
severe toxicosis, accompanied by vomiting, due to which the body does not receive the full range of necessary substances.

Even in the case of injections, the period of their use does not last long: the patient remains in the hospital and receives injections for several days, after which she can switch to home use of tablets or capsules.

Possible side effects

A small papule or bruise may occur at the injection site. They dissolve quickly, but when touched cause pain.

Other possible problems after injections:

A rapidly developing allergic reaction. May lead to anaphylactic shock.
ICE syndrome.
Exceeding the permissible concentration of iron in the body. Leads to dizziness, nausea and other disturbances of well-being.
The appearance of abscesses in the area of the needle insertion.

Important. Side effects are less likely to occur with professional injections.

The likelihood of allergic reactions

In the case of intravenous and intramuscular administration, there is a high risk of an allergic reaction. Some patients develop anaphylactic shock within a short time.

You can prevent an allergy attack only by first checking the body for a tendency to it. A specialist should determine the level of sensitivity of the body to iron preparations.

If an allergy is detected, you will have to abandon the specific medication and look for an analogue. Often, an allergic reaction does not develop on the iron itself, but on the auxiliary substance contained in the solution.

Contraindications to the use of injections

Injections are prohibited under certain conditions of the body. You will have to refuse to use this method of administration if:

the body is too sensitive to influences, which is why bruises constantly appear on the surface of the skin after injections;
the body is oversaturated with iron;
non-disposable, non-sterilized syringes are used;
there is a suspicion of an allergic reaction from the body.

It is strictly forbidden to exceed the dosage. If, when taking tablets, it is calculated as 2 mg of the drug per kg of weight, then when using a solution, the calculations are different. The patient should not use more than one ampoule per day.

List of drugs for intravenous and intramuscular administration

List of medicines containing iron:

"Ferrum Lek" - a drug for intramuscular injection. Ampoules contain 2 ml of solution. Dextran and iron hydroxide are the main and only components of the substance. If you are allergic to dextran, the drug will have to be abandoned. Assigned by weight, in one ampoule iron content equivalent to 100 mg tablets (maximum dose).
Venofer is available in 5 ml ampoules. One ampoule is the equivalent of a 100 mg tablet. In addition to iron, sucrose compound products are included in the composition. Allergic reactions may occur with intolerance to sucrose.
"Ferkoven". The ampoule is minimal, with a volume of only 1 ml. The composition contains cobalt compounds, carbohydrate complexes. Easily administered intravenously.
"Gektofer". It is considered a combined type of medicine, because it contains citric acid. "Gektofer" is injected into the muscles, the solution is available in containers of 2 ml.
"Ferrlecite". Produced with sodium and ferrous gluconate in the composition. It can be in the form of a 1 ml ampoule for injection into muscles or 5 ml (injected into a vein).

Prescribers must prescribe the drug. Without a prescription, the ampoule may not be sold.

When choosing a drug, the dosage of the substance is taken into account. Ampoules of most of the listed preparations are equivalent to 100 mg of dry preparation. This dose is the maximum allowable for the patient per day. If it is exceeded, side effects and ailments may develop.

Conclusion

Iron preparations for parenteral administration are widely used in modern medicine. However, before using them, it is imperative to familiarize yourself with the specifics of solutions from ampoules, take into account possible disadvantages and complications. It is forbidden to use the solution without the permission of a specialist.

Iron deficiency anemia is considered a very common disease that impairs a person's quality of life. Most often, this pathology is diagnosed in women, but it can also overtake men. At the same time, patients complain of severe weakness, dizziness, headaches.

From the side of appearance and general health, the following changes are observed:

A person loses vital energy, becomes weak, lethargic and inactive. To confirm the diagnosis, it is necessary to take blood tests that show a decrease in hemoglobin levels and low iron levels. When confirming the diagnosis, it is required to take special iron-containing drugs, which are selected by a specialist.

The role of iron in the body

Iron plays an important role in the coordinated work of the human body. It takes an active part in the process of hematopoiesis, therefore, with anemia, a person experiences such severe discomfort. Normally, the body has no more than 3.5 mg of iron, most of which is in hemoglobin.

This substance is not synthesized on its own, but comes with food. The excess is deposited in the liver in the form of hemosiderin, due to which the deficiency of this element is then replenished. If all the reserves are over, then oxygen starvation sets in with all the ensuing consequences.

Causes of iron deficiency

Iron deficiency anemia can be caused by various reasons, so the treatment should be selected by a specialist. Only he will reveal the origins of the disease, find means that will act faster and safer.

Common causes of anemia:

Internal bleeding.
Pregnancy, childbirth and lactation.
Abundant menses.
The presence of chronic inflammatory processes.
Pathology of the intestines and digestive system.
Improper diet low in iron.
Increased physical activity without dietary modification.

With gastritis, peptic ulcer and erosion, the absorption of iron is disrupted, against which anemia develops.

If a woman has painful and profuse menstruation every month, she loses a huge amount of iron.

If on such days the diet is not adjusted, weakness occurs, up to fainting. In a similar way, internal bleeding that accompanies many intestinal diseases, fibroids and hemorrhoids affects.

During pregnancy, the body needs more iron, as it also goes to the development of the embryo. With a lack of this element, the development of the baby's internal organs is disrupted, and the mother's well-being also worsens.

Similar changes occur during HS, when many nutrients are given with the baby's milk. For prevention, doctors prescribe iron preparations to girls of childbearing age. The prescribed medicine for anemia is used several days a month to stabilize the state of health.

Vegetarians often experience anemia due to a lack of protein in their diet. To prevent problems, you should take special supplements. Also, special attention should be paid to the nutrition of athletes, since increased physical activity requires a huge amount of oxygen.

If a person does not take into account this feature, fainting, dizziness and problems with the work of the cardiovascular system are possible. For any ailment, you should visit a doctor and go through a complete examination to avoid more serious changes.

Modern drugs for the treatment of anemia

With low hemoglobin, specialists prescribe an examination, after which they select special drugs for treatment. The doctor takes into account the general condition of the patient, the presence of concomitant pathologies, and the financial situation. Some medicines are characterized by too high cost, so the doctor is obliged to consult with the patient. Only through joint work is it possible to choose such a scheme of influence that will give the maximum result and will suit both parties.

Traditionally, two types of iron supplements are prescribed for anemia:

Bivalent.
trivalent.

Preparations containing ferrous iron

Form	Name	Reception features
Pills	Sorbifer durules, Tardiferron	Take 30 minutes before the intended meal twice a day
Capsules	Ferrofolgamma, Ferretab, Fenyuls	Drink before meals
Solution	Totem	Injected intramuscularly
Dragee	Hemopher prolongatum	Chewed shortly before meals
bar	Hematogen	Taken with or without food

Iron tablets are considered the most effective, as they are absorbed better. To reduce the effect of iron on the intestines, you can take the medicine in capsules.

If the patient is diagnosed with serious problems with the functioning of the intestines, drugs are administered intravenously. However, the effectiveness of the impact in such cases is greatly reduced.

What preparations contain 3-valent iron:

In this case, there is a list of drugs that are prescribed most often:

Maltofer,
ferlatum,
Fenyuls,
Ferro - Folgamma.

Ferrous preparations are gradually being replaced by products with a high content of ferric iron. In this case, only a specialist can say for sure which medicines are better to use and when. And for each category of patients there are cures for iron deficiency anemia.

For pregnant women, the following drugs are provided:

totem,
Sorbifer Durules,
Maltofer,
Ferrum-Lek.

To increase the effectiveness of treatment in pregnant women, sorbifer and folic acid are often prescribed simultaneously. Folic acid improves the absorption of iron and has a beneficial effect on the health of the child.

The best medicines for children:

To better understand the possibilities of drugs, you should carefully study their composition and effects on the body.

Preparations with ferrous iron

Name	Characteristic
Fenyuls	A multivitamin product containing iron, folic acid and vitamin C. It is produced in capsules, so it does not cause severe irritation of the stomach and mucous membranes.
Ferrofolgamma	Gelatin capsules with vitamin C and folic acid
Totem	Iron-containing preparation with the addition of manganese and copper. Available in ampoules for oral administration.
Aktiferrin	Contains serine, which improves iron absorption. It can be used in the treatment of children and pregnant women.

If the patient has a limited budget, you can try analogues of known drugs. A drug such as Fenyuls has names in Russia - Hemofer Prolangatum, Sebidin. Ferrofolgamma from the Belarusian manufacturer is called ferronal, which is in no way inferior to the original, but pleases with its low cost.

If the patient is interested in a drug that is better absorbed in the body, it is worth giving preference to complexes with ferric iron. Patients are often prescribed sorbifer, which can be taken by children from 12 years of age and adults. Because of this, doubts arise, totem or sorbifer - which is better and more effective.

Video: Iron supplements for iron deficiency anemia

If we compare these drugs in terms of effectiveness, it is similar, but in terms of safety, sorbifer is inferior. It affects the concentration of attention, therefore it is dangerous when performing precise work and driving vehicles.

Preparations with ferric iron

Reception features

Many experts recommend exactly ferric iron-based medicines containing vitamins. They quickly find a response in children and adults, cause fewer side effects and are characterized by maximum efficiency.

However, the cost in the pharmacy for such complexes is impressive, so patients are trying to find a reasonable alternative. Instead of maltofer, with iron deficiency, they take hemojet, iron saccharate or profer, which are analogues of Ukrainian production.

Regardless of what type of drug is prescribed to the patient, you should remember the main features of iron intake.

Features of taking iron supplements:

Self-administration of drugs with iron is prohibited.
Do not exceed therapeutic doses.
Liquid medicines are more irritating than tablets and capsules.
You can not simultaneously take some antibiotics and iron-containing complexes.
It is recommended to drink iron before meals.
Iron injections are less effective and are therefore used last.
You cannot stop treatment on your own.

If the patient needs to undergo an additional examination, he must definitely warn the doctor about taking iron supplements. They can interfere with the results of some tests, making diagnosis difficult.

You should also be more attentive to your own well-being, reporting the presence of any alarming symptoms.

side properties

Iron preparations, especially in liquid form, cause negative reactions from the gastrointestinal tract. They also pose a danger to humans if used uncontrolled. It should be understood that there are no drugs without side effects. They just do not always appear and not in all patients.

Side effects of drugs:

The symptoms become especially strong if the doctor has prescribed a liquid remedy. When the patient's condition has deteriorated greatly, the drug should be replaced or another form of exposure should be selected.

If the drug was administered by injection, then the side effects are as follows:

Negative manifestations of treatment are aggravated if the daily dose is exceeded in women and men. Even more dangerous consequences are for children, so a specialist selects a specific remedy and its dosage.

Adverse reactions develop on iron itself, so replacement with analogues often does not work. The only option in such cases is to reduce the dose or change to a liquid preparation for intramuscular injection.

Treatment effectiveness

The effectiveness of treatment is determined by the general condition of the patient and the results of the tests. The first changes appear after a month of correct use of the selected medication.

When hemoglobin began to rise, the specialist determines the duration of the drug, which is usually six months. During this period, it is possible to replenish the iron-deficient depot, after which it is enough to take the prescribed complex prophylactically.

A specific treatment regimen is selected by a specialist taking into account the patient's condition, as well as on the basis of the action of various drugs.

Video: What not to eat while taking iron supplements

Sometimes during the examination it becomes clear that anemia is not iron deficiency in nature. In such cases, only the attending physician can tell the name of the drug for treatment and how to help the patient on the basis of numerous studies.

In a standard situation with anemia, the drug effect is effective, and after a few weeks the person feels significant relief. If the pathology is provoked by some diseases of the internal organs, a complex effect is necessary. This is the only way to get maximum results and restore health to a person.

Active substance

Iron (III) hydroxide sucrose complex (iron sucrose)

Release form, composition and packaging

Solution for intravenous administration brown, watery

Excipients: sodium hydroxide, water for injection - up to 1 ml.

5 ml - colorless glass ampoules (5) - blister packs (1) - cardboard packs.

pharmachologic effect

Iron preparation. The polynuclear centers of iron (III) hydroxide are surrounded on the outside by many non-covalently bound sucrose molecules. As a result, a complex is formed, the molecular weight of which is approximately 43 kD, as a result of which its excretion by the kidneys in unchanged form is impossible. This complex is stable and does not release iron ions under physiological conditions. The iron in this complex is associated with structures similar to natural ferritin.

Pharmacokinetics

Distribution

After a single intravenous injection of the drug Venofer, containing 100 mg of iron, C max iron, an average of 538 μmol, is achieved 10 minutes after the injection.

V d of the central chamber almost completely corresponds to the volume of serum - about 3 liters.

V d in the equilibrium state is approximately 8 l (which indicates a low distribution of iron in body fluids). Due to the low stability of iron saccharate compared to transferrin, there is a competitive exchange of iron in favor of transferrin. As a result, about 31 mg of iron (III) is transferred in 24 hours.

breeding

T 1/2 - about 6 hours. In the first 4 hours, less than 5% of iron from the total clearance is excreted by the kidneys. After 24 hours, the serum iron level returns to its original (before administration) value, and approximately 75% of the sucrose leaves the vascular bed.

Indications

Iron deficiency states:

- if necessary, rapid replenishment of iron;

- with intolerance to oral iron preparations or non-compliance with the treatment regimen;

- in the presence of active inflammatory bowel disease, when oral iron preparations are ineffective.

Contraindications

- anemia not associated with iron deficiency;

- signs of iron overload (hemosiderosis, hemochromatosis);

- Violation of the iron utilization process;

- I trimester of pregnancy;

- Hypersensitivity to the components of the drug.

WITH caution prescribe the drug to patients with eczema, polyvalent allergies, allergic reactions to other parenteral iron preparations; patients with low serum iron-binding capacity and / or deficiency; patients with hepatic insufficiency, with acute or chronic infectious diseases, with elevated serum ferritin levels due to the fact that iron, when administered parenterally, can have an adverse effect in the presence of a bacterial or viral infection.

Dosage

Venofer is administered only in / in (slow drip or jet) or in the venous area of the dialysis system. Not intended for i / m administration. Simultaneous administration of the full therapeutic dose of the drug is unacceptable.

Before the introduction of the first therapeutic dose, it is necessary to prescribe a test dose. If intolerance occurs during the observation period, the administration of the drug should be stopped immediately. Before opening the ampoule, inspect it for possible sediment and damage. Only brown solution without sediment can be used.

Drip Introduction: Venofer is preferably administered during a drip infusion in order to reduce the risk of a pronounced decrease in blood pressure and the risk of the solution entering the perivenous space. Immediately before the infusion, Venofer should be diluted with a 0.9% solution in a ratio of 1:20, for example, 1 ml (20 mg of iron) in 20 ml of a 0.9% sodium chloride solution. The resulting solution should be administered at the following rate: 100 mg of iron - not less than 15 minutes; 200 mg of iron - within 30 minutes; 300 mg of iron - for 1.5 hours; 400 mg of iron - within 2.5 hours; 500 mg of iron - within 3.5 hours. The introduction of the maximum tolerated single dose of 7 mg iron / kg should be carried out for at least 3.5 hours, regardless of the total dose of the drug.

Before the first drop infusion of a therapeutic dose of Venofer, it is necessary to administer a test dose: 20 mg of iron for adults and children weighing more than 14 kg, and half the daily dose (1.5 mg iron / kg) for children weighing less than 14 kg for 15 min. In the absence of adverse events, the remainder of the solution should be administered at the recommended rate.

Inkjet introduction: Venofer can also be administered as an undiluted IV solution slowly, at a rate (norm) of 1 ml of Venofer (20 mg iron) per minute; 5 ml of Venofer (100 mg of iron) should be administered at least 5 minutes before. The maximum volume of the drug should not exceed 10 ml of Venofer (200 mg of iron) for 1 injection.

Before the first jet injection of a therapeutic dose of Venofer, a test dose should be prescribed: 1 ml of Venofer (20 mg of iron) for adults and children weighing more than 14 kg and half the daily dose (1.5 mg iron / kg) for children weighing less than 14 kg for 1-2 min. In the absence of adverse events during the next 15 minutes of observation, the remainder of the solution should be administered at the recommended rate. After the injection, the patient is recommended to fix the arm in an extended position for a while.

Introduction to the dialysis system

Venofer can be injected directly into the venous site of the dialysis system, strictly following the rules described for intravenous injection.

Dose calculation: the dose is calculated individually according to the total iron deficiency in the body according to the formula:

Total iron deficiency (mg) = body weight (kg) × [normal Hb level - patient's Hb level] (g/l) × 0.24* + deposited iron (mg).

For patients weighing less than 35 kg: the normal level of Hb=130 g/l, the amount of deposited iron=15 mg/kg of body weight.

For patients weighing more than 35 kg: normal Hb level = 150 g / l, the amount of deposited iron = 500 mg.

*Coefficient 0.24 = 0.0034×0.07×1000 (iron content in Hb=0.34%; blood volume = 7% of body weight; coefficient 1000 = conversion from "g" to "mg").

Total volume (ml) of Venofer to be administered = total iron deficiency (mg)/20 mg/ml (Tables 1 and 2).

Table 1.

Body mass (kg)
	Hb 60 g/l		Hb 75 g/l
	mg Fe	ml	mg Fe	ml
5	160	8	140	7
10	320	16	280	14
15	480	24	420	21
20	640	32	560	28
25	800	40	700	35
30	960	48	840	42
35	1260	63	1140	57
40	1360	68	1220	61
45	1480	74	1320	66
50	1580	79	1400	70
55	1680	84	1500	75
60	1800	90	1580	79
65	1900	95	1680	84
70	2020	101	1760	88
75	2120	106	1860	93
80	2220	111	1940	97
85	2340	117	2040	102
90	2440	122	2120	106

Table 2.

Body mass (kg)	Cumulative therapeutic dose of Venofer for administration
	Hb 90 g/l		Hb 105 g/l
	mg Fe	ml	mg Fe	ml
5	120	6	100	5
10	240	12	220	11
15	380	19	320	16
20	500	25	420	21
25	620	31	520	26
30	740	37	640	32
35	1000	50	880	44
40	1080	54	940	47
45	1140	57	980	49
50	1220	61	1040	52
55	1300	65	1100	55
60	1360	68	1140	57
65	1440	72	1200	60
70	1500	75	1260	63
75	1580	79	1320	66
80	1660	83	1360	68
85	1720	86	1420	71
90	1800	90	1480	74

In the case when the total therapeutic dose exceeds the maximum allowable single dose, fractional administration of the drug is recommended. If after 1-2 weeks after the start of treatment with Venofer, there is no improvement in hematological parameters, it is necessary to reconsider the initial diagnosis.

Calculation of the dose to replenish iron levels after blood loss or autologous blood donation

The dose of Venofer is calculated using the following formula:

If the amount of blood lost is known: intravenous administration of 200 mg of iron (10 ml of Venofer) leads to the same increase in the concentration of Hb as a transfusion of 1 unit of blood (=400 ml with a concentration of Hb=150 g/l).

Iron Needed to be Replaced (mg) = Blood Units Lost × 200
or
Required volume of Venofer (ml) = number of lost blood units × 10.

With a decrease in the level of Hb: the previous formula should be used, provided that the iron depot does not need to be replenished.

The amount of iron (mg) to be replenished = body weight (kg) × 0.24 × [normal Hb level - patient's Hb level] (g / l).

For example: body weight 60 kg, Hb deficiency = 10 g / l: the required amount of iron is approximately 150 mg, and the required volume of Venofer = 7.5 ml.

Standard dose

Adults and elderly patients prescribe 5-10 ml of the drug Venofer (100-200 mg of iron) 1-3 times a week, depending on the level of hemoglobin.

There are only limited data on the use of the drug in children under the age of 3. If necessary, it is recommended to administer no more than 0.15 ml of Venofer (3 mg of iron) per kg of body weight 1-3 times a week, depending on the level of hemoglobin.

Maximum tolerated single dose

Adults and elderly patients: for jet administration - 10 ml of Venofer (200 mg of iron), the duration of administration is at least 10 minutes; for drip administration, depending on the indications, a single dose can reach 500 mg of iron. The maximum allowable single dose is 7 mg / kg and is administered once a week, but it should not exceed 500 mg of iron. The time of administration of the drug and the method of dilution, as indicated above.

Side effects

Side effects, probably associated with the administration of the drug Venofer, were observed very rarely (< 0.01% и ≥ 0.001%).

From the nervous system: dizziness, headache, loss of consciousness, paresthesia.

From the side of the cardiovascular system: palpitations, tachycardia, decrease in blood pressure, collaptoid states, feeling of heat, flushing of blood to the face.

From the side of the respiratory system: bronchospasm, shortness of breath.

From the digestive system: spilled, pain in the epigastric region, diarrhea, taste perversion, nausea, vomiting.

From the side of the skin: erythema, itching, rash, pigmentation disorders, excessive sweating.

From the musculoskeletal system: arthralgia, joint swelling, myalgia, pain in the extremities.

Allergic reactions: anaphylactoid reactions, swelling of the face, swelling of the larynx.

Local reactions: pain and swelling at the injection site (especially with extravasal ingestion of the drug).

General violations: asthenia, chest pain, feeling of heaviness in the chest, weakness, peripheral edema, feeling unwell, pallor, fever, chills.

Overdose

Symptoms: hemosiderosis due to acute overload.

drug interaction

Do not prescribe the drug simultaneously with iron dosage forms for oral administration, tk. reduced absorption of iron from the gastrointestinal tract. Treatment with oral iron preparations can be started no earlier than 5 days after the last injection.

Pharmaceutical interaction

Venofer can be mixed in one syringe only with saline. No other IV solutions or therapeutic agents may be added as there is a risk of precipitation and/or other pharmaceutical interactions. Compatibility with containers made of materials other than glass, polyethylene and polyvinyl chloride has not been studied.

special instructions

Venofer should be prescribed only to those patients in whom the diagnosis of anemia is confirmed by relevant laboratory data (for example, the results of determining serum ferritin or hemoglobin and hematocrit levels, the number of erythrocytes and their parameters - the average volume of an erythrocyte, the average content of hemoglobin in an erythrocyte).

IV iron preparations can cause allergic or anaphylactoid reactions, which can be potentially life-threatening.

The rate of administration of the drug Venofer should be strictly observed (with the rapid administration of the drug, blood pressure may decrease). A higher incidence of adverse reactions (in particular, a decrease in blood pressure), which can also be severe, is associated with an increase in dose. Thus, the recommended time of administration of the drug should be strictly observed, even if the patient does not receive the drug in the maximum tolerated single dose.

Studies conducted in patients with hypersensitivity reactions to iron dextran showed no complications during treatment with Venofer.

Penetration of the drug into the perivenous space should be avoided, tk. getting Venofer outside the vessel leads to tissue necrosis and brown staining of the skin. In the event of the development of this complication, in order to accelerate the excretion of iron and prevent its further penetration into the surrounding tissues, it is recommended that heparin-containing preparations be applied to the injection site (gel or ointment is applied with light movements, without rubbing).

From a microbiological point of view, the drug should be used immediately.

Shelf life after dilution with saline: chemical and physical stability after dilution at room temperature is 12 hours. From a microbiological point of view, the drug should be used immediately. If the product is not used immediately after reconstitution, the user is responsible for the storage conditions and time, which in any case should not exceed 3 hours at room temperature, if reconstitution has been carried out under controlled and guaranteed aseptic conditions.

Influence on the ability to drive vehicles and control mechanisms

It is unlikely that the drug Venofer may have an undesirable effect on the ability to drive vehicles and work with mechanisms.

Pregnancy and lactation

Contraindicated in the first trimester of pregnancy.

Limited experience with the use of the drug Venofer in pregnant patients has shown the absence of an undesirable effect of iron saccharate on the course of pregnancy and the health of the fetus / newborn. To date, there have been no well-controlled studies in pregnant women. IN experimental studies effects on reproduction in animals, no direct or indirect harmful effects on the development of the embryo / fetus, childbirth or postnatal development have been identified. However, further research is required on the relationship between the expected benefit of therapy for the mother and the possible risk to the fetus.

The drug should be stored out of the reach of children, in the original packaging, at a temperature of 4 ° to 25 ° C; do not freeze. Shelf life - 3 years.