Iron preparations — group of the medicines containing salts or complexes of two - and trivalent iron and also their combination with other drugs. Are generally used for treatment and prevention of an iron deficiency anemia. The combined drugs entering into this group have to contain not less than 30 mg of the main active ingredient in terms of elementary iron, otherwise they cannot be applied at treatment of iron deficiency states and will be classified as vitamins or all-tonics.
Iron preparations are used in treatment of an iron deficiency anemia including at children. Each of these means has the dosage, the release form and also the accompanying substances. Additional components can play very important role in this case as they increase comprehensibility of active agent and reduce risk of development of side effects. These means have also other features which should be considered when assigning: in detail read in cycle materials.
The diet, even with the raised contents of this miroelement, often is not capable to prevent anemia. In risk group of development of anemia - children, women (especially pregnant), patients with chronic diseases of digestive tract.
Regulations of Admission of iron preparations
Iron preparations are recommended to be washed down with water. It is inexpedient to combine peroral (through a mouth) administration of drugs of iron with some medicines breaking their absorption from intestines (tetracyclines, calcium drugs, LEVOMYCETINUM, antacids - ALMAGEL, FOSFALYuGEL, etc.). Therefore do not use the antacids containing calcium carbonate or drugs of calcium have no coffee, tea or milk, do not eat some bread from whole grains or flakes, eggs or dairy products within two hours after iron administration of drugs. They can slow down iron absorption. The liquid dosage form or contents of capsules can be accepted separately or to mix with juice, flakes or other food. If you missed the next reception, take the drug as soon as remembered it, but miss reception if already almost time of the following administration of drug. Do not accept double doses.
However all above-stated drugs have widely used ionized bivalent compound of iron in the basis. The majority of side effects and the undesirable phenomena is connected with a bivalent ion of iron. And the most important danger — high risk of glut iron that at pregnant women just inadmissibly because the surplus of this ion is not less dangerous, than a shortcoming, especially to a fruit: in its fabrics the excess of iron will be postponed, and it will be irreversible to break their work.
Appoint iron preparations most often for intake - in tablets, syrup or other forms. Injections have no advantages, but are fraught with complications. At intravenous administration of iron preparations the development of a state of shock, disturbances of a coagulant system of blood is possible, and at intramuscular - abscesses (formation of cavities with pus) in places of injections. Doctors appoint injections only in some cases when there is a disturbance of absorption of iron in digestive tract, in diseases of the digestive system, intolerance of iron preparations (nausea, vomiting), exacerbation of a peptic ulcer of a stomach or duodenum.
Now there are new highly effective drugs which are deprived of many side effects of drugs of the previous generation. These are drugs which part so-called trivalent iron is. Not ionic compounds of iron have big molecular weight that complicates their penetration through a membrane mucous intestines. They come from intestines to blood as a result of active absorption, practically without depending on interaction with intestines fibers "directly". It explains impossibility of overdose of these drugs, unlike bivalent iron. Interaction of food, their with components, and medicines does not happen that allows to use drugs, ferric, without breaking a diet and therapies of the accompanying pathology. From side effects only the feeling of overflow of a stomach is in certain cases noted. Representatives of such drugs are known in the Russian market also the drugs of MALTOFER and FERLATUM which are well studied abroad in numerous clinical trials. There are also other drugs containing in the structure trivalent iron, for example ferrum lek.
Side effects of iron preparations for intake
Lack of the iron preparations which are quickly soaking up from a GIT — absorption of a large number of Fe2 + on the site of a GIT of a small extent. Iron of the prolonged drugs even at its higher daily dose renders less side effects. At an average daily dose of iron of 180 — 200 mg approximately 10% of patients have side effects in this connection patients stop further reception. Most often there are a dermahemia, nausea, a loss of appetite up to anorexia, a constipation (binding of Fe2 + with hydrogen sulfide — a physiological stimulator of motility of intestines), diarrhea, pains in epigastric area, intestinal gripes, an eructation are more rare. At increase in a dose up to 300 mg a day these effects appear at 25% of patients; perhaps also exacerbation of a peptic ulcer, enteritis, ulcer colitis. The daily dose of 400 mg is well transferred only by certain patients. So high doses at children can lead to a lethal outcome.
At emergence of side effects tactics of the doctor is defined by their expressiveness. At not significant side effects (dispeptic disorders) the dose decline or prescribing of drug in time or right after food is reasonable; also its replacement by the drug containing other salt of iron, or drug of the prolonged action is possible. At side effects of average expressiveness resolve an issue of expediency of prescribing of iron preparations parenterally. At the significant side effects (when symptoms of resorptive action join) the treatment by iron preparations is stopped.
It should be noted that such side effects as a constipation, diarrhea, face reddening, nausea, vomiting, coloring of urine in dark color (formation of iron sulfide at reception of high doses of drug), consider only in case of their weight and big duration. An abdominal pain, a breast and a throat (especially when swallowing), existence in stool of blood can be connected with presence of an ulcer or erosion. Diarrhea, nausea, pains in epigastric area, intestinal gripes, repeated vomiting, sometimes with blood — precursory symptoms of poisoning with iron.
At use of iron preparations are inside possible coloring of stool (less often) of urine in black color (formation of iron sulfide), false positive reaction to the occult blood (guaiac test, at the same time benzidine test does not change), the false positive new test of an ortotoluida, blackening of teeth (formation of iron sulfide in an oral cavity, especially in the presence of caries). Prolonged use of iron preparations, especially in high doses, influences phosphorus assimilation that can cause heavy rickets in children. When prescribing of some prolonged drugs (ferro-gradumt) in stool perhaps detection of porous plastic. Long administration of drugs of iron (in the absence of indications) can lead to development of a hemosiderosis (the organism is not capable to remove excess of iron more than 6 months).