Iron preparations for anemia: a review of the means
Jul 03, 2018
Iron is one of the indispensable elements that ensure the stable functioning of the body.Basically, this microelement enters the body together with food - there are a number of products in which the level of iron content is very high.But in some cases, even the active use of such peculiar foods does not help to keep the balance of iron in the body - in this case, doctors diagnose anemia of iron deficiency and prescribe therapy with specific medications.
Basic information about iron preparations
In the dosage form, the useful micronutrient in question can be contained in two different forms:
- is a divalent form - iron preparations are absorbed quickly and fully, applied orally( ingestion by ingestion);
- trivalent form - drugs are digested worse, injected.
A medicinal preparation with iron content is absorbed in the digestive tract, but for this process it is necessary to have a sufficient amount of hydrochloric acid in the stomach.Therefore, if the patient is prescribed iron therapy, but he was previously diagnosed with a deficiency in hydrochloric acid production, the patient must necessarily take in parallel the medicines that increase the acidity of the gastric juice.
There is a definite differentiation of substances that increase or decrease the absorption of iron preparations:
- fructose, succinic acid, cysteine and ascorbic acid - increase;
- tannin, phosphoric acid, tetracycline, almagel - lower.
Naturally, the latter substances with the use of drugs with iron content should be excluded.
Iron preparations for ingestionRecommended to read:
Usually, when diagnosing iron deficiency anemia, doctors prescribe medications for ingestion.Dosage is established strictly on an individual basis, but there are general recommendations - adults usually need to take 2 mg per kilogram of weight and, as a rule, a day it is 100-200 mg of the drug, extremely rarely 300 mg.
If the dose of iron-containing drug was correctly selected, after a few days of therapy the patient begins to feel better, the standard symptoms of iron deficiency anemia practically disappear.In the first 5-7 days of the use of drugs with iron content, the first positive changes in the results of laboratory blood tests appear - the number of reticulocytes begins to grow.And after 60-90 days of regular intake of iron-containing drugs, stable growth of hemoglobin is observed.
Note: patients need to take iron preparations inside for a long time to restore their health.Even if the hemoglobin and general health status have already stabilized, it is impossible to stop therapy - it is necessary to create a micronutrient reserve in the body.But at the time of "storage" of iron in the body do not need to take the prescribed daily dose of medications - the doctor, based on the results of laboratory blood tests, usually adjusts the dosage to reduce it by 2 times.
Taking iron preparations orally( orally) may be accompanied by the development of side effects:
- nausea and vomiting that appear regardless of eating;
- decreased appetite, and in some cases, a complete aversion to food;
- strongly pronounced metallic taste in the mouth;
- disruption of the bowels - constipation or diarrhea.
Often, against the background of the use of iron-containing drugs orally( inside), there may appear a gray coating on the tooth enamel, so doctors recommend either rinsing the mouth immediately after using the medication, or drinking it through the tube if the drug is in liquid form.
There are also categorical contraindications to the use of iron drugs inside. These include:
- Previously diagnosed leukemia-cancerous blood disease;
- diagnosed aplastic and / or hemolytic anemia;
- mandatory intake of drugs from the group of tetracyclines or antacids;
- diagnosed inflammatory diseases of kidney and liver, proceeding in chronic form;
- consumption of foods high in calcium, fiber and caffeine.
There are a number of contingent contraindications, that is, iron preparations can be prescribed, but their use should be under constant monitoring of the patient's condition by health professionals. Conditional contraindications include:
- ulcerative colitis;
- peptic ulcer of the stomach and / or duodenum;
- enteritis of various etiologies.
Doctors do not prescribe iron preparations simultaneously with drugs that reduce the acidity of gastric juice, belong to the group of tetracycline antibiotics.This precaution is necessary to ensure maximum absorption of iron in the body.
Anemia medications in tableted form
The following are medicines with iron content, which are usually prescribed for iron deficiency anemia:
- Aktiferrin belongs to the group of combined preparations, available in capsules and drops.
- Hemofluor prolongatum - the main active substance is iron, is available in tablet form.
- Tardiferone - tablets, which contain, in addition to iron, ascorbic acid and mucoproteosis.
- Ferrogradumet - comes in the form of coated tablets, iron sulfate and a plastic matrix are included in the composition.
- Gemsineral-TD - is available in granules, consisting of elemental iron, cyanocobalamin and folic acid.
- Ferronal and Ferrogluconate are 300 mg tablets based on ferrous sulphate.
- Fenules is a combined preparation that is available in capsules.The composition contains riboflavin, ascorbic acid and folic acid, pyridoxine, fructose, yeast, iron sulfate, cyanocobalamin, cysteine.
- Gyno-tardyferon - tablets, in which the dose of elemental iron is 80 mg.The composition contains, in addition to the main active ingredient, folic and ascorbic acids, mucoproteosis.
- Heparol capsules containing 100 mg of iron are made on the basis of fumaric acid.
- Globirone - gelatin capsules, which contain iron sulfate, vitamins B6 and B12, folic acid.
- Totem - is available as a solution for oral administration( orally) in 10 ml ampoules.The composition contains sucrose, copper and benzoate / sodium citrate.
- Ranferon-12 - is available in two pharmacological forms: elixir and capsules.In the first case, the iron content in 5 ml is 41 mg, and in one capsule there is 100 mg of elemental iron.
- Sorbifer durulis - capsules, which contain 100 mg of iron.
Which of the listed medicinal preparations of iron will be appointed by a physician, is determined on an individual basis.Therefore, it is not recommended to make a choice on your own.
Iron preparations for parenteral use
This will be the injection of iron preparations. It should be known that they are prescribed only under certain circumstances:
- chronic pathology of the digestive tract, which is accompanied by a reduced absorption of iron - for example, pancreatitis( inflammation of the pancreas), malabsorption syndrome, celiac disease, enteritis and others;
- ulcerative colitis of a non-specific nature;
- intolerance to iron salts or hypersensitivity with allergic manifestations;
- peptic ulcer of the stomach and / or duodenum during periods of exacerbation;
- previous removal of the stomach or part of the small intestine.
Iron preparations in the form of injections are also prescribed if the patient's body needs to quickly and maximally saturate with iron before the prescribed surgical interventions for hemorrhoids, fibroids and other diseases.
Please note: is strictly forbidden to inject more than 100 mg of iron preparation into the body - this dose completely provides a daily requirement for the micronutrient in question.
If iron-containing preparations are injected into the patient, then side effects are most likely to be expected:
- seals( infiltrates) at the site of injection of the iron preparation;
- abscesses at the injection site;
- allergic reaction - sometimes anaphylactic shock develops immediately;
- overdose of iron in the body.
Iron preparations that are injected into the body:
- Ferrum Lek - available in ampoules of 2 ml, which is identical to 100 mg of elemental iron, is administered intramuscularly.The composition contains iron hydroxide and dextran - they are also the main active substances.
- Venofer - ampoules of 5 ml, intended for intravenous injection, which is equivalent to 100 mg of iron.The composition contains iron hydroxide of sucrose complexes.
- Ferkoven - the composition contains iron sugar, a solution of carbohydrates and cobalt gluconate.Produced in ampoules of 1 ml, is intended for intravenous injection.
- Jektofer is a combined preparation, iron-sorbitol-citric-acid complex is in structure.Produced in ampoules of 2 ml, the route of administration - intramuscular.
- Ferrelcit is the main active ingredient in this active sodium-iron-gluconate complex.Produced in the form of a solution for injection in ampoules of 1 and 5 ml.In the first case, the drug is administered intramuscularly, and 5 ml ampoules are intended for intravenous administration.
- Ferbitol - the basis of this drug is iron-sorbitol complex, is available in ampoules of 1 ml for intramuscular injection.
Preparations of iron during pregnancy
If iron deficiency anemia has been diagnosed in a woman during the period of gestation, then all of the above drugs are allowed for use in therapy.But appointments should be made only by a specialist - it is often during pregnancy that the daily dosage is reduced.Often during the gestation period, a preventive intake of iron preparations is required, in which case the individual dose will also be selected.
There are general recommendations for the intake of iron preparations by women during the gestation period:
- if the pregnancy occurs without any pathologies, then the woman in the third trimester is prescribed oral iron at 30 mg per day;
- if the pregnancy is within normal limits, but the woman has a tendency to develop iron deficiency anemia, the prevention is carried out during the 21-25 weeks of pregnancy - 30 mg twice a week;
- if iron deficiency anemia is diagnosed in full against the background of pregnancy, then the daily dose for a woman is usual - 100-200 mg, depending on the weight of the patient;
- if iron deficiency anemia was diagnosed in a woman before pregnancy, then she should take iron supplements and the entire pregnancy, and during the breastfeeding period of 200 mg per day.
Iron preparations can and should be taken to people both as an anemia treatment and as part of preventive measures.But the dosage and duration of the course of admission should be determined only by a specialist - much depends on the picture of the laboratory blood test, on whether iron deficiency anemia was previously diagnosed, what pathologies are present in the body.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category