избыточное содержание железа в организме (например, гемохроматоз); - нарушения утилизации железа (например, анемия, вызванная интоксикацией свинцом, сидероахрестическая анемия); - анемии, не связанные с дефицитом железа (например, гемолитические анемии, мегалобластная анемия, вызванная недостатком цианокобаламина); - повышенная чувствительность к компонентам препарата.
1 жевательная таблетка содержит: Активное вещество: железа (III) гидроксид полимальтозат 400 мг, в пересчете на железо 100 мг. Вспомогательные вещества: макрогол 6000, аспартам, ароматизатор шоколадный, тальк, декстраты.
Фармакологические свойства
Антианемический препарат. В препарате Феррум Лек железо находится в виде комплексного соединения железа (III) гидроксид полимальтозат. Молекулярная масса комплекса настолько велика (около 50 кДа), что его диффузия через слизистую оболочку ЖКТ в 40 раз медленнее, чем диффузия двухвалентного железа. Комплекс стабилен и в физиологических условиях не высвобождает ионы железа. Железо многоядерных активных зон комплекса связано в структуру, подобную структуре естественного соединения железа - ферритина. Благодаря этому сходству железо данного комплекса абсорбируется только путем активного всасывания. Железосвязывающие белки, находящиеся на поверхности кишечного эпителия, поглощают железо (III) из комплекса посредством конкурентного обмена лигандами. Абсорбированное железо в основном депонируется в печени, где оно связывается с ферритином. Позже в костном мозге оно включается в гемоглобин. Комплекс железа (III) гидроксид полимальтозат не обладает прооксидантными свойствами, присущими солям железа (II).
избыточное содержание железа в организме (например, гемохроматоз); - нарушения утилизации железа (например, анемия, вызванная интоксикацией свинцом, сидероахрестическая анемия); - анемии, не связанные с дефицитом железа (например, гемолитические анемии, мегалобластная анемия, вызванная недостатком цианокобаламина); - повышенная чувствительность к компонентам препарата.
Применение при беременности и в период грудного вскармливания
В ходе контролируемых исследований при применении препарата во II и III триместрах беременности не отмечено отрицательного влияния на организм матери или плода. Не выявлено вредного воздействия на плод при применении препарата в I триместре беременности.
Способ применения и дозы
Препарат рекомендуется принимать во время или сразу после еды. Жевательные таблетки можно разжевывать или глотать целиком. Ежедневную дозу можно поделить на несколько приемов или принять за 1 раз. Дозы и продолжительность лечения зависят от степени дефицита железа. Сироп можно смешивать с фруктовыми или овощными соками или добавлять в детское питание. Вложенная в упаковку мерная ложка используется для точного дозирования сиропа. При железодефицитной анемии продолжительность лечения составляет около 3-5 мес. После нормализации уровня гемоглобина следует продолжать прием препарата еще в течение нескольких недель, чтобы пополнить запасы железа в организме. Детям в возрасте до 1 года назначают 2.5-5 мл (1/2-1 мерная ложка) сиропа/сут. Детям в возрасте от 1 до 12 лет - 5-10 мл (1-2 мерные ложки) сиропа/сут. Детям старше 12 лет, взрослым и матерям, кормящим ребенка грудью, - 1-3 таб. жевательных или 10-30 мл (2-6 мерных ложек) сиропа/сут. Беременным женщинам назначают по 2-3 таб. жевательные или 20-30 мл (4-6 мерных ложек) сиропа до нормализации уровня гемоглобина. После этого следует продолжать принимать по 1 таб. жевательной или 10 мл (2 мерные ложки) сиропа/сут, по крайней мере, до конца беременности для пополнения запасов железа в организме. При латентном дефиците железа продолжительность лечения составляет около 1-2 мес. Детям в возрасте от 1 до 12 лет - 2.5-5 мл (1/2-1 мерная ложка) сиропа/сут. Детям старше 12 лет, взрослым и матерям, кормящим ребенка грудью, - 1 таб. жевательная или 5-10 мл (1-2 мерные ложки) сиропа/сут. Беременным женщинам назначают по 1 таб. жевательной или 5-10 мл (1-2 мерные ложки) сиропа/сут.
Побочное действие
Со стороны пищеварительной системы: очень редко - чувство тяжести, ощущение переполнения и давления в области эпигастрия, тошнота, запор, диарея. При приеме препарата отмечается окрашивание кала в темный цвет, что обусловлено выведением невсосавшегося железа и не имеет клинического значения. Отмечавшиеся побочные эффекты были в основном слабыми и преходящими.
Передозировка
В случаях передозировки препарата Феррум Лек для приема внутрь до настоящего времени не было описано признаков интоксикации или признаков избыточного поступления железа в организм, поскольку железо из действующего вещества не присутствует в ЖКТ в свободной форме и не всасывается путем пассивной диффузии.
Особые указания
Таблетки жевательные и сироп не вызывают окрашивания эмали зубов. При назначении Феррум Лек пациентам с сахарным диабетом следует учитывать, что 1 таб. жевательная и 1 мл сиропа содержит 0.04 ХЕ. В случаях анемии, вызванной инфекционным или злокачественным заболеванием, железо накапливается в ретикуло-эндотелиальной системе, из которой мобилизуется и утилизируется только после излечения основного заболевания. Прием препарата не оказывает влияния на результаты анализов кала на скрытую кровь (избирательно на гемоглобин). Использование в педиатрииДетям в возрасте до 12 лет в связи с необходимостью назначения препарата в низких дозах предпочтительно применение в форме сиропа. Влияние на способность к вождению автотранспорта и управлению механизмамиНе оказывает влияния на способность к концентрации внимания.
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