Ferrum Lek, 50 pcs., 2 ml, 50 mg/ml, solution for intramuscular administration

Pharmacological properties of the drug Ferrum lek

Iron supplement. Contains iron Fe3+ in the form of a complex compound of iron (III) hydroxide with polymaltose (HPA). The iron in the polynuclear "core" is associated with a structure similar to serum ferritin. This macromolecular complex is stable and under physiological conditions does not release iron in the form of free ions. Therefore, when taken orally, iron, which is part of the GPC, enters the blood from the intestine only through active absorption. There is a correlation between the degree of iron deficiency and the amount of iron absorbed (the higher the iron deficiency, the better the absorption). It is this property of the drug that explains the impossibility of poisoning with the drug even in the case of an overdose, unlike simple iron salts, the absorption of which occurs along a concentration gradient. Maximum absorption of iron after oral administration occurs in the duodenum and jejunum, and its absorption is not reduced by interaction with certain food components or with drugs containing a phenolic group (for example, tetracycline). Iron administered in the form of HPA is slowly absorbed and enters the blood serum, from where it quickly passes into iron-depositing tissues. Absorbed iron is stored bound to ferritin, mainly in the liver. Later in the bone marrow it is included in hemoglobin. In hemoglobin, iron is in divalent form, but it is Fe3+ (trivalent iron) that stimulates the formation of globin, which ultimately helps to increase hemoglobin levels. Since iron in the dosage form for oral administration is contained in non-ionized form, the drug does not have such side effects as irritation of the mucous membrane of the digestive tract, staining of tooth enamel, and the appearance of a metallic taste in the mouth. Chewable tablets and syrup are characterized by a high degree of safety and are well tolerated by patients. Comparative studies of the bioavailability of Ferrum Lek oral dosage forms using the radioisotope method, as well as comparative clinical trials, have proven that the absorption and bioavailability of iron in the form of iron (III) hydroxide complex with polyisomaltose is equivalent to the absorption and bioavailability of iron (II) salts.

Ferrum Lek 50 mg/ml 2 ml N5 solution for injection

Latin name

Ferrum Lek

Release form

Solution for intramuscular administration.

Compound

1 ml 1 amp. iron (III) hydroxide polyisomaltose 50 mg 100 mg

Excipients: sodium hydroxide, hydrochloric acid (concentrated), water for injection.

Package

2 ml in ampoules, 5 ampoules in a box.

pharmachologic effect

Antianemic drug.

In the preparation, iron is in the form of a complex compound of iron (III) hydroxide polyisomaltose. This macromolecular complex is stable and does not release iron in the form of free ions. The complex is similar in structure to the natural iron compound ferritin. Iron (III) hydroxide polyisomaltose does not have the pro-oxidant properties that are inherent in iron (II) salts.

Iron, which is part of the drug, quickly compensates for the lack of this element in the body (including in iron deficiency anemia), restores the level of hemoglobin (Hb).

When using the drug, there is a gradual regression of clinical (weakness, fatigue, dizziness, tachycardia, soreness and dry skin) and laboratory symptoms of iron deficiency.

Indications

- for the treatment of iron deficiency conditions that require rapid and reliable replacement of iron losses in the body (severe posthemorrhagic anemia);

- iron absorption disorders; inability to fully absorb iron from the gastrointestinal tract; malabsorption syndrome, ulcerative colitis and some other diseases of the gastrointestinal tract;

- intolerance to oral iron supplements;

— ineffectiveness of treatment of iron deficiency anemia with oral iron supplements.

Contraindications

- hypersensitivity to the components of the drug;

- excess iron in the body (hemochromatosis, hemosiderosis);

— violation of the mechanisms of iron utilization (lead anemia, sideroachrestic anemia, thalassemia);

- anemia not associated with iron deficiency (for example, hemolytic, megaloblastic, caused by a lack of cyanocobalamin).

— I trimester of pregnancy;

- Osler-Rendu-Weber syndrome;

— infectious kidney diseases in the acute stage;

- uncontrolled hyperparathyroidism;

— decompensated cirrhosis of the liver;

- infectious hepatitis.

Carefully

The drug should be used for bronchial asthma, chronic polyarthritis, cardiovascular failure, low ability to bind iron and/or folic acid deficiency, in pediatric patients under 4 months.

Use for liver dysfunction

The use of the drug is contraindicated in cases of decompensated liver cirrhosis and infectious hepatitis.

Use for renal impairment

The use of the drug is contraindicated for infectious kidney diseases in the acute stage.

Use in children

The drug should be used with caution in pediatric patients under 4 months of age. Use during pregnancy and breastfeeding

Parenteral administration of the drug is contraindicated in the first trimester of pregnancy. In the second and third trimesters of pregnancy and during breastfeeding, the drug is prescribed only if the expected benefit to the mother outweighs the potential risk to the fetus or infant.

Directions for use and doses

The drug in solution form can only be administered intramuscularly. IV administration of the drug is not allowed!

Before administering the first therapeutic dose, each patient should be given a test dose of 1/4-1/2 ampoule (25-50 mg of iron) for adults and 1/2 the daily dose for children. If there are no adverse reactions within 15 minutes after administration, the remainder of the initial daily dose is administered.

Doses of the drug Ferrum Lek® are selected individually in accordance with the general iron deficiency, calculated using the following formula:

Total iron deficiency (mg) = body weight (kg) x (calculated Hb level (g/l) - detected Hb (g/l)) x 0.24 + deposited iron (mg).

For body weight up to 35 kg: calculated Hb level = 130 g/l, deposited iron = 15 mg/kg body weight.

With a body weight of more than 35 kg: calculated Hb level = 150 g/l, deposited iron = 500 mg.

Factor 0.24 = 0.0034 x 0.07 x 1000 (iron content in Hb = 0.34%, total blood volume = 7% body weight, factor 1000 - conversion from g to mg).

Calculation of the total number of ampoules of the drug based on the detected hemoglobin level and body weight

Body weight (kg) Total number of ampoules at Hb level 60 g/l 75 g/l 90 g/l 105 g/l 5 1.5 1.5 1.5 1 10 3 3 2.5 2 15 5 4.5 3.5 3 20 6.5 5.5 5 4 25 8 7 6 5.5 30 9.5 8.5 7.5 6.5 35 12.5 11.5 10 9 40 13.5 12 11 9.5 45 15 13 11.5 10 50 16 14 12 10.5 55 17 15 13 11 60 18 16 13.5 11.5 65 19 16.5 14.5 12 70 20 17.5 15 12.5 75 21 18.5 16 13 80 22.5 19.5 16.5 13.5 85 23.5 20.5 17 14 90 24.5 21.5 18 14.5

If the total number of ampoules that must be administered exceeds the maximum permissible daily dose, then the total number of ampoules should be divided by the required number of days. If hematological parameters do not improve 1-2 weeks after the start of treatment, the diagnosis should be clarified again.

Calculation of the total dosage for iron replacement due to blood loss

With a known amount of lost blood, intramuscular administration of 200 mg of iron (2 ampoules) leads to an increase in hemoglobin equivalent to 1 blood unit (400 ml with a hemoglobin content of 150 g/l).

Amount of iron to be replaced (mg) = number of blood units lost x 200 or number of ampoules required = number of blood units lost x 2

When the final hemoglobin level is known, the above formula is used, taking into account the fact that the deposited iron does not need to be replenished.

Amount of iron to be replaced (mg) = body weight (kg) x (estimated Hb level (g/L) - detected Hb level (g/L)) x 0.24

Usual doses

Ferrum Lek®

Adults and elderly patients are prescribed 100-200 mg (1-2 ampoules) depending on the hemoglobin level; children - 3 mg/kg/day (0.06 ml/kg body weight/day).

The maximum daily dose for adults is 200 mg (2 ampoules); for children - 7 mg/kg/day (0.14 ml/kg body weight/day).

Rules for administering the drug

The drug is injected deep intramuscularly alternately into the right and left buttocks.

In order to reduce pain and avoid skin staining, the following rules should be followed:

- the drug should be injected into the upper outer quadrant of the buttock using a needle 5-6 cm long;

— before injection, after disinfection of the skin, the subcutaneous tissues should be moved down 2 cm to prevent subsequent leakage of the drug;

- after administration of the drug, the subcutaneous tissues should be released, and the injection site should be pressed and held in this position for 1 minute.

Before using the solution for intramuscular injection, ampoules should be carefully inspected. Only ampoules containing a homogeneous solution without sediment should be used. The solution for intramuscular injection should be used immediately after opening the ampoule.

Side effects

From the digestive system:

nausea, vomiting.

From the side of the central nervous system:

headache, dizziness.

Local reactions:

If the drug is administered incorrectly, it is possible to stain the skin, develop pain and an inflammatory reaction at the injection site.

Other:

arterial hypotension, arthralgia, enlarged lymph nodes, fever, malaise; extremely rarely - allergic or anaphylactic reactions.

special instructions

The drug should be used only in a hospital setting.

When prescribing Ferrum Lek®, laboratory tests are required: a general clinical blood test and determination of serum ferritin levels; it is necessary to exclude impaired iron absorption.

Treatment with oral forms of iron-containing drugs should begin no earlier than 5 days after the last injection of Ferrum Lek®.

The contents of the ampoules should not be mixed with other drugs.

Drug interactions

Ferrum Lek® for intramuscular injection should not be used simultaneously with iron preparations for oral administration.

The simultaneous use of Ferrum Lek® with ACE inhibitors may increase the systemic effects of parenteral iron preparations.

Overdose

Symptoms:

An overdose of iron supplements can lead to acute iron overload and hemosiderosis.

Treatment:

symptomatic therapy. As an antidote, deferoxamine is administered intravenously slowly (15 mg/kg/hour), depending on the severity of the overdose, but not more than 80 mg/kg/day. Hemodialysis is ineffective.

Storage conditions

The drug should be stored out of the reach of children at a temperature not exceeding 25°C. Do not freeze.

Best before date

5 years.

Indications for use of the drug Ferrum lek

Orally prescribed for the prevention and treatment of iron deficiency conditions of various etiologies, including the prevention of iron deficiency in children, women of childbearing age (especially during pregnancy and breastfeeding), adults (especially vegetarians) and the elderly; treatment of iron deficiency anemia. Ferrum Lek for parenteral administration is indicated for the treatment of iron deficiency conditions that require rapid and reliable compensation of iron deficiency: severe posthemorrhagic anemia, impaired iron absorption, as well as when treatment of iron deficiency anemia with oral iron preparations is ineffective. Ferrum Lek is used in patients with clear indications for the drug, with mandatory determination of the level of ferritin in the blood plasma and the number of red blood cells in the peripheral blood. If iron malabsorption is suspected, an iron absorption test should be performed.

How to give injections

Vitamin B12 injections

can be done in different ways:

• subcutaneously;
• intramuscularly;
• intravenously;
• into the spinal cord.

The instructions say that cyanocobalamin cannot be used simultaneously with drugs that increase blood clotting, as well as with vitamins B1 and B6. If you have an allergy to B1, then B12 can make it worse.

Administer the drug intramuscularly and intravenously

you can do it yourself. For injection into the spinal cord, you should consult an experienced doctor.

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Use of the drug Ferrum lek

The dose and duration of taking the drug depend on the severity of iron deficiency. Tablets and syrup for the treatment of iron deficiency conditions are prescribed in the usual daily dose: adults and children over 12 years of age in the absence of clinical signs of anemia - 10 ml of syrup or 1 tablet per day, in the presence of clinical signs of anemia - 30 ml of syrup per day or 1 tablet 3 times a day; children aged 1–12 years - at the rate of 3 mg of iron per 1 kg of body weight per day or 5–10 ml of syrup per day; it is recommended that syrup be prescribed to infants in an initial dose of 10 drops per day, gradually increasing the dose to 5 ml (1 teaspoon of syrup) per day. A teaspoon of syrup contains 100 drops. Women during pregnancy or breastfeeding are prescribed 20–30 ml of syrup or 1–3 tablets per day.

The duration of use of chewable tablets or Ferrum Lek syrup is at least 3 months after normalization of the peripheral blood composition to restore the iron depot in the body (course of treatment is 6 months). To prevent iron deficiency conditions, the usual dose for pregnant and breastfeeding women is 5–10 ml of syrup or 1 tablet per day. Solution for IM administration IV administration of the solution is contraindicated! Before administering the first therapeutic dose of the drug, its tolerability is determined by administering a test dose - 1/4–1/2 from an ampoule of Ferrum Lek (which corresponds to 25–50 mg of iron) for adults and half the daily dose for children. If no undesirable effects develop over the next 15 minutes, administer the remainder of the initial daily dose. 1 ) first, calculate the total iron deficiency (TID) (mg): TID = TI + ID, where TI is iron included in hemoglobin, mg: TI is = MT (CZG - AIG) 0.24, where MT body weight (kg); CZH - target hemoglobin value, g/l (for body weight up to 35 kg - 130 g/l, for body weight more than 35 kg - 150 g/l); AUC —actual hemoglobin level, g/l; coefficient 0.24 = 0.0034 • 0.07 • 1000, where 0.34% is the iron content in hemoglobin; 7% - total blood volume as a percentage of body weight; 1000 is the conversion factor from grams to milligrams; ID - deposited iron, mg (for body weight up to 35 kg - 15 mg per 1 kg of body weight, for body weight more than 35 kg - 500 mg); 2) calculate the total number of ampoules per course of treatment (OCA): OKA = OCA: 100, where 100 is the iron content in 1 ampoule, mg. Calculation example: body weight = 70 kg; actual hemoglobin level = 80 g/l; iron included in hemoglobin - 70 • 0.24 • (150 – 80) = 1200 mg of iron; deposited iron - 500 mg of iron; general iron deficiency - 1200 + 500 = 1700 mg of iron; the total number of ampoules per course of treatment is 1700: 100 = 17. Table for calculating the total number of ampoules for one patient per course of treatment.

If the total number of Ferrum Lek ampoules exceeds the maximum daily dose, it is necessary to divide the administration of the drug into several doses. If after 1–2 weeks of therapy there is no normalization of blood counts, it is necessary to reconsider the established diagnosis. Calculation of the total dose of Ferrum Lek for intramuscular injection to replenish iron losses due to blood loss. The required number of ampoules is calculated using the following formulas:

1. If the amount of blood lost is known, the administration of 200 mg of iron IM (2 ampoules) causes an increase in hemoglobin levels by 1 unit of blood (400 ml 150 g/l hemoglobin content). Required amount of iron (mg) = number of blood units lost • 200 or required number of Ferrum Lek ampoules = number of blood units lost • 2.
2. If a reduced hemoglobin level is known , use the formula for calculation, assuming that there is no need to replenish stored iron: required amount of iron (mg) = body weight (kg) • (target hemoglobin value [g/l] - actual hemoglobin level [g/l ]) • 0.24. For patients weighing 60 kg with a hemoglobin deficiency of 10 g/l, the required amount of iron is 150 mg or 1.5 ampoules of Ferrum Lek.

The usual dose of Ferrum Lek for intramuscular administration : Children: 0.6 ml of the drug per 1 kg of body weight per day (3 mg of iron per 1 kg of body weight per day). Adults and elderly patients: contents of 1-2 ampoules of Ferrum Lek (100-200 mg iron) depending on the hemoglobin level. Maximum daily dose of Ferrum Lek for intramuscular administration Children: 0.14 ml of the drug per 1 kg of body weight per day (7 mg of iron per 1 kg of body weight per day). Adults: 4 ml of the drug (contents of 2 ampoules) Ferrum Lek. Ferrum Lek for intramuscular injection is administered every other day, deep intramuscularly, alternately into the left and right gluteal muscles. Before use, carefully check the ampoule visually. It is allowed to use only a transparent solution that does not contain sediment. If sediment appears and after the expiration date indicated on the package, the ampoule is not suitable for use. The ampoule is opened immediately before injection. The IM injection is performed slowly to avoid pain and staining of the skin, into the upper outer quadrant of the buttock with a needle 5–6 cm long. Before the injection, wipe the skin with alcohol, pull it to the side by 2 cm so that after removing the needle the injection channel is covered with skin to prevent fluid from leaking into the subcutaneous fat. During injection, the pulled skin is gradually released; after the injection, the injection site is pressed for 1 minute.

Ferrum Lek for intramuscular administration

Release form, composition and packaging

The solution for intramuscular administration is brown, opaque, with virtually no visible particles.

1 ml. iron [III] hydroxide polyisomaltose 50 mg.

1 amp. iron [III] hydroxide polyisomaltose 100 mg.

Excipients: sodium hydroxide, hydrochloric acid (concentrated), water for injection.

Clinical and pharmacological group: Antianemic drug.

pharmachologic effect

Antianemic drug.

In the preparation, iron is in the form of a complex compound of iron (III) hydroxide with polyisomaltose. This macromolecular complex is stable and does not release iron in the form of free ions. The complex is similar in structure to the natural iron compound ferritin.

Iron (III) hydroxide polyisomaltose complex does not have the pro-oxidant properties that are inherent in iron (II) salts. Iron, which is part of the drug, quickly compensates for the lack of this element in the body (including in iron deficiency anemia), restores the level of hemoglobin (Hb).

When using the drug, there is a gradual regression of clinical (weakness, fatigue, dizziness, tachycardia, dry skin) and laboratory symptoms of iron deficiency.

Pharmacokinetics

Suction

After intramuscular administration of the drug, iron quickly enters the bloodstream: 15% of the dose - after 15 minutes, 44% of the dose - after 30 minutes.

Iron, in combination with transferrin, is transported to the cells of the body, where it is used for the synthesis of hemoglobin, myoglobin and some enzymes.

Removal

T1/2 - 3-4 The complex of iron (III) hydroxide with polyisomaltose is large enough and therefore is not excreted through the kidneys; the compound is stable and does not release iron ions under physiological conditions.

Indications

Treatment of all iron deficiency conditions requiring rapid replenishment:

• severe iron deficiency due to blood loss;
• impaired absorption of iron in the intestines;
• conditions for which treatment with oral iron preparations is ineffective or impracticable.

Dosage regimen

The drug in solution form can only be administered intramuscularly. IV administration of the drug is not allowed!

Before administering the first therapeutic dose, the patient should be given a test dose of 1/4-1/2 ampoule (25-50 mg of iron) for adults and 1/2 the daily dose for children. If there are no adverse reactions within 15 minutes after administration, the remainder of the initial daily dose is administered.

Doses of the drug Ferrum Lek are selected individually in accordance with the general iron deficiency, calculated using the following formula:

Total iron deficiency (mg) = body weight (kg) x (calculated Hb level (g/l) - detected Hb (g/l)) x 0.24 + deposited iron (mg).

For body weight up to 35 kg: calculated Hb level = 130 g/l, deposited iron = 15 mg/kg body weight.

With a body weight of more than 35 kg: calculated Hb level = 150 g/l, deposited iron = 500 mg.

Calculation of the total dosage for iron replacement due to blood loss

With a known amount of lost blood, intramuscular administration of 200 mg of iron (2 ampoules) leads to an increase in hemoglobin equivalent to 1 blood unit (400 ml with a hemoglobin content of 150 g/l).

Amount of iron to be replaced (mg) = number of blood units lost x 200 or number of ampoules required = number of blood units lost x 2

When the hemoglobin level is known, the above formula is used, taking into account the fact that the deposited iron does not need to be replenished.

Amount of iron to be replaced (mg) = body weight (kg) x (estimated Hb level (g/l) - detected Hb level (g/l)) x 0.24

Usual doses of Ferrum Lek

Adults and elderly patients are prescribed 100-200 mg (1-2 ampoules) depending on the hemoglobin level; children - 3 mg/kg/(0.06 ml/kg body weight/day).

The maximum daily dose for adults is 200 mg (2 ampoules); for children - 7 mg/kg/(0.14 ml/kg body weight/day).

Rules for administering the drug

The drug is administered every other day deep intramuscularly alternately into the right and left buttocks.

In order to reduce fighting sensations and avoid skin staining, the following rules should be followed:

• the drug should be injected into the upper outer quadrant of the buttock using a needle 5-6 cm long;
• before injection, after disinfection of the skin, the subcutaneous tissues should be moved down 2 cm to prevent subsequent leakage of the drug;
• after administration of the drug, the subcutaneous tissues should be released, and the injection site should be pressed and held in this position for 1 minute.

Before using the solution for intramuscular injection, ampoules should be carefully inspected. Only ampoules containing a homogeneous solution without sediment should be used. The solution for intramuscular injection should be used immediately after opening the ampoule.

Side effect

From the digestive system: nausea, vomiting.

From the side of the central nervous system: headache, dizziness.

Local reactions: if the drug is administered incorrectly, it is possible to stain the skin, develop pain and an inflammatory reaction at the injection site.

Other: arterial hypotension, arthralgia, enlarged lymph nodes, increased temperature; extremely rarely - allergic or anaphylactic reactions.

Contraindications

• excess iron content in the body (hemosiderosis, hemochromatosis);
• violations of the mechanisms of inclusion of iron in hemoglobin (anemia caused by lead poisoning, sideroachrestic anemia, thalassemia);
• anemia not associated with iron deficiency;
• Osler-Rendu-Weber syndrome;
• infectious kidney diseases in the acute stage;
• uncontrolled hyperparathyroidism;
• decompensated cirrhosis of the liver;
• infectious hepatitis;
• I trimester of pregnancy;
• hypersensitivity to the components of the drug.

The drug should be used with caution in case of bronchial asthma, chronic polyarthritis, cardiovascular failure, low ability to bind iron and/or folic acid deficiency, in pediatric patients under 4 months.

Pregnancy and lactation

Parenteral administration of the drug is contraindicated in the first trimester of pregnancy. In the second and third trimesters of pregnancy and during breastfeeding, the drug is prescribed only if the expected benefit to the mother outweighs the potential risk to the fetus or infant.

Use for liver dysfunction

The use of the drug is contraindicated in cases of decompensated liver cirrhosis and infectious hepatitis.

Use for renal impairment

The use of the drug is contraindicated for infectious kidney diseases in the acute stage.

special instructions

The drug should be used only in a hospital setting.

When prescribing Ferrum Lek, laboratory tests are required: a general clinical blood test and determination of serum ferritin levels; it is necessary to exclude impaired iron absorption.

Treatment with oral forms of iron-containing drugs should begin no earlier than 5 days after the last injection of Ferrum Lek. Ferrum Lek is intended for intramuscular administration only. It is necessary to insert deeply into the gluteal muscle (a needle 5-6 cm long), as well as shifting the tissue when inserting the needle and squeezing the tissue after removing the needle; injected in turn into the right and left gluteal muscles.

The opened ampoule should be used immediately.

The contents of the ampoules should not be mixed with other drugs.

The use of ampoules in which sediment has formed as a result of improper storage of the drug is unacceptable.

Overdose

Symptoms: An overdose of iron supplements can lead to acute iron overload and hemosiderosis.

Treatment: symptomatic therapy. As an antidote, deferoxamine is administered intravenously slowly (15 mg/kg/hour), depending on the severity of the overdose, but not more than 80 mg/kg. Hemodialysis is ineffective.

Contraindications to the use of the drug Ferrum lek

Hypersensitivity to the drug , anemia not caused by iron deficiency, including hemolytic; hypersensitivity to any of the components of the drug; excess iron in the body (hemochromatosis, hemosiderosis); disorders of hemoglobin synthesis (anemia caused by lead poisoning, sideroblastic anemia), thalassemia; severe hemostasis disorders (hemophilia); oral administration is not advisable when there is a decrease in the concentration of iron in the blood serum and anemia caused by a chronic inflammatory process or neoplasm.

Side effects of Ferrum Lek

Usually well tolerated, side effects are mostly transient and mild. Gastrointestinal disorders such as a feeling of heaviness and fullness in the stomach, distension in the epigastric region, nausea, constipation or diarrhea are very rarely observed. Dark coloration of stool caused by iron supplementation is not clinically significant. With intramuscular administration, arterial hypotension, arthralgia, swollen lymph nodes, fever, headache, dizziness, and infiltrate at the injection site rarely occur; very rarely - anaphylactic and anaphylactoid reactions.

Special instructions for the use of the drug Ferrum Lek

1 tablet contains 0.04 XE, 1 ml of syrup - 0.04 XE. Each Ferrum Lek tablet contains 1.5 mg of aspartame (a precursor to phenylalanine), and may therefore have an adverse effect on patients with phenylketonuria. In controlled trials, the use of the drug in the second and third trimester of pregnancy did not have a negative effect on the fetus. Iron is released into breast milk in the form of a complex with lactoferrin, only a small amount of iron from the complex of iron (III) hydroxide with polymaltose passes into breast milk in ionized form, so the occurrence of side effects in an infant when the mother takes Ferrum Lek is unlikely. Parenteral administration of iron preparations can cause the development of allergic reactions. For an allergic reaction of moderate severity, the administration of antihistamines is recommended. If an anaphylactic reaction develops, immediate administration of epinephrine is indicated. The risk of developing anaphylaxis is quite high in patients with asthma, Crohn's disease, polyarthritis, reduced iron binding capacity and/or folic acid deficiency.

Interactions of the drug Ferrum lek

Do not mix the solution for intramuscular administration with other medications; Like other iron preparations for parenteral use, Ferrum Lek is not prescribed simultaneously with iron preparations for oral administration. The interval between parenteral use of the drug and the start of use of oral dosage forms of iron should be at least 5 days. Since iron is included in the drug in the form of a complex of iron (III) hydroxide with polymaltose, when taken in the form of chewable tablets or syrup, it does not form insoluble chelate compounds with components of food products (phytin, oxalates, tannin) or medicines (tetracyclines, antacids ).

Cyanocobalamin treatment regimen

When vitamin B12 is prescribed, instructions for use

will help you calculate the correct dosage. The treatment plan looks like this:

• For the prevention of anemia and vitamin deficiency - from 200 to 500 mcg per day. The course of treatment ranges from 7 to 15 days.
• For the treatment of diseases of the central nervous system - 200 mcg per day daily for the first 3 days. Then 300 mcg daily for 4 days.
• If cyanocobalamin is used in complex therapy, the dosage is from 200 to 500 mcg per day.

Take vitamin B12

It is necessary only in the dosage recommended by the doctor. It is not recommended to use the drug on your own, since it is quite difficult to determine an individual treatment regimen.

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Ferrum lek overdose, symptoms and treatment

With parenteral administration, hemosiderosis may develop. Incorrect diagnosis of anemia as iron deficiency can lead to iron overdose. In case of an overdose of tablets or syrup, symptoms of acute poisoning can develop in extremely rare cases, since iron from HPA is absorbed not through passive diffusion, but through active transport, and the degree of absorption of iron from HPA directly depends on the severity of iron deficiency. Treatment is symptomatic; a specific iron antidote is the chelating agent deferoxamine.