Ferrolek Health

Ferrolek Health is an antianemic medicine.

Indications Ferrolek Health

It is used for therapy in case of iron deficiency, when it is impossible or inefficient to use iron medications for ingestion.

[1],

Release form

The release of the drug is made in the form of injection fluid, inside the ampoules with a volume of 2 ml, 3, 5 or 10 ampoules inside the blister.

Pharmacodynamics

Iron is an important component of hemoglobin with myoglobin, as well as some other enzymes. Its main function is the movement of oxygen molecules and electrons, as well as oxidative metabolism during reproduction and growth of tissues. Being a constituent element of enzymes, iron catalyzes the processes of hydroxylation, oxidation, and other metabolic processes important for life.

Iron deficiency develops as a result of insufficient receipt of this element with food, absorption disorders inside the gastrointestinal tract, either due to increased need for it (during pregnancy or during the period of enhanced growth) and subsequent blood loss.

Inside the blood plasma, iron is transported by transferrin β-globulin, which is synthesized inside the liver. All transferrin molecules are synthesized with 2 iron atoms. Iron in combination with transferrin is transported into the cells of the body, where its reversible synthesis with ferritin takes place. This component is necessary for carrying out the binding processes of myoglobin, hemoglobin and individual enzymes.

With parenteral use of iron dextran, hemoglobin indices increase more rapidly than in the case of oral administration of iron salts (although the pharmacokinetics of iron incorporation do not depend on the method of its use).

The iron dextran complex is quite large in size, which is why its excretion via the kidneys is impossible. This complex demonstrates stability, therefore, under physiological conditions, iron is not released in the form of ions.

Pharmacokinetics

After applying the element through the injection, it is absorbed mainly through the lymph, diffusing into the blood after 3 days. Information on bioavailability is not available, but there is information that a sufficiently large part of the drug complex is not absorbed from muscle tissue over the long term. Indicators t½ substances - 3-4 days.

The dextran macromolecular complex penetrates into the reticuloendothelial system and disintegrates there, forming dextran with an iron-containing element. Further, iron is synthesized with hemosiderin or ferritin, as well as, in smaller volumes - with transferrin, and then used to bind hemoglobin. The dextran component is metabolized or excreted. The amount of excreted iron is insignificant.

Dosing and administration

The drug is administered exclusively in the / m way. Before using the first medicinal portion, it is necessary to reveal the patient's tolerability of the patient - an adult is administered a test dosage equal to ¼-½ volume of the ampoule (about 25-50 mg of iron), and the child - 0.5 daily portion. In the absence of negative signs for 15 minutes from the moment of introduction of the substance, it is allowed to introduce the remainder of the initial daily dose of the drug.

Often, the solution is injected in a day - deep into the area of the outer upper quadrant of the muscles of the buttock (it is necessary to change the injection sites - in the left and right buttock alternately).

In order to avoid staining of the epidermis and the appearance of pain, it is necessary to perform an injection in accordance with the rules - use a needle that has a length of 50-60 mm (adult) or 32 mm (child). Before performing the injection, the epidermis must be disinfected, and the subcutaneous tissue should be slightly pulled down (about 2 cm) to reduce the spreading of the substance. After the injection, in the next 60 seconds, press the injection area.

The child must be administered at 0.06 ml / kg of substance per day (at 3 mg / kg of iron per day).

For adults or the elderly, it is necessary to administer 1-2 ampoules of medication per day (0.1-0.2 g of iron).

The maximum allowable daily rations: for a child - 0.14 ml / kg (corresponds to 7 mg / kg of iron); for an adult - 4 ml (corresponding to 0.2 g or 2 nd ampoules).

Use Ferrolek Health during pregnancy

It is prohibited to use Ferrolek Health in the 1st trimester. On the 2nd and 3rd trimesters, it is used only in situations where the likely benefit to a woman is more expected than the risk of complications in the fetus. 

Contraindications

Among the contraindications:

• the presence of strong sensitivity to the elements of the drug;
• An excess of iron inside the body (for example, with hemosiderosis or hemochromatosis);
• the breakdown of the incorporation of iron into hemoglobin (for example, in anemia provoked by lead intoxication, thalassemia, or sideroblastic anemia);
• anemia, caused by non-iron deficiency (for example, megaloblastic or hemolytic form of anemia);
• severe hemostasis disorders (hemophilia);
• disorders of erythropoiesis;
• bone marrow hypoplasia;
• epidermal porphyria. 

[2],

Side effects Ferrolek Health

Negative manifestations are mainly dependent on the size of the dose of drugs. Acute anaphylactoid symptoms in severe form often develop over several initial minutes after the use of the drug and manifest in the form of difficulty in the respiratory process or collapse in the CVS area (there are also reports of deaths). When symptoms of anaphylactoid reactions appear, the injection of the drug should be immediately stopped. The effects listed below are of a delayed type (they can develop in the period from a few hours up to 4 days from the moment of use of the substance), and can have a severe degree of manifestation. Such manifestations can last for 2-4 days, disappearing spontaneously or as a result of taking standard analgesics. In rheumatoid arthritis, pain in the joints may increase. Among the side effects are:

• Dysfunction of the cardiovascular system: tachycardia, palpitations, arrhythmia, and in addition discomfort (pressure) and sternum pain, and bradycardia in the embryo;
• disorders of the lymph and blood-forming organs: lymphadenopathy, as well as hemolysis or leukocytosis;
• NA problems: numbness, fainting, convulsions, tremor, visual misting, as well as a feeling of excitement, dizziness, paresthesias, headaches, and transient taste disorder (for example, metallic taste);
• lesions of the auditory organs and the labyrinth: short deafness;
• disorders of respiratory activity: dyspnea, bronchospasm, and also the arrest of the respiratory process;
• digestive disorders: vomiting, diarrhea, abdominal pain and nausea;
• lesions of the subcutaneous layer or epidermis: urticaria, erythema, pruritus, purpura, exanthema, and in addition to this rash, angioedema and hyperhidrosis;
• manifestations in the osteo-muscular structure: myalgia, muscle cramps, pain in the back, arthritis and arthralgia;
• impaired vascular function: collapse, hot flashes, decrease or increase in blood pressure values;
• systemic disorders and local manifestations: severe fatigue, malaise or fever, feverish condition, asthenia, peripheral edema, chills, pallor, chromaturia, and in addition pain or epidermis coloring in a brown shade (in the injection area). There are data on such local symptoms as a bulge, burning and inflammation in the injection area or next to it, and besides bleeding, phlebitis, tissue necrosis or atrophy and abscess formation;
• immune lesions: anaphylactoid signs, sometimes in severe acute degree (sudden difficulty of the respiratory process or collapse in the CCC area);
• mental disorders: disorders of consciousness or its confusion, as well as changes in the state of the psyche.

[3], [4]

Overdose

Poisoning can provoke an acute glut of iron, which manifests itself in the form of hemosiderosis.

In cases with overdose of medication, no symptoms of overload or iron intoxication were observed. This is due to the fact that free iron is absent inside the gastrointestinal tract, and in addition to the fact that this component, in combination with dextran, is not subject to movement inside the body through passive diffusion.

Iron antidote deferoxamine, which is a chelating agent that synthesizes iron. It is administered in a dosage of 1000 mg (not more than 15 mg / kg / hour).

[5], [6]

Interactions with other drugs

Drug efficacy of parenteral iron drugs is enhanced when they are combined with an ACE inhibitor.

Ferrolek Health cannot be combined with ingested iron. Therapy with the use of such funds should be started at least after 5 days from the moment of injection of the last injection of drugs.

[7], [8]

Storage conditions

Ferrolek Health must be kept in a closed from the penetration of young children. Temperatures - a maximum of 25 ^o C. It is forbidden to freeze the drug.

Shelf life

Ferrolek Health can be used within 5 years from the date of manufacture of a therapeutic agent.

[9]

Application for children

Due to the lack of experience of use, it is impossible to prescribe medication to babies up to 4 months of age.

Analogs

Analogues of the drug are drugs Sufer and Firinzhekt with Ferrum-Lek.

[10], [11]