Ferrum Lek

Ferrum Lek is an antianemic medication.

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Indications Ferrum Leka

It is used for the treatment of iron deficiency anemia of various origins.

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Release form

The drug is released in the form of injection liquid, in ampoules of 2 ml. Inside the blister package there are 5 or 10 ampoules. The pack contains 1 package with 5 ampoules or 5 packages with 10 ampoules.

Pharmacodynamics

Iron is an important component of myoglobin with hemoglobin and other individual enzymes. Its main function is the transfer of oxygen molecules with electrons, and in addition, the implementation of oxidative metabolism during tissue growth and reproduction. As a component of enzymes, iron acts as a catalyst for hydroxylation with oxidation, as well as other metabolic processes important for life.

Iron deficiency develops due to insufficient intake of iron from food, absorption disorders in the gastrointestinal tract, or in the case of increased need for it (acceleration of growth processes or pregnancy), as well as as a result of blood loss.

In the plasma, iron transfer occurs with the participation of β-globulin transferrin, the binding of which occurs in the liver. All transferrin molecules are synthesized with 2 iron atoms. Together with transferrin, this iron moves into the body cells, where it undergoes reverse synthesis with ferritin and is used to bind myoglobin, hemoglobin and individual enzymes.

With parenteral use of iron hydroxide (3) complex with dextran, hemoglobin values increase more rapidly than in the case of oral administration of iron salts (2), although the kinetics of iron incorporation processes does not depend on the method of its use.

The above complex is quite large in size, so it cannot be excreted through the kidneys. This complex has a noticeable stability, so iron is not released in the form of ions under physiological conditions.

Pharmacokinetics

After the injection, the drug complex is absorbed mainly through the lymph, and then, after 3 days, diffuses into the blood. There is no information regarding the bioavailability of the drug, but there is data that a fairly large part of it is not absorbed from muscle tissue for a long period of time. The half-life of the drug complex is about 3-4 days.

The dextran complex, consisting of macromolecules, penetrates the macrophage system, where it is broken down to form dextran and an iron-containing element. The iron is then synthesized with hemosiderin or ferritin, and also (a small part) with transferrin, after which it is used to bind hemoglobin. The dextran component undergoes metabolic processes or is excreted. The volume of excreted iron is extremely small.

Dosing and administration

The drug must be administered deeply, intramuscularly, in the amount of 2 ml (the procedure is performed every other day). The following intramuscular doses are allowed per day: 4 ml (for adults), 0.5 ml (for infants weighing less than 5 kg) and 1 ml (for children weighing 5-10 kg).

The drug is administered intravenously to adults: on the 1st day - in the amount of 2.5 ml (corresponds to 0.5 ampoules), on the 2nd day - in the amount of 5 ml (corresponds to 1 ampoule) and on the 3rd - in the amount of 10 ml (corresponds to 2 ampoules). Subsequently, 10 ml of the substance should be used 2 times a week.

Use Ferrum Leka during pregnancy

It is prohibited to administer the medication parenterally in the 1st trimester. In the 2nd and 3rd trimesters, as well as during breastfeeding, the medication may be prescribed only in situations where the probable benefit to the woman is more expected than the risk of negative consequences for the child or fetus.

Contraindications

Main contraindications:

• hemochromatosis (a disorder of the metabolism of pigments containing iron);
• hemosiderosis (an iron-containing pigment with a dark yellow tint is deposited inside the epidermis);
• anemias that are not caused by iron deficiency, but by other reasons.

Side effects Ferrum Leka

Adverse symptoms are mainly related to the size of the dosage portion. The appearance of acute anaphylactoid symptoms in severe form is often noted already in the first minutes after the use of the drug and is expressed in the form of difficulty in breathing or collapse affecting the cardiovascular system; there are also data on fatal outcomes.

If anaphylactoid symptoms develop, the administration of the medication must be stopped immediately.

There are also delayed reactions to the drug (developing after a minimum of several hours and a maximum of 4 days after taking the drug), which can be severe. Such manifestations can last 2-4 days, disappearing spontaneously or after taking standard analgesics. Pain in the joints may also increase in rheumatoid arthritis. Side effects include:

• lesions affecting the function of the cardiovascular system: tachycardia, palpitations, arrhythmia, a feeling of strong compression and pain in the sternum, as well as bradycardia in the embryo;
• disorders in the hematopoietic system and lymph: lymphadenopathy, hemolysis, and leukocytosis;
• disorders of the nervous system: dizziness, a feeling of numbness or agitation, blurred vision, tremors, fainting and convulsions, as well as paresthesia, headaches and transient taste disorders (for example, the appearance of a metallic taste);
• problems with the auditory organs and labyrinth: short-term deafness;
• manifestations from the respiratory system: respiratory arrest, bronchial spasms and dyspnea;
• digestive disorders: vomiting, diarrhea, nausea and abdominal pain;
• lesions of the subcutaneous layer with the epidermis: rashes, purpura, itching with erythema or urticaria, as well as hyperhidrosis and Quincke's edema;
• disorders of the musculoskeletal system: myalgia, muscle cramps, back pain, arthritis, and arthralgia;
• symptoms in the vascular system: decrease or increase in blood pressure, hot flashes, and collapse;
• local manifestations and systemic disorders: a feeling of fatigue or heat, fever, asthenia, severe chills, noticeable pallor, malaise, peripheral edema, chromaturia, as well as pain and brown discoloration of the epidermis at the injection site. There are also data on such local symptoms as a bulge, inflammation and a burning sensation at or near the injection site, as well as bleeding, phlebitis, tissue atrophy or necrosis and abscess formation;
• mental disorders: changes in mental state, feeling of confusion or disorder of consciousness.

Overdose

In case of overdose due to intramuscular administration of the drug, hemosiderosis and acute iron overload may be observed.

Symptomatic measures are taken to eliminate the disorders. As an antidote, deferoxamine is administered intravenously (at a slow rate) in a dose of 15 mg/kg/hour. The dosage of the antidote may vary depending on the severity of the intoxication, but should be a maximum of 80 mg/kg/day. The hemodialysis procedure will be ineffective.

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Interactions with other drugs

The therapeutic efficacy of parenterally administered iron preparations increases when used in combination with ACE inhibitors.

Ferrum Lek is prohibited to be used in combination with orally administered iron preparations. Therapy with oral iron preparations must be started at least 5 days after the last injection of the drug.

It is prohibited to mix the medicinal substance with other medications.

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Storage conditions

Ferrum Lek must be maintained at temperatures no higher than +25°C.

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Shelf life

Ferrum Lek can be used within 5 years from the date of manufacture of the drug.

Application for children

Since there is no experience of using Ferrum Lek injection liquid in infants under 4 months of age, it is not prescribed to this age group.

Analogues

The analogs of the drug are Maltofer, Ferinject, Sufer with Ferrumbo, and also Ferrolek-Zdorovye and Orofer.

Reviews

Ferrum Lek receives mostly positive reviews - patients note that thanks to its introduction, it is possible to quickly increase hemoglobin levels. But along with high efficiency and speed of achieving results, patients often complain that the injections are very painful, and the bruises after them do not go away for a long time.