Instructions for use FERRUM LEK®

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 100 mg 50 pcs. chewable tablets

pharmachologic effect

Replenishes iron deficiency, antianemic.

Composition and release form Ferrum lek 100 mg 50 pcs. chewable tablets

Chewable tablets - 1 tablet:

• active substance: iron (III) hydroxide polymaltosate - 400 mg (in terms of iron - 100 mg);
• excipients: macrogol 6000; aspartame; chocolate flavoring; talc; dextrates.

Chewable tablets, 100 mg. 10 tablets each in a strip or blister; 3, 5 or 9 strips in a cardboard pack.

Description of the dosage form

Round flat tablets, dark brown interspersed with light brown, with a bevel.

Directions for use and doses

Inside, during or immediately after meals.

Ferrum Lek® chewable tablets can be chewed or swallowed whole.

The daily dose can be divided into several doses or taken at one time.

Pharmacodynamics

The molecular mass of the complex is so large - about 50 kDa - that its diffusion through the gastrointestinal mucosa is 40 times slower than the diffusion of ferrous iron. The complex is stable and does not release iron ions under physiological conditions. The iron of the multinuclear active zones of the complex is bound into a structure similar to the structure of the natural iron compound - ferritin. Due to this similarity, the iron of this complex is absorbed only through active absorption. Iron-binding proteins located on the surface of the intestinal epithelium absorb iron (III) from the complex through competitive ligand exchange. Absorbed iron is mainly deposited in the liver, where it binds to ferritin. Later in the bone marrow it is incorporated into hemoglobin.

Iron (III) complex polymaltose hydroxide does not have the pro-oxidant properties inherent in iron (II) salts.

Pharmacokinetics

Studies using the dual isotope method (55Fe and 59Fe) have shown that iron absorption, as measured by red blood cell hemoglobin levels, is inversely proportional to the dose administered (the higher the dose, the lower the absorption). There is a statistically negative correlation between the degree of iron deficiency and the amount of iron absorbed (the higher the iron deficiency, the better the absorption). Iron is absorbed to the greatest extent in the duodenum and jejunum.

The remaining (unabsorbed) iron is excreted in the feces. Its excretion with exfoliating epithelial cells of the gastrointestinal tract and skin, as well as with sweat, bile and urine is approximately 1 mg of iron per day. Women experience additional iron loss during menstruation, which must be taken into account.

Indications for use Ferrum lek 100 mg 50 pcs. chewable tablets

• treatment of latent iron deficiency;
• treatment of iron deficiency anemia;
• prevention of iron deficiency during pregnancy.

Contraindications

• hypersensitivity to the components of the drug;
• excess iron in the body (hemochromatosis, hemosiderosis);
• violation of iron utilization mechanisms (lead anemia, sideroachrestic anemia, thalassemia);
• anemia not associated with iron deficiency (for example, hemolytic, megaloblastic, caused by a lack of cyanocobalamin).
• children's age up to 12 years.

With caution: bronchial asthma; chronic polyarthritis; cardiovascular failure; low ability to bind iron and/or folic acid deficiency.

Application Ferrum lek 100 mg 50 pcs. Chewable tablets during pregnancy and breastfeeding

During controlled studies in pregnant women (II, III trimesters of pregnancy), no negative effects on the body of the mother and fetus were noted. No harmful effects on the fetus were detected when taking the drugs in the first trimester of pregnancy.

special instructions

For children under 12 years of age, due to the need to prescribe low doses of the drug, it is preferable to prescribe Ferrum Lek® in syrup form.

Neither chewable tablets nor Ferrum Lek® syrup cause staining of tooth enamel.

In cases of anemia caused by an infectious or malignant disease, iron accumulates in the reticuloendothelial system, from which it is mobilized and utilized only after the underlying disease has been cured.

When using the drug Ferrum Lek®, the stool may turn dark, which does not have any clinical significance. Taking iron supplements does not affect the results of the test for hidden bleeding (selective for hemoglobin).

Notice for diabetics: 1 chewable tablet or 1 ml of Ferrum Lek® syrup contains 0.04 XE.

Notice to patients with phenylketonuria: Ferrum Lek® contains aspartame (E951), a source of phenylalanine, in an amount equivalent to 1.5 mg per tablet.

Impact on the ability to drive a car or perform work that requires increased speed of physical and mental reactions. The drug does not affect the ability to concentrate.

Overdose

Symptoms: in case of an overdose of Ferrum Lek® syrup or chewable tablets, there were no signs of intoxication or excess iron in the body, because iron from the active substance is not present in the gastrointestinal tract in free form and is not absorbed by passive diffusion.

Treatment: symptomatic; 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.

Side effects Ferrum lek 100 mg 50 pcs. chewable tablets

The side effects reported were mostly mild and transient.

According to WHO, adverse reactions are classified according to their frequency as follows: very often (≥1/10), often (≥1/100,

From the gastrointestinal tract: very rarely - pain in the abdomen, nausea, constipation, diarrhea, dyspepsia, vomiting, change in the color of feces (due to the excretion of unabsorbed iron, has no clinical significance).

From the skin and subcutaneous tissue: very rarely - urticaria, rash, itching of the skin.

Drug interactions

No interactions with other drugs or food products have been identified.

Concomitant use of polymaltosate hydroxide with parenteral iron preparations and other oral iron (III) preparations is not recommended due to the pronounced inhibition of the absorption of orally administered iron.

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.

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®

Ferrum Lek® solution is intended for intramuscular administration only.

The drug should be administered only in a hospital setting, by specially trained personnel who can recognize the signs of incipient anaphylactic shock, in conditions of availability of resuscitation facilities and the possibility of carrying out a complex of anti-shock measures.

The patient should be observed for at least 30 minutes after each injection.

Before administering the first therapeutic dose of the drug, each patient should be given a test dose of 1/4-1/2 ampoule of Ferrum Lek® (25 - 50 mg of iron) for an adult and half the daily dose for a child. If there are no adverse reactions, the remainder of the daily dose should be administered within 15 minutes.

The dose of Ferrum Lek® must be selected individually in accordance with the general iron deficiency, which is calculated using the following formula:

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

Body weight up to 35 kg: calculated hemoglobin level = 130 g/l and deposited iron = 15 mg/kg body weight.

Body weight over 35 kg: estimated hemoglobin level = 150 g/l and deposited iron = 500 mg.

*Factor 0.24 = 0.0034 x 0.07 x 1000: (Iron content = 0.34%; total blood volume = 7% body weight; factor 1000 = conversion from g/L to mg/L).

Example: Patient's body weight: 70 kg. Real hemoglobin concentration: 80 g/l. Total iron deficiency = 70 x (150 - 80) x 0.24 + 500 = 1676 ̴1700 mg of iron.

The total number of Ferrum Lek® ampoules that must be administered = Total iron deficiency (mg)/100 mg.

Table: Calculation of the total number of Ferrum Lek® ampoules that need to be administered, based on the actual hemoglobin concentration and body weight.

If the required dose of Ferrum Lek® exceeds the maximum daily dose, the drug should be administered in fractional doses (over several days).

If 1-2 weeks after the start of treatment the hematological parameters do not change, an additional examination should be carried out to clarify the diagnosis.

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

The required amount of the drug to compensate for post-hemorrhagic iron deficiency is calculated using the following formula:

If the amount of blood lost is known

: administration of 200 mg intramuscularly (2 ampoules of Ferrum Lek®) leads to an increase in hemoglobin concentration, which is equivalent to 1 unit of blood (400 ml of blood with a hemoglobin content of 150 g/l).

Iron to be replaced (mg) = number of lost units of blood x 200 or Required number of ampoules of Ferrum Lek® = number of lost units of blood x 2.

If the final hemoglobin level is known

: Use the following formula, taking into account that deposited iron does not need to be reimbursed.

Iron to be replaced (mg) = body weight (kg) x (estimated hemoglobin level (g/L) - actual hemoglobin level (g/L) x 0.24.

Example: A patient with a body weight of 60 kg and a hemoglobin deficiency of 10 g/l should be replaced with 150 mg of iron, which is 1 1/2 ampoules of Ferrum Lek®.

Standard doses

For children

: 0.06 ml/kg body weight/day (3 mg iron/kg/day).

For adults:

1 - 2 ampoules of Ferrum Lek® (100 - 200 mg iron), depending on the hemoglobin content.

Maximum daily doses

For children:

0.14 ml/kg body weight per day (7 mg iron/kg/day).

Adults: 4

ml (2 ampoules of Ferrum Lek®) per day.

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.

FERRUM LEK (syrup)

.
Our local therapist just throws up his hands and says: “You are still adapting. Be patient. You'll have to get sick."" No adaptation. More than a year! I could believe this if my daughter had been weak and sickly since birth, but for 1 year 10 months, before she went to kindergarten, she never sniffled (believe it or not). In general, we suffered a lot. And at one fine moment we were lucky enough to temporarily get to another doctor. I explained our problem to her. After flipping through our card, the doctor asks me: “Do you know that your hemoglobin has been very low for a year? What do you take to raise it? Do you know that low hemoglobin weakens the immune system?” etc., etc. Honestly, I didn’t know about this and was in quiet shock (And our doctor didn’t tell us anything, citing poor health from -for adaptation and getting used to kindergarten. Apparently, all doctors have their own hemoglobin standards for children, or maybe our doctor simply doesn’t know them? Which is more likely, judging by the current situation.

On the recommendation of a doctor, I purchased Ferrum-Lek syrup in syrup. At the pharmacy the price is for a 100 ml bottle. cost us around 150 rubles (the price varies in each pharmacy). We need to take it for 2 months, then take a general blood test, and then continue taking the drug for 1 month.

Fortunately for me))) we had no problems taking this syrup. It tastes sweet, but has a metallic aftertaste, which I didn’t like when I tasted it, but my daughter drinks it with pleasure and reminds me every time that it’s time to take the “syrup.”

The bottle itself is glass with a plastic cap and a wide neck. For one appointment I give my daughter 5 ml (a teaspoon).

The syrup is dark brown in color and for those who don’t know, this syrup (and perhaps all iron supplements, I don’t know) has one huge disadvantage: children’s milk teeth very quickly become dark, with a brown coating... And this plaque can no longer be cleaned off with a toothbrush . Yes, these are the consequences that appear after taking this drug for a long time. But thanks to the pharmacist at the pharmacy, who advised us to give this syrup from a syringe so that the syrup does not get on the teeth, as it could if given from a spoon. After my daughter took the syrup, I let her drink a sip of water, or rather rinse her teeth, which she does without thinking) And you know, our teeth are perfectly white, just like before taking the syrup)

Since the beginning of September (and this is already 2 months), my daughter has been taking Ferrum-Lek and already for 2 months!!!! My daughter has been going to kindergarten for months without getting sick. Last week I had a general blood test and the test was normal!!! We have to take this drug for another month and, to be honest, I’m afraid that the hemoglobin will again be below normal. I hope that everything will remain as it is now, i.e. normal!

In the meantime, I recommend Ferrum-Lek syrup to all those whose hemoglobin is below normal! Of course, only on the recommendation of your attending physician, since this is first and foremost a medicine, and all medicines, as we know, have contraindications and side effects.

Thank you for your attention to my review! Be healthy! Bye bye!!!

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.

Instructions for use FERRUM LEK®

Chewable tablets

It is recommended to take the drug during or immediately after meals. The tablet can be chewed or swallowed whole. The daily dose can be taken at one time or divided into several doses.

The dose of the drug and duration of treatment depend on the degree of iron deficiency.

Iron-deficiency anemia

Treatment continues for 3-5 months until hemoglobin levels normalize. After this, the drug is prescribed for several more weeks to replenish iron reserves in the body.

Adults, nursing mothers, children and adolescents over 12 years of age

Prescribe, as a rule, 1-3 chewable tablets per day.

Pregnant women

Prescribe 2-3 chewable tablets per day until hemoglobin levels normalize. After this, 1 chewable tablet per day is prescribed, at least until the end of pregnancy, to replenish iron reserves in the body.

Children 0-12 years old

Ferrum Lek® is prescribed in syrup form.

Latent iron deficiency

Treatment continues for 1-2 months.

Adults, nursing mothers, children and adolescents over 12 years of age are prescribed

1 chewable tablet per day.

Children aged 1 to 12 years

Ferrum Lek® is prescribed in syrup form.

Due to the fact that children under 1 year of age

Iron supplements are prescribed in very low doses; Ferrum Lek® in the form of chewable tablets is not intended for this category of patients.

Latent iron deficiency and prevention of iron deficiency

Pregnant women

Prescribe 1 chewable tablet per day.

Table. Daily doses of Ferrum Lek® chewable tablets

* - for this indication, the drug is prescribed in very low doses, so chewable tablets are not used.

Solution for intramuscular administration

Ferrum Lek® can only be administered intramuscularly. The drug cannot be used for intravenous administration.

Before administering the first therapeutic dose of Ferrum Lek®, each patient should be given a test dose

, amounting to 1/4-1/2 ampoule of Ferrum Lek® (25-50 mg of iron) for
an adult
and half the daily dose for
a child
. If there are no adverse reactions, the remainder of the daily dose can be administered within 15 minutes.

Doses of Ferrum Lek® must be selected individually in accordance with the general iron deficiency, which is calculated using the following formula:

General iron deficiency = body weight (kg) × (calculated hemoglobin level (g/l) - actual hemoglobin level (g/l) × 0.24 + deposited iron (mg)

Body weight up to 35 kg:

calculated hemoglobin level = 130 g/l and deposited iron = 15 mg/kg body weight

Body weight over 35 kg:

estimated hemoglobin level = 150 g/l and deposited iron = 500 mg

Factor 0.24 = 0.0034×0.07×1000

(Iron content = 0.34%; total blood volume = 7% body weight; factor 1000 = conversion from g to mg).

Example:

Patient body weight: 70 kg

Real hemoglobin concentration: 80 g/l

Total iron deficiency = (150 – 80)×0.24 + 500 = 1700 mg iron

Total number of Ferrum Lek® ampoules that must be administered = Total iron deficiency (mg) / 100 mg

Table. Calculation of the total number of Ferrum Lek® ampoules that must be administered, based on the actual hemoglobin concentration and body weight

Body weight (kg)	Total number of Ferrum Lek® ampoules to be administered
Нb 60 g/l	Нb75 g/l	Нb 90 g/l	Нb 105 g/l
5	1.5	1.5	1.5	1.0
10	3.0	3.0	2.5	2.0
15	5.0	4.5	3.5	3.0
20	6.5	5.5	5.0	4.0
25	8.0	7.0	6.0	5.5
30	9.5	8.5	7.5	6.5
35	12.5	11.5	10.0	9.0
40	13.5	12.0	11.0	9.5
45	15.0	13.0	11.5	10.0
50	16.0	14.0	12.0	10.5
55	17.0	15.0	13.0	11.0
60	18.0	16.0	13.5	11.5
65	19.0	16.5	14.5	12.0
70	20.0	17.5	15.0	12.5
75	21.0	18.5	16.0	13.0
80	22.5	19.5	16.5	13.5
85	23.5	20.5	17.0	14.0
90	24.5	21.5	18.0	14.5

If the total number of Ferrum Lek® ampoules to be administered exceeds the maximum daily dose, they should be divided into several days.

If, 1-2 weeks after the start of Ferrum Lek® administration, the hematological parameters do not change, the diagnosis should be clarified.

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

Required number of Ferrum Lek® ampoules to compensate for post-hemorrhagic iron deficiency

calculated using the following formula:

If the amount of blood lost is known: administration of 200 mg IM (2 ampoules of Ferrum Lek®) leads to an increase in hemoglobin level, which is equivalent to 1 unit of blood (400 ml of blood with a hemoglobin content of 150 g/l):

iron to be replaced (mg) = number of blood units lost×200 or required number of Ferrum Lek® ampoules = number of blood units lost×2

If a reduced hemoglobin level is known, then the following formula should be used, taking into account that the deposited iron does not need to be replaced:

iron to be replaced (mg) = body weight (kg)× (estimated hemoglobin level (g/L) - actual hemoglobin level (g/L)×0.24

A patient with a body weight of 60 kg and a hemoglobin deficiency of 10 g/l should be replaced with 150 mg of iron, which is 1 1/2 ampoules of Ferrum Lek®.

Ferrum Lek® injection solution is prescribed in the following doses.

Children:

0.06 ml Ferrum Lek®/kg body weight/day (3 mg iron/kg/day).

Adults and elderly patients:

1-2 ampoules of Ferrum Lek® (100-200 mg of iron), depending on the hemoglobin level.

Maximum daily doses of Ferrum Lek®:

• children -
  0.14 ml Ferrum Lek/kg/day (7 mg iron/kg/day);
• adults -
  4 ml (2 ampoules) Ferrum Lek®.

Rules for administration and handling of the drug

If the ampoules are stored incorrectly, sediment may form. The use of such ampoules is unacceptable. If sediment appears in the ampoules or the shelf life has expired, they must be destroyed.

An opened ampoule should be used immediately.

It is important to administer IM injections carefully and appropriately to avoid pain and discoloration of the skin. IM injections of Ferrum Lek® are made into the upper outer quadrant of the gluteal muscle. The minimum needle length for adults is 50 mm, for overweight patients - from 80 to 100 mm, for children - 32 mm. Before injection, the skin should be disinfected and the subcutaneous tissue should be moved down 2 cm to reduce leakage of the drug after injection. After injection, the subcutaneous tissue is released and the injection site is held under pressure for 1 minute.

The contents of Ferrum Lek® ampoules should not be mixed with other drugs.

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 ).

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.