Ferumbo

General characteristics. Structure:

International and chemical names: Ferric hydroxide; main physical and chemical properties: red-brown viscous liquid, with a specific smell; structure: 5 ml of syrup contain 50 mg of iron in the form of a complex of iron (III) of hydroxide with a polymaltose; excipients: glycerin, sorbitol, sucrose, hydroxyethylcellulose, Natrium benzoicum, fragrance food vanilla butter, the water purified.

Pharmacological properties:

Pharmacodynamics. Drug fills shortage of iron in an organism, stimulates haemo - and an erythrogenesis. At course treatment promotes bystry regression of clinical and laboratory symptoms of anemia. The complex of ferrous hydroxide (III) with a polymaltose is stable, does not emit iron in the form of free ions in this connection has no such side effects inherent to iron preparations (II) as irritation of a mucous membrane of a GIT, coloring of teeth, metal smack. It is characterized by high degree of safety. Iron transport in plasma is carried out with the help scale of globulin of the transferrin which is synthesized in a liver. Iron in a complex with transferrin is transferred to organism cells where it is used for synthesis of hemoglobin, a myoglobin and some enzymes. The soaked-up iron remains in the form of the connected connection with ferritin, mainly in a liver. Trivalent iron participates in education gem that leads to increase in level of hemoglobin. At use of drug there is a gradual regression clinical (weakness, fatigue, dizziness, tachycardia, dryness of integuments) and laboratory symptoms of deficit of iron.

Pharmacokinetics. At intake iron from a polymaltose complex   of ferrous hydroxide (III) is actively soaked up from a duodenum and a small intestine (the more deficit of iron, the better it absorption). Active absorption of the drug containing iron (III) excludes development of overdose, possible at absorption of simple salts of iron (II) on a concentration gradient. The iron which is a part of a complex of ferrous hydroxide (III) with a polymaltose has no pro-oxidatic properties which are inherent in simple salts of iron (II).

Indications to use:

Prevention and treatment of iron deficiency anemias of various etiology at children. Appoint the adult at deficit of iron (a polymenorrhea, a metrorrhagia, childbirth, hemorrhoids, a round ulcer of a stomach and an ulcer of a duodenum, surgical interventions, frequent nasal bleedings), at the increased need for iron during the periods of pregnancy and feeding by a breast, at donorship, burns, a hemodialysis; at alimentary insufficiency of iron or disturbance of its absorption, at chronic diarrhea, a disease Krone, enteritis, malabsorption.  

Route of administration and doses:

 Ferumbo's syrup is accepted in time or right after food, mixing with fruit and vegetable juice or nutritious mixes is possible. The daily dose can be applied in one or several receptions.
For treatment of clinically expressed deficit of iron drug is accepted proceeding from recommendations which are given below:

Age group	Dosing		Reception frequency in days	Daily dose drug, (mg)
	Measured spoon	ml
Premature children *			1	2,5-5
Children till 1 year	1/2-1	2,5-5	1	25-50
Children from 1 year to 3 years	1	5	1	50
Children from 3 to 6 years	1	5	1-2	50-100
Children from 6 to 12 years	1	5	2	100
Adults and children are more senior than 12 years	2-6	10-30	1-2	100-300

* Premature children accept daily 5-10 drops (1 ml of drug / 20 drops contains 10 mg of iron).

In the specified doses treatment is carried out to achievement of normal level of hemoglobin to blood.
At latent deficit of iron recommend such scheme of use of Ferumbo:

Age group	Dosing		Reception frequency in days	Daily dose drug, (mg)
	Measured spoon	ml
Children till 1 year	1/3-1/2 *	1,5-2,5	1	15-25
Children from 1 year to 12 years	1/2 - 1	2,5-5	1	25-50
Adults and children are more senior than 12 years	1-2	5-10	1	50-100

* Or 30–50 drops of syrup. 

 After that administration of drug in preventive doses has to be continued within several months for recovery of a reserve of iron in an organism.
For prevention use the following dosing of syrup of Ferumbo:
children till 1 year   – 5-10 mg of iron a day (10-20 drops);
children from 1 year to 12 years  – 10-15 mg of iron a day (20-30 drops);
adults and children are more senior than 12 years – 15-20 mg of iron a day (30-40 drops).
For prevention of deficit of iron at pregnancy appoint 5-10 ml of syrup (50-100 mg of iron) once a day.

Features of use:

Use of drug can cause coloring a calla in dark color that is caused by removal of not soaked up iron and has no clinical value. Administration of drugs of iron needs to be continued also after hemoglobin normalization.
Pregnancy and lactation. At long reception for prevention of deficit of iron at pregnancy and in the period of a lactation clinical and epidemiological toxic, cancerogenic or mutagen properties of drug are not revealed. Thus, Ferumbo's drug for intake it is recommended at deficit of iron at pregnancy.

Side effects:

Occasionally side effects from a GIT can be noted (feeling of overflow and pressure in epigastriums, nausea, a lock or diarrhea). In case of by-effects follows quickly (for 3 days) to lower a drug dose  twice.

Interaction with other medicines:

Because iron is a part of drug in the form of a complex of ferrous hydroxide (III) with a polymaltose, it does not form insoluble chelate compounds with food components (phytin, oxalates, a tannin) or medicines (tetracyclines, antacids). Salts of iron (II) reduce absorption of iron from syrup.

Contraindications:

Hypersensitivity to any component of drug. Diseases which are followed by accumulation of iron in an organism (aplastic and hemolitic anemias, hemochromatosis, a hemosiderosis); the anemias which are not connected with deficit of iron (the megaloblastny anemia caused by a lack of B12 vitamin); disturbances of inclusion of iron in hemoglobin (the anemia caused by poisoning with lead, sideroblastny anemia).

Overdose:

Drug belongs to almost non-toxic substances that excludes a possibility of overdose. So far symptoms of intoxication caused by excess intake of iron in an organism at use of drugs on the basis of a complex of ferrous hydroxide (III) with a polymaltose were not described.
However in case of considerable exceeding of a dose development of such clinical symptoms as weakness, a dermahemia, a hyperthermia, dizziness, a dentagra and breast pain, an acrimony, paresthesia, a Crocq's disease, an abdominal pain, vomiting and diarrhea with blood impurity is possible. At prolonged use erosive cankers of a digestive tract, darkening of an adamantine substance of tooth are observed. Arterial pressure decreases, tachycardia develops, convulsive attacks and a coma develop.
Treatment: gastric lavage; in case of a serious poisoning introduction of a specific antidote – Deferoxaminum is shown. Enter intravenously, slowly: to children – 15 mg/h, adult – 5 mg/kg/h (to 80 mg/kg a day). The hemodialysis is in that case inefficient.

Storage conditions:

To store dry, protected from light, the place, unavailable to children, at a temperature from 15 to 25 to a °s.posla of opening of a bottle a drug period of validity – 30 days at a temperature of 8 - 15 °C.

Period of validity - 2 years.

Issue conditions:

According to the recipe

Packaging:

Syrup on 50 ml in bottles or banks, on 1 bottle or bank with the portioning device in a pack. Syrup on 100 ml in bottles or banks, on 1 bottle or bank with the portioning device in a pack.