Aktiferrin, syrup 100 ml

Interaction

The specific antidote is deferoxamine (desferal).

When used concomitantly, iron salts reduce absorption of such drugs as tetracyclines, gyrase inhibitors (e.g., ciprofloxacin, levofloxacin, norfloxoccin, ofloxacin), penicillamine, levodopa, carbidopa and methyldopa.

In patients receiving levothyroxine sodium replacement therapy, iron salts decrease its absorption.

High doses of iron preparations decrease renal absorption of zinc preparations (it is recommended to take these 2 hours after taking iron preparations).

The absorption of iron is reduced when colestyramine, antacids (containing aluminum, magnesium, calcium, bismuth), and calcium and magnesium supplements are taken at the same time.

The concomitant use of iron salts and nonsteroidal anti-inflammatory drugs may increase the damaging effects of iron on the gastrointestinal mucosa.

In children, concomitant use of iron reduces the effectiveness of vitamin E.

Therefore, all of the above remedies are recommended to be taken 3-4 hours before or after taking Aktiferrin. Systematic clinical and laboratory monitoring should be carried out if concomitant administration of drugs is necessary.

Tea, coffee, plant foods containing iron-chelating agents (such as phosphates, phytates, oxalates), milk, eggs reduce iron absorption.

Ascorbic acid and citric acid increase iron absorption.

Ethanol increases iron absorption and the risk of toxic complications.

Special Instructions

The use of the drug may cause persistent darkening of the teeth. Hepatic or renal insufficiency increases the risk of iron cumulation. Use of the drug may aggravate ulcerative and inflammatory bowel diseases.

Influence on driving and operating machinery

Have not been identified.

Synopsis

Transparent solution from greenish to yellow-brownish color with raspberry and creamy odor.

Contraindications

– Hypersensitivity to the active or excipient components of the drug;

– disorders of iron absorption (sideroachrestic anemia, lead anemia, thalassemia);

– increased iron in the body (hemochromatosis, hemolytic anemia);

– anemia not related to iron deficiency.

Cautions

Caution should be exercised when concomitant use of iron preparations with dietary products and supplements containing iron salts (possible risk of overdose).

In patients with gastrointestinal inflammation and mucosal ulcers, the benefit ratio of treatment versus risk of gastroenterological exacerbations with therapy with iron should be assessed.

Patients with hereditary fructose or galactose intolerance, lack of lactase, glucose-galactose malabsorption or sucrose-isomaltose deficiency should not take the drug.

Side effects

Immune system disorders: rare (> 1/10 000 and < 1/1000) skin allergic reactions.

Gastrointestinal tract: very rare (< 1/10 000) constipation, diarrhea, abdominal pain, nausea, vomiting.

When taking iron-containing drugs, dark (black) staining of the feces is possible, which is not clinically significant.

The gastrointestinal disturbances may be prevented by gradually increasing the dose at the beginning of treatment or by reducing the dose during treatment.

Overdose

In children there is a high risk of intoxication with iron preparations, life-threatening conditions can occur when taking 1 g of iron sulfate. Therefore, iron preparations should be kept out of the reach of children.

Symptoms:the following symptoms may occur if very large doses of the drug are taken accidentally: weakness, fatigue, paresthesias, pale skin, cold clammy sweat, decreased blood pressure, palpitations, acrocyanosis, abdominal pain, diarrhea with blood mixed in, cyanosis, confusion, weak pulse, hyperthermia, lethargy, seizures, hyperventilation symptoms, coma.

The signs of peripheral circulatory collapse appear within 30 minutes after ingestion; metabolic acidosis, seizures, fever, leukocytosis, coma within 12-24 hours; acute renal and hepatic necrosis within 2-4 days.

Treatment:before specific therapy – take measures to remove from the stomach the drug has not yet been absorbed (gastric lavage), give milk, raw eggs. Specific therapy is carried out by prescribing deferoxamine (desferal) orally and parenterally. In acute poisoning to bind iron not yet absorbed from the gastrointestinal tract, 5-10 g of the drug are given by dissolving the contents of 10-20 ampoules in drinking water.

In case of development of poisoning phenomena deferoxamine is administered slowly, in children – 15 mg/h, in adults – 5 mg/kg/h (up to 80 mg/kg/day); in mild poisoning – in children 1 g every 4-6 hours, in adults – 50 mg/kg (up to 4 g/day).

Hemodialysis is ineffective for iron excretion, but can be used to accelerate excretion of the iron-deferoxamine complex, and can also be administered in oligo- and anuria. Peritonial dialysis may also be used.

The systematic monitoring of serum iron levels and other serum indices is necessary during the course of treatment with iron preparations.

Special measures:in severe intoxication – Unithiol (dimercaptopropane sodium sulfonate) parenterally.

Because of the possibility of formation of neurotoxic complexes, Unityol should be used with caution.

Pregnancy use

Use during pregnancy and lactation is possible if the potential benefit to the mother exceeds the potential risk to the fetus and child.