Dextrafer

The dextrafer is an injection solution. It is an iron preparation that is used as an anti-anemic drug.

[1], [2], [3]

Indications Dextrafer

It is indicated with a deficiency of iron in the body, in situations where a person needs a quick replenishment of the indices of this substance. It is also used when it is impossible or ineffective treatment with oral iron drugs.

Release form

Produced in the form of an injection solution (5%), in ampoules of 2 ml. One package contains 3, 5 or 10 ampoules.

Pharmacodynamics

The dextrafer helps to fill the deficiency in the body of iron ions, which is observed with iron deficiency anemias of various origins, and besides it promotes erythropoiesis.

Iron is an important component of hemoglobin with myoglobin, as well as a number of enzymes. The main function of iron is the movement of oxygen molecules and electrons, and also participation in the processes of oxidative metabolism.

A deficiency of iron occurs due to a lack of the necessary amount of this substance together with food, a violation of the absorption process in the digestive tract, and in addition because of the increased need (rapid growth) or loss of large amounts of blood.

As a result of the course therapy, a gradual regress of laboratory as well as clinical (such as severe fatigue and weakness, as well as tachycardia, dizziness and dry skin) of symptoms of anemia begins.

As a result of parenteral administration of iron-containing drugs, hemoglobin levels increase faster than due to oral intake of iron salts.

Pharmacokinetics

After intravenous administration of the drug, the iron-dextran complex is quickly cumulated inside the cells of the reticuloendothelial system and, in addition, partially inside the spleen with the liver. Iron is slowly excreted from these organs, after which it is synthesized with proteins.

Hemopoiesis increases during the next 6-8 weeks. The half-life lasts 5 hours (circulating iron) and 20 hours (total iron: both bound and circulating).

Synthesis of iron with proteins occurs with the subsequent formation of physiological components of iron - it is ferritin or hemosiderin, and also, to a small extent, transferrin. These elements are under physiological control, they increase the parameters of hemoglobin, and together with this they fill the level of iron inside the body.

The iron is excreted rather slowly, and the accumulation of this component can be toxic. The iron-dextran complex can not be eliminated by the kidneys, since it has a large molecular mass. A small part of the element is excreted through the kidneys, and also along with feces.

After administration, the drug is absorbed from the injection site inside the capillaries, as well as into the lymphatic system. A significant amount of substance is absorbed during 72 hours, and the remainder - during the next 3-4 weeks.

Dextran undergoes a metabolic process or is excreted.

Dosing and administration

The medication is prescribed for children from 14 years old, as well as for adults (injected in / m and / in the form of slow injections or drop infusion). Drip IV infusion is considered the most acceptable option, because with this method of administration, the probability of developing hypotension is the lowest.

With any method of administration, before starting the use of a patient, it is necessary to enter a dose test-this is 0.5 ml (adult dosage) or half the daily dosage (nursery). If no adverse reaction occurs within the next hour, it is permissible to continue treatment.

The anaphylactoid response to the medication usually occurs several minutes after the injection, but the patient needs to be monitored throughout the period of administration. If, after using Dextrafer, any symptoms of intolerance appear, you should immediately discontinue the use of drugs.

The course dosage of drugs is established in accordance with the weight of the patient, his sex, and also the level of hemoglobin. Doses are calculated on the basis of general indicators of a deficiency in the body of iron.

As a rule, a dosage of 2-4 ml (about 100-200 mg of iron) per day is recommended in accordance with the parameters of hemoglobin. If it is required to quickly restore the level of iron, the drug is administered by infusion in a dosage of 0.4 ml / kg (or 20 mg iron / kg).

If the total exchange rate is exceeded, the maximum allowable daily value should be divided into the introduction of drugs into several procedures. If, after 1-2 weeks of treatment, the hematologic indices are not normalized, a diagnosis should be reviewed.

[5]

Use Dextrafer during pregnancy

It is forbidden to use the medicine on the 1st trimester. In the period of II-III trimesters, he is appointed exclusively in cases where the possible benefits for a woman are more expected than the risk of the appearance of negative reactions in the fetus.

There is no information as to whether the medicine passes into breast milk, so it is recommended that breastfeeding be stopped for the duration of drug use.

Contraindications

Among the contraindications of drugs:

• intolerance of the elements of the drug;
• anemia, which occurs not because of a lack of iron (among them also hemolytic);
• excess in the body of iron (with hemochromatosis or hemosiderosis);
• the breakdown of the passage of iron into the hemoglobin (sidero-sacramental form of anemia, as well as anemia, caused by intoxication with lead);
• presence of bronchial asthma;
• pronounced hemostasis disorders (such as hemophilia);
• presence of eczema or other skin allergic diseases;
• hepatitis, as well as liver cirrhosis in the decompensated stage;
• presence of infectious pathologies;
• acute form of renal failure;
• Rheumatoid arthritis type in the presence of signs of an active inflammatory process.

There is insufficient information on the use of drugs in children under 14 years of age.

Side effects Dextrafer

Due to the use of the medication, these side effects may occur (usually they are rather weak and quickly pass):

• cardiovascular disorders: occasionally arrhythmia or tachycardia develops, and in rare cases, there may be an increase in heart rate;
• organs of the lymphatic and hematopoietic systems: occasionally lymph nodes may increase or (uniquely) develop hemolysis;
• neurological disorders: occasionally there are convulsions or tremor, there may be a loss of consciousness, dizziness and a sense of anxiety. Paresthesia or headaches are sometimes observed;
• visual organs: single blurred vision;
• hearing organs: there may be a momentary deafness;
• chest and respiratory tract organs: in rare cases, dyspnea develops, and in some cases pain may appear inside the sternum;
• disorders in the gastrointestinal tract: occasionally nausea with vomiting, as well as abdominal pain, in very rare cases - diarrhea;
• subcutaneous tissue with skin: rashes on the skin and itching with redness, occasionally observed development of edema Quincke and increased sweating;
• connective tissue and organs of the OA: in rare cases there are convulsions, single - the development of myalgia;
• complications during the procedure: occasionally - inflammation and pain at the injection site, the appearance of abscesses, the skin at the site of the injection becomes brown, tissue necrosis develops. As a result, in / in the introduction of phlebitis;
• cardiovascular disorders: occasionally the level of blood pressure decreases, and in rare cases it may, on the contrary, increase;
• common frustration: sometimes fever develops, and rarely enough fatigue can be felt;
• immune system: anaphylaxis is rare, as well as anaphylactoid manifestations (hives, dyspnoea or fever develops occasionally, itching with a rash occurs, and nausea, and respiratory failure, as well as the heart, can occur sporadically);
• mental disorders: in rare cases, the patient's mental status may change.

[4]

Overdose

As a result of an overdose of the drug, acute over-saturation with iron - hemosiderosis is possible. To cause such a violation may be an incorrect diagnosis - the patient's diagnosis of an iron deficiency anemia. As a result of repeated administration of large doses of iron, its overabundance can be cumulated in the liver, provoking inflammation, which can cause fibrosis.

To eliminate the violation, treatment is needed, aimed at getting rid of the symptoms. If heavy intoxication is observed, a specific antidote, deferoxamine (chelate, which synthesizes iron) is used.

Interactions with other drugs

The drug has a pharmaceutical incompatibility with other drugs, so it can not be used in combination.

As with other parenteral iron drugs, the dextrafer should not be used in conjunction with oral analogs, because this reduces the absorption of the ingested iron. The interval between parenteral use of drugs and the onset of oral iron intake should be at least 5 days.

[6], [7]

Storage conditions

Contain ampoules with medicine should be in the original package, in a place inaccessible to children. Temperature - up to 25 ^{of the} S. Freeze ampoule can not.

Shelf life

The dextrafer is suitable for use within 2 years from the date of release of the medicinal product.