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Active ingredients
Iron sulfate
Release form
Syrup
Composition
per 100 ml: Active substances: iron sulfate heptahydrate - 3.42 g, D, L-serine - 2.58 gActivating agents: ascorbic acid - 0.4 g, sugar syrup invert (72.7% TS) - 86.6 g, ethanol 96% - 0.3133 g, flavoring raspberry - 0.1 g, cream flavor - 0.025 g, purified water - 32.2 g
Pharmacological effect
The drug is iron. Iron is the most important trace element in the body. As a coenzyme of cytochrome oxidase, catalase, and peroxidase, as well as an integral part of hemoglobin, myoglobin, and cytochrome, it is involved in many metabolic processes, stimulates erythropoiesis. to the rapid restoration of normal iron in the body. This provides the best tolerability of the drug and allows you to reduce the required dose of iron. The daily need for iron in adults is 1-2 mg, in pregnant women - 2-5 mg, in children under the age of 7 years - 0.5-1.5 mg. On average, 10% is absorbed, so to replenish the need for iron, the dose for ingestion should exceed the daily requirement by 10 times.
Pharmacokinetics
AbsorptionAfter ingestion, about 10-15% of ferrous iron is absorbed from the duodenal and jejunum. Iron absorption is also possible through the mechanism of passive diffusion. Iron absorption increases significantly with its deficiency and with increased erythropoiesis. In patients with low hemoglobin and depleted iron depot, absorption may increase to 50-60% and decrease with normalization of these indicators. Cmax of iron is achieved 2-4 hours after administration. DistributionIn the blood, iron binds to transferrin and is transported in trivalent form to sites of hematopoiesis and to specific depots. After iron is bound to apoferritin, it is deposited in the liver, spleen, and bone marrow in the form of ferritin. Iron penetrates the placental barrier, the minimum amount excreted in breast milk.
Indications
- treatment of iron deficiency.
Contraindications
- hypersensitivity to the components of the drug; - iron absorption disorders (sideroachrestic anemia, lead anemia, thalassemia); - elevated levels of iron in the body (hemochromatosis, hemolytic anemia); - anemia not related to iron deficiency. dietary products and supplements containing iron salts (possible risk of overdose).In patients with inflammation and ulcerative lesions of the mucous membrane of the gastrointestinal tract, the ratio of treatment benefit to the risk of developing gastrointestinal disease exacerbations during iron therapy should be evaluated. isomaltase.
Use during pregnancy and lactation
Use during pregnancy and lactation is possible if the potential benefit of therapy for the mother outweighs the possible risk to the fetus or infant.
Dosage and administration
Actiferrin is taken internally just before a meal or during a meal. Syrup is taken with a small amount of liquid (fruit tea or water). If your doctor has not prescribed other dosages, then you should strictly follow the instructions given below. Syrop is the most convenient form for children over 2 years old. Daily dose: 5 ml per 12 kg of body weight. Children of preschool age: the average dose is 5 ml 2-3 times / day. Children of school age: the average dose is 5 ml 1-2 times / day. After reaching normal levels of serum iron and hemoglobin, treatment with the drug is continued for at least 8-12 weeks, prescribing a maintenance dose. Note: to open the vial, press the cap down and simultaneously turn it in the direction of the arrow. After applying the medication cap set and tightly screwed (prevents access for children).
Side effects
Allergic reactions: rarely (> 1/10 000 and <1/1000) - skin manifestations. From the digestive system: very rarely (<1/10 000) - constipation, diarrhea, abdominal pain, nausea, vomiting. When taking iron-containing drugs it is possible to stain feces in a dark (black) color, which has no clinical significance. Gastrointestinal disorders can be prevented by gradually increasing the dose at the beginning of treatment or by lowering the dose during treatment.
Overdose
Children have a high risk of intoxication with iron preparations; life-threatening conditions can occur when taking 1 g of iron sulfate. Therefore, iron preparations should be kept out of the reach of children. Symptoms: if you accidentally take the drug in very high doses, weakness, fatigue, paresthesia, pale skin, cold sticky sweat, decreased blood pressure, palpitations, acrocyanosis, abdominal pain, diarrhea with an admixture blood, cyanosis, confusion, weak pulse, hyperthermia, lethargy, convulsive seizures, symptoms of hyperventilation, coma.Signs of peripheral vascular collapse appear within 30 minutes after ingestion; metabolic acidosis, convulsions, fever, leukocytosis, coma - within 12-24 hours; acute renal and hepatic necrosis - in 2-4 days. Treatment: before specific therapy, measures should be taken to remove the not yet absorbed drug from the stomach (gastric lavage), give the patient to drink milk, raw egg. Specific therapy is carried out by the prescription of deferoxamine (desferal) orally and parenterally. For acute poisoning to bind iron, not yet absorbed from the gastrointestinal tract, 5-10 g deferoxamine is administered orally (dissolve the contents of 10-20 ampoules in drinking water). To remove absorbed iron, deferoxamine is injected intramuscularly slowly, for children - 15 mg / h, for adults - 5 mg / kg / h (up to 80 mg / kg / day); in case of mild poisoning, i / m children take 1 g every 4-6 hours, adults 50 mg / kg (up to 4 g / day). In severe cases, accompanied by the development of shock, injected into / in a drip in a dose of 1 g and spend symptomatic therapy. Fatal outcome mainly occurs when late anti-shock therapy. Hemodialysis is not effective for removing iron, but can be used to accelerate the elimination of the iron-deferoxamine complex, and can also be prescribed for oligo- and anuria. Peritoneal dialysis is possible. In case of a course of treatment with iron preparations, systematic control of the level of serum iron and other serum indicators is necessary. In case of severe intoxication, unitiol (sodium dimercaptopropanesulfonate) is administered parenterally. Because of the possibility of formation of neurotoxic complexes, unitiol should be used with caution.
Interaction with other drugs
Specific antidote - deferoxamine (desferal). When used simultaneously, iron salts reduce the absorption of drugs such as tetracyclines, gyrase inhibitors (for example, ciprofloxacin, levofloxacin, norfloxacin, ofloxacin), penicillamine, levodopa, carbidopa and methyldopa. , iron salts reduce its absorption. Preparations of iron in high doses reduce renal absorption of zinc preparations (the latter are recommended to be taken 2 hours after taking iron preparations). Suction the reduction of iron decreases with co-estramine,antacids (containing aluminum, magnesium, calcium, bismuth) and supplements containing calcium and magnesium. Simultaneous use of iron salts and NSAIDs can enhance the damaging effect of iron on the mucous membrane of the gastrointestinal tract. take 3-4 hours before or after taking Aktiferrin. If necessary, simultaneous prescribing of drugs should be carried out systematic clinical and laboratory control. Tea, coffee, plant foods containing iron chelating agents (such as phosphates, phytate, oxalates), milk, eggs reduce iron absorption. Ascorbic acid and citric acid increase iron absorption Ethanol increases iron absorption and the risk of toxic complications.
special instructions
Hepatic or renal failure increases the risk of iron cumulation. The drug may cause an aggravation of ulcerative and inflammatory bowel diseases. With the use of the drug, persistent darkening of the teeth is possible. The effect on the ability to drive motor vehicles and control mechanisms is not detected.