Gemsineral-td

Gemsineral-td is an anti-anemic drug containing various medicinal elements.

Indications Gemsinerala-td

It is used to prevent the development of or for the treatment of anemia, which has folic deficiency or iron deficiency. Such anemia occurs when the following disorders and conditions occur:

• alimentary deficiency of iron;
• lactation or pregnancy;
• ankylostomy ;
• bleeding, having a chronic form (menorrhagia or bleeding hemorrhoidal nature).

Also, the medication is used with increased need for medicinal components arising from burn diseases, hypochlorhydria, malabsorption syndrome, gluten enteropathy, hemodialysis, and also after surgical procedures.

Gemsineral-td is prescribed for persons who lose weight rapidly, as well as for the prevention of the development of anemia or its therapy in elderly people on special diets.

[1], [2]

Release form

Release of the substance is made in capsules, packed in blister plates 10 pieces each. Inside the box there are 3 such plates.

Pharmacodynamics

Gemsineral-td is a complex agent that helps to treat or prevent the development of anemia of folic acid or iron deficiency. It contains cyanocobalamin with iron fumarate, and in addition vitamin B9.

Iron fumarate is an organic component containing a large amount of elemental iron (the figure reaches 66.6 mg). It promotes the rapid development of medicamentous effects in anemia of iron deficiency.

Cyanocobalamin is required for the formation of erythrocytes, and besides for DNA binding processes.

Vitamin B9 is converted inside the body, taking the form of folinic acid, and becomes a participant in the binding of nucleotides, together with cyanocobalamin helping the maturation of red blood cells. This acid is needed to strengthen the immunity of cells.

The specific technology of moving active elements of LS to the inside of the 12-типерстной of the intestine allows to prevent the development of irritating effect in relation to the gastric mucosa. Iron fumarate is released within those parts of the intestine, where the degree of its absorption has the maximum value (in the upper part of the small intestine and in the 12-типерстной of the intestine). This is due to the slow dissolution of pellets.

Pharmacokinetics

Elements Gemsinerala-td quickly absorbed inside the intestine. The increase in the indices of iron within the blood serum is recorded already after the lapse of 1 hour after the application of the medication.

The technology of transportation and subsequent slow release of active elements allows to avoid sharp fluctuations in the blood values of iron, and its medicinal effect persists for the next 10-12 hours.

Dosing and administration

During the treatment of anemia, a person needs to take 1 capsule 2-3 times a day for at least 3-4 weeks (the exact duration depends on the degree of the disease intensity).

In case of prophylaxis, the medication is taken on the 1 capsule per day.

Use Gemsinerala-td during pregnancy

With lactation or pregnancy, a medication can be prescribed exclusively for diagnosed iron deficiency, after consultation with the doctor and under his supervision.

Contraindications

The main contraindications:

• the presence of high sensitivity for medicinal substances;
• an excess of iron (the presence of hemosiderosis or -chromatosis) or a predisposition to its development;
• Other types of anemia that do not result from iron deficiency (hemolytic, sidero-sacral, aplastic, as well as iron-refractory and lead-induced intoxication, besides hemoglobinopathy, thalassemia, etc.);
• pernicious form of anemia;
• frequent procedures of blood transfusion;
• erythrocytosis or erythremia, acute forms of thromboembolism;
• Tumors, except in the case of a megaloblastic form of anemia;
• hepatic cirrhosis;
• late porphyria of the skin;
• Inflammatory nature of intestinal diseases in acute form;
• exacerbated ulcers in the gastrointestinal tract;
• stenosis affecting the esophagus, or other obstructive diseases developing in the digestive tract;
• intestinal diverticulum or intestinal obstruction;
• combined use with parenteral types of iron.

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Side effects Gemsinerala-td

The taking of capsules can provoke the appearance of some side effects:

• disorders in the digestive system: gastralgia, a feeling of overcrowding or pain in the epigastric region or abdomen, vomiting, bloating, loss of appetite, constipation or diarrhea, nausea, staining the stool in a black tint, and with it a darkening of the tooth enamel;
• lesions affecting subcutaneous tissue and epidermis: acne, pruritus, epidermal rash, redness, urticaria, and bullet-like eruptions;
• disorders of the immune function: bronchospasm or anaphylaxis;
• problems with the work of the National Assembly: dizziness, nervous excitement and headaches;
• disorders in the heart: pain or tachycardia;
• Other: a feeling of general weakness, hyperhidrosis, hot flashes and hyperthermia.

With continued unjustified use of drugs can develop hemosiderosis.

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Overdose

Intoxication can provoke an increase in the symptoms of side effects. With uncontrolled long-term Gemsinerala-td, hemochromatosis can develop.

Excess of the medicinal portions required for treatment may cause overdose symptoms.

In acute iron poisoning, vomiting appears with nausea, and with severe forms of intoxication, death is collapsed. The lethal dosage of elemental iron is 180-300 mg / kg of the substance. It should be understood that for some patients, an iron dose of 30 mg / kg may be toxic.

With an acute degree of iron intoxication, signs of impairment can develop in the period of 10-60 minutes or after several hours. There are abdominal or epigastric pains, nausea, diarrhea with feces of green color, further acquiring a tarry shade. There is also vomiting (sometimes with blood), melena, a feeling of weakness or drowsiness, pallor of the epidermis, cyanosis with acrocyanosis and a sticky cold sweat. In addition, there is a lethargic state, a weak pulse, a decrease in blood pressure, a sense of confusion or fatigue, a heartbeat, a coma or shock, hyperthermia and signs of hyperventilation, and cramps, paresthesia and necrosis in the gastrointestinal mucosa.

After about 4-6 hours, remission is often observed. Further, after 12-48 hours, a severe shock can occur, against which periodic breathing develops, coagulopathy, oliguria and liver toxic insufficiency.

Because of the possible appearance of toxic symptoms of poisoning, the patient should immediately provide the required assistance. By slowing down the process of iron release, it is possible to prevent strong absorption, which will increase the time interval for countermeasures. If you unintentionally use a large number of capsules, the victim should drink milk and eat raw eggs - this will form insoluble iron compounds inside the gastrointestinal tract and promote excretion of iron from the body. You can also remove the capsules from the stomach by vomiting.

Specific medical procedures.

The patient's vomiting needs to be checked for capsules. With a small number of removed capsules, a gastric lavage is required, in which a 0.9% NaCl solution or a 1% aqueous solution of soda ash is used, and a laxative preparation is administered to the patient. In addition, an x-ray of the peritoneum is performed to determine the number of capsules left in the stomach. If there is no desired result after applying all of the above methods, a surgical procedure may be necessary.

The most suitable way to assess the severity of the condition is to check for serum iron and the level of JCSS. With iron values inside the serum, exceeding the level of the JCSS, it is possible to suspect a general intoxication.

For treatment, you may need to use deferoxamine. Chelation treatment using deferoxamine is carried out in such situations:

• when using a potentially lethal dose (180-300 + mg / kg);
• serum iron values are more than 400-500 mg / dL;
• the index of iron inside the blood serum is higher than the values of the JCSS, or the patient has such signs of severe iron poisoning as a shock or coma.

In case of acute intoxications, 5-10 g of deferoxamine are taken orally for the synthesis of iron not absorbed from the digestive tract (10-20 ampoules inside ordinary water should be dissolved). To eliminate already absorbed iron, the substance is injected in / m by the method (12 g) at intervals of 3-12 hours. In severe disorders, against the background of which a shock condition is noted, intravenous intravenous drug is injected through a dropper of 1 g of medicine and symptomatic measures are taken.

In young children, the possibility of acute iron intoxication is extremely high. It is considered dangerous for life to take 1 g of medicinal substance.

If necessary, procedures are performed to treat acidosis and shock.

People with anuria or oliguria undergo hemodialysis or peritoneal dialysis sessions.

Interactions with other drugs

Absorption of iron salts is mutually disturbed and may be weakened when combined with tetracyclines.

The degree of intensity of iron absorption inside the gastrointestinal tract can decrease with the combination of Gemsinerala-td with diamond, calcium, cimetidine, phosphates, and in addition with aluminum, magnesium salts, organic acids and drugs containing pancreatic enzymes.

Combination of the substance with carbamazepine, hormonal contraception, phenobarbital, and in addition valproate sodium, pyrimethamine, trimethoprim and sulfasalazine, as well as with folic acid antagonists and triamterene leads to a decrease in the bioavailability of folic acid.

[8], [9]

Storage conditions

Gemineral-td must be kept in a place that is closed from small children. The temperature is within 25 ° C.

Shelf life

Gemsineral-td is allowed to be used within 24 months from the date of manufacture of the therapeutic agent.

Application for children

Gemsineral-td is forbidden to use in pediatrics - children under 12 years of age.

Analogues

Analogues of the drug are medicines Ranferon-12, as well as Ferro-Folgamma.