Totem solution for oral administration ampoules 10ml N20
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Release form
Solution
Composition
Active ingredient: Iron gluconate + Manganese gluconate + Copper gluconate (Ferrous gluconate + Manganese gluconate + Cuprum gluconate) Active ingredient concentration (mg): Iron gluconate dihydrate (amount corresponding to the elemental gland) 50 mg, manganese gluconate (amount corresponding to elemental manganese) 1, 33 mg, copper gluconate (amount corresponding to elemental copper) 0.7 mg
Pharmacological effect
Combined antianemic drug. It contains iron, which is necessary for the synthesis of heme, which is part of hemoglobin, myoglobin, flavoproteins, iron-ferritin and iron-transferrin complexes, various enzymes; participates in a number of redox reactions. Copper and manganese are trace elements and are cofactors of some enzymes. The absorption of trace elements is the more intense, the greater the iron deficiency in the body. When taking the drug, there is a gradual regression of the clinical and laboratory symptoms of anemia.
Pharmacokinetics
Absorption of iron and other trace elements occurs mainly in the duodenum and the upper part of the jejunum.
Indications
Treatment and prevention of iron deficiency anemia in adults and children from 3 months of age, caused by various reasons: - bleeding; - increased need for iron (pregnancy); - lack of iron intake from food or a violation of its absorption.
Contraindications
Anemias not associated with iron deficiency - hemochromatosis, hemosiderosis; - thalassemia; - gastric ulcer and duodenal ulcer in the acute phase; - lead intoxication; - copper or manganese intoxication; , galactose glucose malabsorption syndrome; - children up to 3 months; - hypersensitivity to the components of the drug. The drug should be prescribed with caution in diabetes mellitus.
Precautionary measures
Precautions should be prescribed the drug for diabetes.
Use during pregnancy and lactation
The use of the drug during pregnancy and lactation is permitted if indicated in recommended doses.
Dosage and administration
For the treatment of anemia, adults are prescribed the drug at the rate of 100-200 mg of iron (2-4 amp.) / Day; children older than 3 months - at the rate of 5-7 mg / kg of body weight / day in 2-4 doses. The drug is administered under the control of the serum iron content, total serum iron-binding ability before the start of treatment and thereafter with a frequency of 1 time in 2 months. With a preventive purpose, adults and pregnant women (starting from the 4th month of pregnancy) are prescribed 50 mg (1 amp.) / day. Depending on the age, the drug is prescribed to children in a dose of 1/4 to 1/2 daily therapeutic dose for adults. The duration of treatment is determined individually. The average duration of the drug intake is from 3 to 6 months (until the iron reserves in the body are restored).
Side effects
Allergic reactions, darkening of the tooth enamel. Stool staining in black (normal), gastrointestinal disorders: heartburn, nausea, vomiting, diarrhea, constipation, pain in the epigastric region. any other side effects not listed in the description should be reported to your doctor.
Overdose
Symptoms: weakness, hyperthermia, convulsions, nausea, vomiting, constipation, diarrhea, epigastric pain. Cases of necrosis of the gastrointestinal tract and shock are described. Treatment: gastric lavage with 1% sodium bicarbonate solution (baking soda). When the serum iron concentration is more than 5 μg / ml, deferoxamine is administered intravenously slowly: for children - 15 mg / kg / h, for adults - 5 mg / kg / h (up to 80 mg / kg / day); in case of mild intoxication: children - 1 g every 4-6 hours, adults 50 mg / kg (up to 4 g / day); conduct symptomatic therapy; in the event of shock, anti-shock therapy is performed.
Interaction with other drugs
The simultaneous use of the drug Totem leads to a decrease in the absorption of bisphosphonates, ciprofloxacin, tetracyclines when taken orally. Salts, oxides and hydroxides of magnesium, aluminum and calcium violate the absorption of iron salts. Totem should be taken no earlier than 2 hours after taking these drugs. The drug cannot be combined with other iron preparations, including administered parenterally.
special instructions
Monitoring the effectiveness of treatment should be carried out no earlier than 3 months after the start of treatment. Excessive consumption of tea inhibits iron absorption. In order to avoid darkening of the tooth enamel, prolonged stay of the solution of the drug in the oral cavity should be avoided. Patients with diabetes should be consideredthat 10 ml of the drug contains 3 g of sucrose. 1 vial of the drug contains 1/4 XE, 1 max. medical intervention. During treatment with iron preparations, fecal occult blood analysis can give a false positive result. Effect on the ability to drive vehicles and control mechanisms There is no data on the negative effect of the drug on the ability to drive vehicles and other mechanisms.