List of iron preparations in the treatment of anemia

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List of iron preparations in the treatment of anemia

Fenulles is a preparation that contains vitamin C and B vitamins in addition to ferrous iron. Using such a complex allows improving the process of assimilation of iron by the body. The main active substance is encapsulated and has the form of microgranules. This allows the iron and other components of the capsule to dissolve slowly, which does not irritate the walls of the intestine and stomach.

Ferro-folgamma is a preparation of ferrous iron supplemented with cyanocobalamin and folic acid. One capsule contains 37 mg of iron. The drug gives a minimum of side effects and is rapidly absorbed in the intestine, in its

totem – drug for the treatment of anemia with ferrous iron, copper and manganese in the composition. A drug is produced in ampoules that are taken orally. Totem is prescribed for children older than 3 months. After its application, darkening of tooth enamel is possible, therefore the contents of the ampoule are recommended to dissolve in any beverage. After taking the drug, you should brush your teeth.

Gino-Tardiferon. This drug is widely known among women in the position. It contains ferrous iron in the amount of 40 mg, as well as folic acid. Gino-Tardiferone is produced in tableted form. It is allowed to be used to treat anemia in children older than seven years. In addition, that this medicine allows you to fill iron stores in the body, it also eliminates the deficiency of folic acid. This is especially true for expectant mothers. Drink the drug followed by water in large quantities.

Sorbifer durules is a preparation of ferrous iron, which is produced in tablet form. In addition, the drug is supplemented with vitamin C. Sorbifer durules can be used to treat children older than 12 years. It is also often prescribed to pregnant women. Take the drug for half an hour before meals, swallow the whole pill and drink it with water. During the therapeutic course, care should be taken in the management of transport, as Sorbifer durules affect the concentration of attention.

Aktiferrin is a preparation containing ferrous iron, as well as D, L-serine.

The drug has several release forms:

  • In the form of capsules containing 34.5 mg of iron and 129 mg of D, L-serine. In one package, there are 20 capsules.

  • In the form of a syrup with a nominal volume of 100 ml. In this case, the iron contained 34.2 mg, and D, L-serine 25.8 mg.

  • In the form of drops in a bottle with a nominal volume of 30 ml. One drop contains 9.48 mg of iron and 35.6 mg of D, L-serine.

Actiferrin is prescribed for treatment of women in the situation. Also it can be taken during lactation. However, during treatment with Actyferrin, darkening of the tooth enamel is possible, so before use it should be diluted. It is important to note the date of opening the integrity of the package, because after a month the drug will become unusable.

Hemofer prolongatum is a preparation containing ferrous iron in an amount of 105 mg per capsule. It can not be used to treat children younger than 12 years. Otherwise, there are no restrictions, so the drug is prescribed for therapy to nursing and pregnant women. The dosage should be selected by the doctor. Accept Hemofer prolongatum before or after a meal, which depends on the individual characteristics of the human body. Recommendations for taking iron preparations

  • You can not deviate from the iron supplementation regimen. It is determined only by the doctor. An overdose of this group of drugs threatens with serious consequences.

  • After 30-45 days from the start of treatment, the hemoglobin level should stabilize. To determine this, it will be necessary to donate blood for analysis.

  • During treatment, a person can find out that his stool masses have turned to a dark color. This should not be frightened, since such a phenomenon is a variant of the norm. When a doctor prescribes the donation of stool tests to occult blood, he should be warned that the patient is taking iron preparations. The intake of iron preparations is associated with a number of complications, including: abdominal pain, nausea and vomiting, bloating, pain along the bowel. Now there is a large selection of iron preparations on the market, which allows selecting the form of release convenient for the patient and making the therapy individually oriented. However, this does not mean that you can prescribe medicines yourself. The choice of therapy should only be done by a doctor and only after a survey. Anemia is treated for a long time and the whole process should under the supervision of a specialist. / h

    Which drugs are more effective

    All the drugs that are used to get rid of iron deficiency can be divided into 2 large groups: preparations of ferrous iron (ionic salt) and preparations of trivalent iron (based on GPC). As the analysis of practical application of preparations of ferrous and ferric iron shows, their therapeutic effect in terms of treatment of anemia is equivalent.

    The intake of ferrous preparations is associated with the following problems:

    • The organism can absorb these medicines in uncontrolled volumes, which can cause serious poisoning of

    • Drugs are able to interact with food and other medicines.

    • During treatment, an unpleasant taste of the metal may appear in the mouth.

    • Teeth and gums can be dyed dark. Sometimes the staining is fairly persistent.

    • About 30-35% of patients stop treatment without completing the course to the end.

    If you use ferric iron preparations based on HPA, many problems can be avoided.

    Compared to their divalent counterparts, they have the following advantages:

    • There is no risk of overdose and poisoning of the body. Drugs are absolutely safe in this respect.

    • The gums and teeth do not stain in a dark color.

    • The preparations have a pleasant taste.

    • They are well tolerated by patients.

    • Most patients adjust their course to the end.

    • With other drugs and food products, ferric compounds do not interact.

    • In addition to saturation of the body with iron, most of these drugs have antioxidant effect. The use of preparations based on ferrous iron can be accompanied by constipation, abdominal pain, diarrhea, nausea and vomiting. As a result of such side effects, a person refuses treatment. In addition, the body is able to absorb iron in excess, which sometimes leads to poisoning. Therefore, specialists prefer modern preparations containing ferric iron.

      The main drugs that are used to treat iron deficiency anemia are presented below in the picture:

      . In addition to oral intake of iron preparations, it is possible to use drugs based on iron in the form of injections. They are administered either intramuscularly or intravenously. Such drugs are recommended for use only if oral intake is impossible, or does not allow achieving the desired effect.

      Indications for parenteral administration of iron preparations:

      • Severe anemia. In modern practice, this situation is rare, no more than 3% of all cases of the disease.

      • Intolerance to iron preparations for oral administration.

      • Resistance to treatment with oral medications.

      • Gastric and duodenal ulcers, operations on the digestive system. And even if the peptic ulcer already existed in an anamnesis, it will still be a contraindication to oral intake of iron preparations.

      • Anemia that develops against the backdrop of chronic intestinal pathologies, for example, against Crohn’s disease or ulcerative colitis.

      • Kidney disease of chronic course. Parenteral iron preparations are also prescribed for patients undergoing hemodialysis. This measure is aimed at preventing anemia.

      • There is no possibility to perform a red blood cell transfusion.

      • The acute need for immediate replenishment of iron stores in the body. Injections into the muscle or intravenous infusions of iron preparations are performed 1-3 times per 7 days. The dose should not exceed the total iron deficiency in the human body. To calculate the total iron deficiency, the following formula should be used:

        Total iron deficiency in mg = Human weight in kg * (Hemoglobin norm in g / l hemoglobin patient in g / l) + iron depot in mg.

        Coefficient 0,24 = 0,0034 * 0,07 * 1000, where:

        • The iron content in the hemoglobin is equal to 0.34%.

        • Blood volume in the human body is 7% of the body weight.

        • .

          • Weight below 35 kg – 15 mg / kg, the target concentration of hemoglobin – 30 g / l. Weight more than 35 kg – 500 mg, the target concentration of hemoglobin – 150 g / l. A distinguishing feature of this formula is that it takes into account iron stores in the body, which account for more than 30% of its total body content. With a decrease in the concentration of SF, a decrease in the concentration of iron in the depot can be detected.

            Calculating the total iron deficiency in the human body in mg and knowing the total amount of iron in the ampule of one drug (eg, 100 mg), you can calculate the number of ampoules that will be needed to complete the course of treatment. The formula for calculating:

            Amount of ampoules per course = total iron deficiency / 100 mg

            Parenteral administration of iron preparations may be associated with a number of side effects, among which:

            • Occurrence of burning, itching and flushing of the skin at the site of drug administration. Allergic reaction, up to anaphylactic shock.

            • The most common shock is the administration of drugs, which include Dextran. Therefore, before the first administration of iron preparations it is recommended to perform a test sample. It is equally important to correctly calculate the dose a person needs. However, negative reactions the body is able to give even if the treatment is carried out with a small amount of iron.

            For the treatment to be effective and safe, the following recommendations for the parenteral administration of iron preparations should be strictly observed:

            • Only modern medicines should be used have minimal toxicity, do not give anaphylactic reactions and do not pose a threat to the life of the patient.

            • Before the administration of the dose, it is necessary to calculate the total iron deficiency in the human body.

            • The course should last as long as necessary. Do not prolong it.

            • It is important to comply with all the rules of parenteral administration of iron preparations.

            • Be sure to enter a trial dose before starting the main treatment.

            • Treatment should be carried out in strictly safe doses. Modern iron preparations for parenteral administration:

              In order to determine whether the selected treatment regimen with iron-containing preparations was effective, it is necessary to focus on the following criteria:

              • On the 7-10th day from the beginning of the intake with iron-containing preparations, the patient has an increase in the level of reticulocytes in the blood. The jump is 2-3% or 20-30% of the initial amount. The increase in the hemoglobin level in the blood by day 28 is 10 g / l, and the hematocrit by 3%.

              • Symptoms of anemia should be completely stopped within 30-45 days from the start of treatment.

              • Iron stores in the depot should be replenished after 3-6 months from the start of therapy. The exact timing of recovery depends on the severity of the anemia. Why can treatment with iron-containing drugs be ineffective?

                Provided that the therapy does not give the desired effect, it is necessary to pay attention to the following items :

                • The diagnosis was not correct.

                • The dose of the drug was not correctly selected.

                • The treatment lasted less than the due date.

                • The patient did not follow the doctor’s recommendation.

                • The patient has problems at the iron absorption stage.

                • The person does not tolerate iron preparations.

                If the diagnosis does not raise doubts, then the effect of taking ferric iron preparations is bound to come. Therefore, in the absence of a reticulocyte crisis and an increase in the level of hemoglobin in the blood, the diagnosis should be revised. With a high degree of probability, the patient does not have iron deficiency anemia, but some other kind of anemia and treatment is chosen incorrectly.

                If the reason for the ineffectiveness of treatment is not established, then we should consider such an option as IRIDA (iron-refractory iron-deficiency anemia). This pathology is inherited and does not respond to oral intake of iron-containing drugs. Parenteral administration of these drugs only has a partial effect. This type of anemia develops when the TMPRSS6 gene mutates. This leads to the fact that the body increases the level of hepcidin, which suppresses the absorption of iron in the intestine and prevents it from being released from the macrophages. Until now, effective treatments for this rare variety of anemia have not been found.

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