Totem

General characteristics. Structure:

Active ingredients:

Gland a gluconate a dihydrate, the quantity corresponding to elementary iron of 50,00 mg

Manganese a gluconate, the quantity corresponding to elementary manganese of 1,33 mg

Copper a gluconate, the quantity corresponding to elementary copper of 0,70 mg

Excipients: Glitserol of 2520,00 mg; dextrose (glucose) of 80,00 mg; sucrose of 3000,00 mg; citric acid of anhydrous 27,40 mg; sodium citrate dihydrate of 30,00 mg; Natrium benzoicum of 20,00 mg; mg polysorbate 80 24,00; caramel TPS dye (Е 150c) 50,00 mg; Tutti-frutti fragrance of 0,20 ml; the water purified to 10,00 ml

Opisaniye:temno-korichnevaya liquid with a characteristic smell. Existence of a small deposit is possible.

Pharmacological properties:

The combined drug.

Contains iron which is necessary for the synthesis gem which is a part of hemoglobin, a myoglobin, flavoproteins, complexes iron - ferritin and iron - transferrin, various enzymes; participates in a number of redoxreactions.

Copper and manganese - belong to microelements and are cofactors of some enzymes. Absorption of iron and microelements happens preferential in a duodenum and an upper part of a jejunum. Absorption takes place the more intensively, than deficit of iron in an organism is more.

At administration of drug there is a gradual regression of clinical and laboratory symptoms of anemia.

Indications to use:

Treatment and prevention of iron deficiency anemias at the adults and children from 3-month age called by various reasons:

- bleedings;
- the increased need for iron (pregnancy);
- insufficiency of intake of iron with food or disturbance of its absorption.

Route of administration and doses:

Inside, before meal; contents of an ampoule are dissolved in idle time or the sweetened water.

Treatment:  

Adult: 100 - 200 mg of iron, i.e. 2 - 4 ampoules of drug a day.

To children is more senior than 3 months: at the rate of 5-7 mg/kg of body weight a day in 2-4 receptions.

Use of drug is carried out under control of content of serum of iron, the general iron-binding ability of serum, etc. prior to treatment and further with frequency of 1 times in 2 months.

Preventive use: 

To adults and women during pregnancy, since 4th month, on 50 mg (1 ampoule) of iron a day.

To children: depending on age drug is appointed in a dose, a component by from 1/4 to 1/2 daily therapeutic doses.

Duration of treatment is defined individually. The average duration of administration of drug from 3 to 6 months (before recovery of reserves of iron in an organism).

Before the use to shake up.

Tear off on a dashed line a cardboard piece from a pack and bend it in half safely to break an ampoule tip. Crack an ampoule from two parties, pour out contents of an ampoule in a glass and dissolve in idle time or the sweetened water.

Features of use:

Control of efficiency of treatment should be carried out not earlier than in 3 months after an initiation of treatment.

1 ampoule of drug contains 1/4 grain units, in the maximum daily dose
(in 4 ampoules of drug) 1 grain unit.

The excess use of tea suppresses iron absorption. In order to avoid darkening of enamel of teeth it is necessary to avoid long stay of solution of drug in an oral cavity.

Patients with a diabetes mellitus need to consider that 10 ml of drug contain
3 g of sucrose.

During treatment by iron preparations at patients the kcal can be observed black, however, it does not demand medical intervention. During treatment by iron preparations the analysis the calla on the occult blood can yield false positive result.

Influence on ability to manage vehicles

There are no data on negative influence of drug on ability to manage vehicles and other mechanisms.

Side effects:

Allergic reactions, darkening of enamel of teeth.

Coloring a calla in black color (is norm), gastrointestinal frustration: heartburn, nausea, vomiting, diarrhea, a lock, pains in the field of an epigastrium.

If any of the side effects specified in the instruction are aggravated, or

You noticed any other side effects which are not specified in the instruction, report about it to the doctor.

Interaction with other medicines:

Reduces absorption of biphosphonates, ciprofloxacin, tetracyclines. Salts, oxides and hydroxides of magnesium, aluminum and calcium break absorption of salts of iron
(an interval between receptions - not less than 2 hours).

It is impossible to combine with reception of other iron preparations, including for parenteral administration.

Contraindications:

- the anemias which are not connected with deficit of iron;
- hemochromatosis, hemosiderosis;
- thalassemia;
- a peptic ulcer of a stomach of a duodenum in an aggravation stage;
- intoxication lead;
- hypersensitivity to drug components;
- children's age up to 3 months;
- intoxication copper or manganese, Wilson-Konovalov's disease;
- deficit of invertase / isomaltase, intolerance of fructose, glyukozo-galaktozny malabsorption.

With care: diabetes mellitus.

Pregnancy and breastfeeding

Use during pregnancy and breastfeeding is authorized.

Overdose:

Symptoms: weakness, a hyperthermia, nausea, vomiting, locks, diarrhea, pains in epigastriums. Cases of a necrosis of walls of digestive tract and shock are described.

Treatment: a gastric lavage by means of 1% of solution of Natrii hydrocarbonas
(baking soda). At concentration of iron in blood serum more than 5 mkg/ml enter Deferoxaminum intravenously slowly: to children — 15 mg/kg/h, adult — 5 mg/kg/h (to 80 mg/kg/days); at slight poisoning intramusculary: to children — on 1 g each 4-6 h, adult — on 50 mg/kg (to 4 g/days); carry out symptomatic therapy; at emergence of shock carry out antishock therapy.

At detection of symptoms of overdose it is necessary to see a doctor.

Storage conditions:

To store at a temperature not above 25 °C. To store in the place, unavailable to children. Period of validity 2 years. Not to use after the period of validity specified on packaging.

Issue conditions:

According to the recipe

Packaging:

Solution for intake.

On 10 ml in two-final ampoules from yellow glass III of type.

On 10 ampoules in cardboard pallets, on 2 pallets with the application instruction in a cardboard pack.