Totema, 10 ml 20 pcs.

Antianemic, replenishing iron deficiency.

Pharmacodynamics

A combined drug. It contains iron, which is necessary for the synthesis of heme, which is part of hemoglobin, myoglobin, flavoproteins, iron-ferritin and iron-transferrin complexes, various enzymes; it participates in a number of redox reactions.

Copper and manganese are related to trace elements and are cofactors of some enzymes.

The absorption of iron and trace elements occurs primarily in the duodenum and upper jejunum. Absorption is more intense the greater the iron deficiency in the body.

When taking the drug there is a gradual regression of clinical and laboratory symptoms of anemia.

Indications

Prevention and treatment of iron deficiency anemia in adults and children from 3 months of age caused by various reasons:

bleeding;
increased need for iron (pregnancy);
insufficient intake of iron from food or impaired absorption.

Pharmacological effect

Antianemic, replenishing iron deficiency.

Pharmacodynamics

Combined drug. Contains iron, which is necessary for the synthesis of heme, which is part of hemoglobin, myoglobin, flavoproteins, iron-ferritin and iron-transferrin complexes, various enzymes; participates in a number of redox reactions.

Copper and manganese are microelements and are cofactors for some enzymes.

Absorption of iron and trace elements occurs predominantly in the duodenum and upper jejunum. Absorption is more intense, the greater the iron deficiency in the body.

When taking the drug, there is a gradual regression of clinical and laboratory symptoms of anemia.

Special instructions

Monitoring the effectiveness of treatment should be carried out no earlier than 3 months after the start of treatment.

Excessive tea consumption inhibits iron absorption.

To avoid darkening of tooth enamel, prolonged exposure of the drug solution to the oral cavity should be avoided.

Patients with diabetes should take into account that 10 ml of the drug contains 3 g of sucrose.

1 ampoule of the drug contains 1/4 XE, the maximum daily dose (in 4 ampoules of the drug) is 1 XE.

During treatment with iron supplements, patients may experience black stool, however, this does not require medical intervention. During treatment with iron supplements, a stool occult blood test may give a false-positive result.

Impact on the ability to drive vehicles and operate machinery

There is no data on the negative effect of the drug on the ability to drive vehicles and other mechanisms.

Active ingredient

Iron gluconate, Manganese gluconate, Copper gluconate

Composition

1 amp.

iron (elemental, in the form of iron gluconate dihydrate) 50 mg
manganese (elemental, in the form of manganese gluconate) 1.33 mg
copper (elemental, in the form of copper gluconate) 700 mcg

Excipients:

glycerol – 2.52 g,

dextrose (glucose) – 80 mg,

sucrose – 3 g,

anhydrous citric acid – 27.4 mg,

sodium citrate dihydrate – 30 mg,

sodium benzoate – 20 mg,

polysorbate 80 – 24 mg,

caramel color TPS (E150c) – 50 mg,

“tutti-frutti” flavoring – 20 µl,

purified water – up to 10 ml.

Pregnancy

The drug is allowed to be used during pregnancy and lactation according to indications in recommended doses.

Use in children

Contraindication: children under 3 months of age.

Contraindications

hypersensitivity to the components of the drug;
anemia not associated with iron deficiency;
hemochromatosis, hemosiderosis;
thalassemia;
peptic ulcer of the stomach and duodenum in the acute stage;
lead intoxication;
copper or manganese intoxication, Wilson-Konovalov disease;
sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption.

The drug should be prescribed with caution for diabetes mellitus.

Side Effects

From the digestive system:

staining of stool black (this is normal);
heartburn; nausea;
vomit;
diarrhea;
constipation;
pain in the epigastric region;
darkening of tooth enamel.

Other: allergic reactions.

Interaction

The simultaneous use of the drug Totema® leads to a decrease in the absorption of bisphosphonates, ciprofloxacin, and tetracyclines when taken orally.

Salts, oxides and hydroxides of magnesium, aluminum and calcium interfere with the absorption of iron salts. Totema® should be taken no earlier than 2 hours after taking these medications.

You cannot combine the drug with other iron preparations, incl. administered parenterally.

Overdose

Symptoms: weakness, hyperthermia, convulsions, nausea, vomiting, constipation, diarrhea, epigastric pain. Cases of necrosis of the walls of the gastrointestinal tract and shock have been described.

Treatment: gastric lavage with 1% sodium bicarbonate solution (baking soda).

When the concentration of iron in the blood serum is more than 5 mcg/ml, deferoxamine is administered intravenously slowly: for children – 15 mg/kg/h, for adults – 5 mg/kg/h (up to 80 mg/kg/day); for mild poisoning IM: children – 1 g every 4-6 hours, adults – 50 mg/kg (up to 4 g/day); carry out symptomatic therapy; If shock occurs, antishock therapy is carried out.

Storage conditions

At a temperature not exceeding 25 °C

Shelf life

2 years

Manufacturer

Innotera Chouzy, France