Ferrum Lek

Ferrum Lek is an antianemic drug.

[1], [2]

Indications Ferrum Leka

It is used for the treatment of anemia of iron deficiency, having a different origin.

[3]

Release form

The release of the medicament is realized in the form of an injection liquid, in 2 ml ampoules. Inside the blister pack - 5 or 10 ampoules. The pack contains 1 pack with 5 ampoules or 5 packs 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. Being a component of the enzyme elements, iron acts as a catalyst for hydroxylation with oxidation, as well as other metabolic processes that are important for life.

The formation of iron deficiency occurs when there is insufficient iron intake with food, absorption disorders inside the gastrointestinal tract or in case of an increased need for it (acceleration of growth processes or during pregnancy), and also as a result of blood loss.

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

With parenteral use of the iron hydroxide complex (3) with dextran, hemoglobin values increase faster than in the case of oral administration of iron salts (2), although the kinetics of iron incorporation does not depend on how it is used.

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

Pharmacokinetics

After applying the injection, the complex of medicinal substances is absorbed mainly through the lymph, and then, after 3 days, diffuses into the blood. Information on the indicators of bioavailability of drugs is missing, but there is evidence that a sufficiently large part of it is not absorbed from muscle tissue over a long period of time. The half-life of the drug complex is about 3-4 days.

The dextran complex consisting of macromolecules penetrates into the macrophage system, where it undergoes decay to form dextran and an iron-containing element. Further, iron is 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 amount of excreted iron is extremely small.

Dosing and administration

It is necessary to introduce the drug deeply, in the / m way, in the amount of 2 ml (the procedure is carried out every other day). It is allowed to administer such intramuscular dosages per day - 4 ml (for adults), 0.5 ml (for babies weighing less than 5 kg) and 1 ml (for children with a weight of 5-10 kg).

By the intravenous method, the drug is administered 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 the 1st ampoule) and on the 3rd - in the amount of 10 ml (corresponds to 2 ampoules). In the future, you need to apply 10 ml of the substance 2-fold per week.

Use Ferrum Leka during pregnancy

Entering the drug parenterally is prohibited in the 1st trimester. On the 2nd and 3rd trimesters, as well as during breastfeeding, medication can be prescribed only in situations where the likely benefits for the woman are more expected than the risk of negative consequences for the child or fetus.

Contraindications

Main contraindications:

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

Side effects Ferrum Leka

Negative symptoms are mainly associated with the size of the dosage portion. The appearance of acute anaphylactoid signs 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 the respiratory process or collapse affecting the cardiovascular system; there are also data on deaths.

With the development of anaphylactoid symptoms, you must immediately stop the introduction of the drug.

There are also delayed drug reactions (developing after a minimum of several hours and a maximum of 4 days after using the drug), which may have a severe degree of severity. Such manifestations can last 2-4 days, disappearing spontaneously or after taking standard analgesics. Pain in the area of the joints may also increase with rheumatoid arthritis. Among the side effects are:

• lesions affecting the function of the cardiovascular system: tachycardia, palpitations, arrhythmia, a feeling of severe compression and pain in the sternum, and bradycardia in the embryo;
• disorders of the hematopoietic system and lymph: lymphadenopathy, hemolysis, as well as leukocytosis;
• Disorders of the NA: dizziness, numbness or agitation, visual misting, tremor, fainting and convulsions, and in addition paresthesias, headaches and transient taste disorder (for example, the appearance of a metallic taste);
• problems with hearing organs and labyrinth: short deafness;
• manifestations of the respiratory system: stopping of the respiratory process, bronchial spasms and dyspnea;
• digestive disorders: vomiting, diarrhea, nausea and abdominal pain;
• lesions of the subcutaneous layer with the epidermis: rash, purpura, itching with erythema or urticaria, as well as hyperhidrosis and angioedema;
• disorders of the musculoskeletal structure: myalgia, muscle cramps, pain in the back, arthritis, and arthralgia;
• symptoms in the vascular system: a decrease or increase in blood pressure, hot flashes, and collapse;
• local manifestations and systemic disorders: fatigue or heat, fever, asthenia, severe chills, noticeable pallor, feeling unwell, peripheral edema, chromaturia, and pain and coloration of the epidermis in the injection shade of brown. There is also evidence of local symptoms such as bulge, inflammation and burning sensation at or near the drug injection site, and in addition to bleeding, phlebitis, tissue atrophy or necrosis, and abscess formation;
• mental disorders: changes in the state of the psyche, a sense of confusion or his disorder.

Overdose

In case of overdose due to i / m administration of the drug, hemosiderosis and acute iron overload can be observed.

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

[4], [5]

Interactions with other drugs

The therapeutic efficacy of parenterally administered iron medications is increased in the case of combined use with an ACE inhibitor.

Ferrum Lek is forbidden to use in combination with ingestible iron. It is required to begin therapy with the reception of oral drugs of iron at least after 5 days from the moment of introduction of the last injection of the drug.

It is forbidden to mix the medicinal substance with other drugs.

[6]

Storage conditions

Ferrum Lek is required to be kept at temperatures not higher than + 25 ° С.

[7]

Shelf life

Ferrum Lek can be used within 5 years from the moment of production of the medicine.

Application for children

Because the experience of using Ferrum Lek injection fluid in infants up to 4 months of age is absent, it is not prescribed for this age group.

Analogs

Analogues of the medication are drugs Maltofer, Firinzhekt, Sufer with Ferrumbo, and in addition Ferrolek Health and Orofer.

Reviews

Ferrum Lek receives mostly positive reviews - patients note that thanks to his introduction, hemoglobin can be quickly increased. But along with the high efficiency and speed of achieving the result, patients often complain that the injections are very painful, and the bruises after them do not last long.