Iron deficiency anemia is considered a very common disease that affects a person’s quality of life. More often this pathology It is diagnosed in women, but can also affect men. At the same time, patients complain about severe weakness, dizziness, headaches.

The following changes are observed in appearance and general health:

1. Dry skin.
2. Excessive pallor.
3. Hair loss.
4. Increased brittleness of nails.
5. Tachycardia.
6. Dyspnea.
7. Reduced blood pressure.

A person loses vital energy, becomes weak, lethargic and lacking initiative.. To confirm the diagnosis, it is necessary to take blood tests, which show a decrease in hemoglobin levels and low iron content. When the diagnosis is confirmed, it is necessary to take special iron-containing medications, which are selected by a specialist.

The role of iron in the body

Iron plays important role in coordinated work human body. It takes an active part in the process of hematopoiesis, therefore, with anemia, a person experiences such severe discomfort. Normally, the body contains no more than 3.5 mg of iron, most of which is found in hemoglobin.

This substance is not synthesized independently, but comes with food. The excess is deposited in the liver in the form of hemosiderin, which then compensates for the deficiency of this element. If all supplies are gone, then oxygen starvation with all the ensuing consequences.

Causes of iron deficiency

Iron deficiency anemia can be caused by various reasons, so treatment should be selected by a specialist. Only he will reveal the origins of the disease and find remedies that will act faster and safer.

Common causes of anemia:

1. Internal bleeding.
2. Pregnancy, childbirth and lactation.
3. Heavy menstruation.
4. The presence of chronic inflammatory processes.
5. Pathologies of the intestines and digestive system.
6. Poor nutrition with low content gland.
7. Elevated physical activity without diet correction.

With gastritis, peptic ulcers and erosions, the absorption of iron is impaired, against which anemia develops.

If a woman has painful and heavy menstruation, she loses a huge amount of iron.

If you do not adjust your diet on such days, weakness occurs, up to fainting. They influence in a similar way internal bleeding, which are accompanied by many intestinal diseases, fibroids and hemorrhoids.

During pregnancy, the body requires more iron, since it also goes into the development of the embryo. If there is a shortage of this element development is disrupted internal organs the baby, and the mother’s well-being worsens.

Similar changes occur during breastfeeding, when many are given in the baby’s milk. nutrients. For prevention, doctors prescribe to girls childbearing age preparations with iron. The prescribed medicine for anemia is used several days a month to stabilize the health condition.

Vegetarians often experience anemia because their diet lacks protein. To prevent problems, you should take special supplements. Also special attention It is worth paying attention to nutrition for athletes, since increased physical activity requires a huge amount of oxygen.

If a person does not take this feature into account, fainting, dizziness and problems with work are possible. cardiovascular system. If you feel unwell, you should visit a doctor and go through full examination to avoid more serious changes.

Modern drugs for the treatment of anemia

If hemoglobin is low, specialists prescribe an examination, after which they select special medications for treatment. The doctor takes into account both the general condition of the patient and the presence accompanying pathologies, And financial situation . Some medications are too expensive, so the doctor must consult with the patient. Only at the expense collaboration it is possible to select a scheme of influence that will give maximum result and will suit both parties.

Traditionally, two types of iron supplements are prescribed for anemia:

1. Bivalent.
2. Trivalent.

Preparations containing ferrous iron

Iron in tablets is considered the most effective, as it is absorbed better. To reduce the effect of iron on the intestines, you can take the medicine in capsules.

If the patient is diagnosed serious problems with the functioning of the intestines, drugs are administered intravenously. However, the effectiveness of the impact in such cases is greatly reduced.

Which preparations contain 3 valent iron:

In this case, there is a list of drugs that are prescribed most often:

• Maltofer,
• Ferlatum,
• Fenyuls,
• Ferro - Foil.

Drugs ferrous iron are gradually being replaced by means high content ferric iron. However, only a specialist can say exactly which medications are best to use and when. And for each category of patients there are their own medicines for iron deficiency anemia.

The following medications are prescribed for pregnant women:

• Totem,
• Sorbifer Durules,
• Maltofer,
• Ferrum-Lek.

To increase the effectiveness of treatment in pregnant women, sorbifer and folic acid simultaneously. Folic acid improves iron absorption and has a beneficial effect on the child's health.

The best medicines for children:

• Totem,
• Maltofer,
• Maltofer-Fol,
• Ferrum-Lek,
• Venofer,
• Actiferrin.

To better understand the capabilities of drugs, you should carefully study their composition and effects on the body.

Preparations with ferrous iron

If the patient has a limited budget, you can try analogues known drugs. A drug such as Fenyuls has names in Russia - Hemofer Prolangatum, Sebidin. Ferrofolgamma from a Belarusian manufacturer is called ferronal, which is in no way inferior to the original, but pleases with its low cost.

If the patient is interested in a medicine that is absorbed better in the body, it is worth giving preference to complexes with ferric iron. Patients are often prescribed sorbifer, which can be taken by children over 12 years of age and adults. Because of this, doubts arise: totem or sorbifer - which is better and more effective.

Video: Iron supplements for iron deficiency anemia

If we compare these drugs in terms of effectiveness, it is similar, but in terms of safety, sorbifer is inferior. It affects concentration and therefore poses a danger when performing precision work and driving vehicles.

Preparations with ferric iron

Reception features

Many experts recommend medications based on ferric iron containing vitamins. They quickly find a response in children and adults, cause fewer side effects and are characterized by maximum effectiveness.

However, the price at the pharmacy for such complexes is impressive, so patients try to choose a reasonable alternative. Instead of maltofer, in case of iron deficiency, take hemojet, iron saccharate or profer, which are analogues of Ukrainian production.

Regardless of what type of drug is prescribed to the patient, one should remember the main features of taking iron.

Features of taking iron supplements:

1. Self-administration of iron medications is prohibited.
2. Do not exceed therapeutic doses.
3. Liquid medications are more irritating than tablets and capsules.
4. You cannot take some antibiotics and iron supplements at the same time.
5. It is recommended to drink iron before meals.
6. Iron injections are less effective and are therefore used as a last resort.
7. You cannot stop treatment on your own.

If the patient needs to undergo additional examination, he must warn the doctor about taking iron supplements. They can interfere with the results of some tests, making diagnosis difficult.

You should also be more attentive to your own well-being, reporting the presence of any alarming symptoms.

Side properties

Iron supplements, especially in liquid form, cause negative reactions from gastrointestinal tract. They also pose a danger to humans if used uncontrolled. It should be understood that there are no drugs without side effects. They just don’t always appear and not in all patients.

Side effects of drugs:

1. Nausea.
2. Pain in the stomach area.
3. Vomit.
4. Decreased appetite.
5. General weakness.
6. Stool disorder.

Symptoms become especially severe if the doctor has prescribed a liquid remedy. When the patient's condition has deteriorated significantly, the drug should be replaced or another form of exposure should be selected.

If the medicine was administered by injection, the side effects are as follows:

1. Headache.
2. Weakness.
3. Unpleasant taste in the mouth.
4. Muscle pain.
5. Discomfort in the joints.
6. Rash.
7. Tachycardia.
8. Painful sensations at the injection site.

The negative manifestations of treatment intensify if the daily dose is exceeded in women and men. Even more dangerous consequences They are for children, so the specific product and its dosage are selected by a specialist.

Adverse reactions develop from the iron itself, so replacing it with analogues often does not work. The only option in such cases is to reduce the dose or replace it with liquid preparation for intramuscular administration.

Treatment effectiveness

The effectiveness of treatment is determined general condition patient and test results. The first changes appear within a month correct application the chosen medication.

When hemoglobin begins to increase, the specialist determines the duration of use of the medicine, which is usually six months. During this period, it is possible to replenish the iron deficiency depot, after which prophylactic administration of the prescribed complex is sufficient.

A specialist selects a specific treatment regimen taking into account the patient’s condition, as well as the effect of various drugs.

Video: What not to eat when taking iron supplements

Sometimes during the examination it becomes clear that the anemia is not iron deficiency. In such cases, only the attending physician can say what the name of the drug for treatment is and how to help the patient, based on numerous studies.

In a standard situation with anemia drug effects It turns out to be effective, and after a few weeks the person feels significant relief. If the pathology is provoked by some diseases of the internal organs, a complex effect is necessary. This is the only way to achieve maximum results and restore a person’s health.

Refers to the iron deficiency variety. Statistics indicate that about 30% of adults have some degree of iron deficiency, and when reaching the age of 60 years, the percentage increases to 60%. Moreover, this pathology is more common among women. The basis of treatment is iron supplements for anemia. Only a doctor can select a list of drugs and the optimal form of release. Therefore, do not try to self-medicate.

The role of iron

Each mineral and vitamin contained in the human body plays its role. Iron (ferrum) is incredibly necessary for us.

The adult body contains an average of 2.5 - 3.5 grams of iron, 70% of which is included in hemoglobin. This element is not synthesized by our internal organs, therefore it can only be obtained through food. Hemoglobin binds oxygen molecules in red blood cells, that is, blood cells.

For the entire body to function well, it needs to maintain iron levels within optimal performance. When it is disrupted, hemoglobin is formed in smaller quantities. As a result, oxygen does not penetrate the tissues actively enough, the nutrition of internal organs is disrupted and oxygen starvation occurs.

Our liver creates a certain reserve of the mineral, presented in the form of hemosiderin. If there is a shortage in the body, then the mineral is extracted from reserves.

Causes of deficiency

Any mineral and vitamin should be supplied in sufficient quantities. This important condition for the proper functioning of the human body.

But it happens that there is a need to take iron supplements for anemia. Anemia or anemia itself occurs in a person due to several reasons:

• insufficient amount of iron supplied with food;
• poor absorption of ferrum in the intestines;
• increased consumption;
• uncompensated growth in the body's microelement needs.

If we do not eat sufficiently varied, excluding or minimizing iron-containing foods, then deficiency quickly develops and anemia is diagnosed.

At risk include athletes due to their excessive physical activity, vegetarians and fans of trendy unhealthy diets.

Experts have found that when consumed with protein foods, iron is absorbed only by 20–40%. If you eat fruits and vegetables, then iron minerals are absorbed by 80%. Vitamin C, which is found in fruits and vegetables, plays an important role here. Ascorbic acid is involved in the processes of ferrum absorption. If you reduce the consumption of iron-containing foods and foods with vitamin C at the same time, this will begin quickly and lead to serious consequences.

Assimilated microelements are gradually eliminated from the body. There are also cases when ferrum is not retained, despite a sufficient amount of it in the diet. This occurs in diseases related to the intestines.

In men, deficiency develops against the background of bleeding due to injuries to the skin or internal organs, while women need to actively compensate for the release of ferrum after menstruation.

Selection of medications

Doctors make the selection individually, based on the results of tests and examinations. Modern medicine and pharmacology offer highly effective means to resume the normal process of blood formation.

Practice has clearly proven that people suffering from anemia are better off taking iron supplements and vitamin C in the form of tablets rather than trying to compensate for the lack of microelements with food.

In terms of absorption, the daily dose of the drug exceeds the iron obtained from food by 20 times. Therefore, even if you decide to switch to a dietary diet, rich in vitamins food, it won't give similar to drugs effect.

Before starting treatment, it is better to consult with a trusted, qualified specialist. He will give directions to necessary tests And additional examinations. Based on them, a list of remedies for anemia is individually selected so that the absorbed iron compensates for the deficiency that has arisen.

There are several key rules that are followed when choosing medications.

1. Intramuscular administration is less effective than oral administration. Therefore, when treating with vitamin complexes, the result is achieved better when taking tablets orally. This confirms the fact that ferrum is better absorbed through the human intestines. Plus, this reduces the likelihood of side effects.
2. Pure iron content. Based on the composition, you can determine which of the drugs contain required quantity trace element in pure form. To achieve therapeutic effect choose a medicine that contains from 80 to 160 mg. substances. If it is a sulfate salt, then its permissible limit will be 320 mg. Any drugs that exceed the established standards can cause an overdose and unwanted side effects.
3. Swallow, don't chew. It is recommended to swallow the tablets whole rather than chew them. At the same time, be sure to wash them down with enough water so that the medicine immediately gets into the stomach. Tablets are better than liquid medications.
4. Complex drugs. Some patients, self-medicating, take vitamin complexes, which includes the minerals and substances required by the body. But their level of effectiveness is lower than that of special iron-containing products. This is due to the small dosage.
5. Iron form. It can be divalent or trivalent. This is important to know when choosing funds. In order for the body to absorb the divalent type of iron, vitamin C must be taken in parallel. When prescribing trivalent ferrum, you need to use a special type of amino acids. They will help deliver ions to the bone marrow.
6. Coated capsules. The optimal form of release is considered to be drugs in the form of capsules with a protective shell. They prevent the manifestation of an irritating effect on the mucous membrane of the patient’s stomach and esophagus.

The treatment course lasts for 6 months or longer. Patients undergo monthly follow-up diagnostics, taking repeat tests blood.

When it is possible to normalize the indicators of red blood cells and , treatment continues for another 1 - 2 months. This is necessary to consolidate the result. For pregnant mothers and nursing women duration drug therapy selected based on the breastfeeding period and trimester. It is important that not only the mother herself takes medications, but also prevents anemia in the child.

Products with ferrous iron

When choosing iron-containing preparations for the treatment of patients with anemia, the list is compiled taking into account individual characteristics patient and stage of anemia development.

In divalent preparations, ferrum or iron is presented in the form of a sulfate salt with vitamin supplements to improve the quality of absorption.

Let's look at some of the most popular tools presented in different forms release:

Make sure that the doctor does not forget to prescribe you a parallel dose of vitamin C. This vitamin promotes better absorption and assimilation of microelements the body lacks.

Products with ferric iron

It uses polymaltosate hydroxide as a form of iron to ensure the normal process of blood formation and nutrition of internal organs.

Among popular drugs the following can be distinguished:

• "Biofer";
• "Matofer";
• "Ferrum Lek";
• "Fenuls";

In rare situations, patients are prescribed medications in the form of injections. This is possible if the patient has pathologies of the stomach or intestines, diseases small vessels or excessive blood loss.

But intravenous method administration of drugs can potentially provoke thrombophlebitis. This is a condition where the veins become inflamed at the injection site.

All patients who take self-selected or prescribed anti-anemia medications may potentially experience unwanted reactions body. This is usually associated with individual intolerance, allergic reactions to the components included in the drugs or the release form.

Practice has shown that products without a shell or in the form of a solution can have a strong irritating effect on digestive system. This can result in constipation and pain. If you feel pain, discomfort in the intestines or notice on the body allergic manifestations, stop taking your medications and consult your doctor. He will select alternative medications and change the tactics of treating anemia.

Determining the effectiveness of therapy

Usually the drugs have a visible effect for about 3 weeks from the start of therapy medicines. This is determined by the increased level of hemoglobin.

Therapy is considered effective if hemoglobin returns to its normal level. normal level within 2 months. But after this you cannot stop taking the medications. Further use of the drugs is maintenance therapy, which helps to consolidate the result and saturate the body with iron.

At the same time, do not forget to follow a diet, eat large number products containing vitamins and minerals. The main emphasis is on fruits, vegetables, fresh juices, protein food and dairy products.

Never choose your medications yourself. This threatens not only the lack of treatment results, but also a number of side effects and the transition of anemia to more severe stages.

If it is necessary to prevent or treat existing iron deficiency anemia, the patient is prescribed iron supplements. Symptoms dangerous disease can develop at any age, during pregnancy, lactation, improper diet. In such situations, doctors prescribe syrups, capsules, solutions based on salts or iron hydroxide.

Causes of iron deficiency

In order for a doctor to prescribe iron supplements to a patient, he must diagnose iron deficiency anemia. It develops for the following reasons:

1. Chronic bleeding – they account for 80% of all cases of disease development. These include lesions of the gastrointestinal tract due to ulcers, hemorrhoids, tumors, erosive gastritis, intestinal diverticulosis. In women, anemia develops due to heavy periods, uterine fibroids, and bleeding. For everyone else, the cause is associated with pulmonary, nasal blood loss, pyelonephritis, urolithiasis, malignant tumors bladder and kidneys.
2. Chronic inflammatory diseases– if there is a focus of inflammation in the body, iron is deposited, which leads to its hidden deficiency. Instead of forming hemoglobin, the element simply accumulates in the depot and is not consumed.
3. Pregnancy, breastfeeding, physical activity, intensive growth of children, active sports – all these conditions cause an increased need for microelements.
4. Impaired absorption of iron is a condition that accompanies certain diseases, for example, malabsorption syndrome, intestinal amyloidosis, chronic enteritis, resection small intestine.
5. Wrong and bad balanced diet nutrition - this is typical for newborns and small children, vegetarians.

Daily iron requirement

Medicines for iron deficiency anemia are prescribed if there are deviations from the norm in iron consumption. His daily indicators:

Regardless of how much iron food contains, no more than 2 mg of the trace element is absorbed by the intestines per day, provided that the person is healthy. An adult man with hair and epithelium loses about 1 mg of iron per day, and a woman during menstruation loses 1.5 mg. Under the condition of normal nutrition, 1 mg of the microelement enters the depot of a man, and 0.5 mg of a woman. At poor nutrition, chronic diseases, heavy periods, iron is completely consumed, and anemia begins to develop.

To normalize hemoglobin production, oral iron supplements are prescribed. The doctor looks at the tests and prescribes a course of several months to replenish the depot. To prevent anemia, women of childbearing age need to take vitamins or dietary supplements with added iron (200 mg of pure element per day) for seven menstrual days each month.

Signs of iron deficiency

On initial stages signs of iron deficiency anemia do not appear. Over time they develop into the following:

• Weakness, lethargy, fatigue.
• Dizziness, loss of appetite and taste.
• Pale and dry skin, brittle hair, layered nails.
• Excessive hair loss.
• Cracks in the corners of the mouth.
• Shortness of breath, rapid heartbeat.
• Smoothness taste buds on the tongue.
• Pregnant women may develop a strange craving for eating chalk or earth.

Mechanism of action of iron-containing drugs

Preparations for the treatment of iron deficiency anemia contain divalent or trivalent iron. Salts of the first compound are absorbed by the cells of the mucous membrane of the gastrointestinal tract. This occurs by binding apoferritin in enterocytes to ions. Because of this, preparations of sulfate, gluconate, fumarate, lactate, succinate and glutamate salts have increased bioavailability and an affordable price.

The disadvantages of ferrous iron salts include high level gastrointestinal side effects, decreased availability when combined with medications, tannins, antacids. The drugs are prescribed only on an empty stomach, their overdose threatens acute poisoning, especially in children younger age. Hematologists recommend no more than 200 mg of drugs per day (in terms of elemental iron), and for pregnant women - 100-120 mg.

Ferric salts are less preferred because they must be reduced to the ferrous element to absorb ions. This leads to lower bioavailability of drugs. Another reason for the difficulty of administration is the easy hydrolysis of salts in upper sections small intestine, the formation of poorly soluble hydroxides and a decrease in their digestibility.

The best iron supplements for anemia

Iron supplements for intravenous administration less preferable compared to tablets, dragees, drops, capsules and syrups. The best remedies for treating iron deficiency anemia:

Iron supplements for children

Iron injection ampoules are not prescribed for children unless they have severe iron deficiency anemia. The child is prescribed pills, syrups or drops. Taking them helps improve the blood supply of oxygen to the blood vessels of the brain. From birth to two years, Hemofer, Maltofer, Aktiferrin can be used. From 2 to 5 years old, children are given syrups Ferronal, Actiferrin, Ferrum Lek. They are equipped with a measuring cap for convenient measurement of the medicine. Children over five years of age can take the tablets. They do not stain tooth enamel yellow.

Preference should be given to capsules with a protective shell: Actiferrin, Hemofer, Ferrum Lek, Tardiferon. The dosage is prescribed by a doctor, but should not exceed 3 mg per kg of body weight per day. The duration of the course will be 2-6 months. The tablets are swallowed whole, they cannot be chewed, but can be washed down with water. During treatment, the children's diet should be enriched with meat, fruits, and vegetables. If the preparation contains divalent iron, foods rich in vitamin C are included in the diet, and trivalent iron – in amino acids.

During pregnancy

If an expectant mother is diagnosed with anemia, she should consult a doctor for a prescription. medicinal product. Treatment is carried out standard means, the selection of which takes into account vitamin B12 deficiency, allergy history. For the treatment to be effective, a pregnant woman needs to adjust her diet - include legumes, bran, oatmeal, buckwheat, and dried fruits.

To prevent anemia, 30-40 mg of iron per day is prescribed in the third trimester. If there is a tendency to anemia, prevention is carried out at 12-14 and 21-25 weeks - during this time, 30-40 mg of the microelement is taken 2-3 times weekly. If persistent iron deficiency anemia is detected, the woman needs to take 100-200 mg of the drug daily. Provided that the pregnant woman suffered from anemia before conception, she should drink 200 mg of the drug while carrying a child. During lactation, use continues.

Features of taking medications with iron

In order for iron-containing drugs to effectively help fight the disease for anemia, you need to know the specifics of taking them. Doctors recommend adhering to the following rules:

1. You cannot prescribe medications yourself or change the dosage. Otherwise, it threatens complications and poisoning. During pregnancy, taking medications is accompanied by strict medical supervision.
2. Parenteral drugs are used during operations on organs digestive tract, removal of part of the stomach or intestines, with exacerbation of ulcers, pancreatitis, enteritis, nonspecific ulcerative colitis.
3. It is prohibited to combine iron supplements with calcium-based products, tetracycline antibiotics, antacids, and Levomycetin.
4. If during therapy the patient suffers from dyspepsia, he is prescribed enzyme preparations Festal, Pancreatin.
5. Sorbitol, ascorbic, lemon, succinic acid, copper, vitamins B6, B1, A, E, cobalt.
6. It is advisable to take iron supplements between meals.
7. If during treatment the patient develops negative symptoms, the medicine is replaced.
8. Anemia is treated by prescribing an initial minimum dose and gradually increasing it. The therapy process is long - first 2 months of therapeutic doses, then 2-3 months of preventive doses.
9. The approximate daily dosage for an adult is 180-200 mg daily. In about three weeks, iron deficiency anemia is corrected by half, and after two months it is cured.
10. If the patient has an intolerance to the drug, then replacing it with another iron preparation will not help with anemia - the element has a negative effect. In this case, the medicine is taken after meals or the dosage is reduced, increasing the course of treatment to six months.

Contraindications

• leukemia, blood oncology;
• aplastic, hemolytic anemia;
• chronic liver and kidney diseases;
• simultaneous use with antacids, tetracyclines, calcium preparations, food products, rich in calcium, caffeine, fiber.

Side effects

Tablets and other forms of iron supplements may cause side effects. More often they manifest themselves in the gastrointestinal tract when taking divalent salts. Adverse reactions include:

• nausea, vomiting, stomach pain;
• loss of appetite, stool disorders, flatulence, constipation;
• weakness, headaches, muscle pain, dizziness;

The daily human requirement for iron is:

• up to 6 months - 6 mg;
• 6 months - 10 years - 10 mg;
• over 10 years - 12-15 mg;
• pregnant women - 19 mg (sometimes - up to 50 mg);
• nursing - 16 mg (sometimes - up to 25 mg).

The bulk of the iron found in the human body is found in hemoglobin, each molecule of which contains 4 iron atoms. It is not surprising in this regard that the main indication for prescribing iron supplements is the prevention and treatment of iron deficiency anemia.

Iron is found in many foods of both plant and animal origin (meat, fish, legumes, cereals, bread, vegetables, fruits, berries). Of fundamental importance is the fact that iron in food sources can be in two forms:

• iron as part of the hemoglobin molecule - heme iron;
• iron in the form of inorganic salts.

The source of heme iron is meat and fish, but in berries, vegetables and fruits it is represented by inorganic salts. Why is this so important? First of all, because heme iron is absorbed (digested) 2-3 times more actively in comparison with inorganic iron. That is why ensuring proper iron intake is exclusively plant products quite difficult.

Currently in use Iron preparations are usually divided into two main groups:

• ferrous iron preparations - iron sulfate, gluconate, chloride, succinate, fumarate, lactate, etc.;
• ferric iron preparations - iron hydroxide in the form of a polymaltose or sucrose complex.

The vast majority of iron preparations are used for oral administration (drops, solutions, syrups, capsules, simple and chewable tablets are available), but there are also dosage forms, intended for parenteral administration - both intramuscularly and intravenously.

Parenteral administration of iron supplements is quite often accompanied by serious adverse reactions(in 0.2-3% of patients, parenteral administration of iron preparations is fraught with severe allergic reactions - even anaphylactic), therefore it is generally accepted that intravenous or intramuscular administration of iron is carried out only when there is absolutely nowhere to go, when oral administration is completely impossible or completely ineffective - intestinal absorption is impaired, surgery was performed to remove a significant part of the small intestine, etc.

Adverse reactions are not uncommon when taking iron supplements orally, but they are predictable and less dangerous. As a rule, there is nausea, pain in the upper abdomen, constipation, and diarrhea. At the same time, the severity of reactions in ferrous iron preparations is much higher. Hence the generally accepted recommendations - start taking ferrous iron supplements at a dose that is 2-4 times less than the average therapeutic dose, and gradually (over 1-2 weeks) increase it, taking into account individual tolerance.

Another the most important nuance- very significant and very negative influence food for the absorption of iron, which again takes place precisely when we're talking about about ferrous iron preparations. No wonder that All drugs in this group are recommended to be taken on an empty stomach - optimally an hour before meals.

There is no particular difference in the clinical effects of various iron salts. The main thing is to select the correct dose of the drug, since each specific salt contains a strictly defined amount of iron. So, for example, in iron sulfate the share of iron is about 20% of the mass, respectively, in gluconate it is 12% iron, and in fumarate it is 33%. But, let us emphasize this again, the given figures do not at all indicate that ferrous fumarate is three times better or three times more active than gluconate. Simply, if you take solutions of the same concentration, you will need 5 drops of fumarate, and 15 drops of gluconate.

The absorption of ferric iron preparations is practically unrelated to food intake, so they can be taken with meals. The tolerability of these drugs does not have such a pronounced relationship with the dose, so full doses are used from the very beginning of treatment.

Treatment of anemia, as a rule, is complex and in addition to iron supplements, patients receive other substances that affect the hematopoietic system and metabolism. It is not surprising in this regard that pharmaceutical market there is a significant amount combination drugs, which in addition to iron contain cyanocobalamin, folic acid, and some other vitamins and microelements.

Another remedy widely used in our country is hematogen.

Hematogen is made from specially processed blood of large cattle. The drug is more than 120 years old and the above-mentioned methods of “special processing” of blood have been changed and improved many times. There are currently several various options hematogens, which may or may not contain hemic iron, can be enriched with iron salts. Modern medicine does not consider hematogen as remedy, and as food additives, that is, its use for the prevention of iron deficiency anemia may well be justified (if, of course, there is iron in the hematogen), but treating anemia with hematogen is wrong, since there are drugs that are many times more effective.

In conclusion, let us formulate 10 basic rules for treating iron deficiency anemiairon supplements:

It is impossible to help a child only by correcting nutrition! The use of iron supplements is always necessary;

whenever possible, iron supplements should be taken orally, but the dose of ferrous iron should be increased gradually, starting with a fourth of the prescribed amount;

the average daily therapeutic dose of iron is 2-3 mg/kg (the average prophylactic dose is equal to half the therapeutic dose - 1-1.5 mg per day);

daily dose are divided into 3 doses, and more or less precise adherence to the intervals is very significant: the bone marrow responds most optimally to the constant supply of iron, so regular use of the medicine dramatically increases the effectiveness of treatment;

hemoglobin levels begin to increase, as a rule, after 3-4 weeks of treatment, although improvement in well-being may occur much earlier;

hemoglobin increases at an average rate of about 10-14 g/l per week. It is obvious in this regard that the duration of treatment is largely determined by the severity of anemia at the time of starting the use of iron supplements, but in most cases recovery normal indicators hemoglobin requires 1-2 months;

normalization of hemoglobin levels in the blood is not a reason to stop treatment: it is necessary to continue using iron supplements in prophylactic dose for another 1.5-3 months to create iron reserves in the child’s body;

parenteral administration of iron supplements, as a rule, is carried out not daily, but once every 2-3 days;

Divalent iron preparations should be taken on an empty stomach, that is, 1-2 hours before meals;

absorption of iron supplements is enhanced in the presence of ascorbic acid, but the risk of side effects also increases.

(This publication is a fragment of the book by E. O. Komarovsky adapted to the format of the article

The use of iron in injection ampoules is justified in cases of iron deficiency anemia. Drugs that are administered parenterally (using injections) begin to act faster and can help cope with anemia in especially severe cases. There are many pros and cons to injecting substances. All features of intramuscular and intravenous administration of iron preparations are described below.

When are injections prescribed?

Indications for parenteral drips or injections when iron is administered intravenously (intramuscularly) are situations where the patient must urgently receive a dose useful substance. The use of ampoules is prescribed when the patient due to injuries, systemic disorders or temporary illnesses cannot fully absorb iron through the gastrointestinal tract.

Indications for the use of injections of the drug only:

1. Ulcerative colitis in the stomach or intestines acute form. The use of iron for ulcers does not in itself harm the patient with an ulcer. However, often during oral iron therapy (with tablets taken by mouth), drugs are additionally prescribed to increase the acidity of the gastric environment. The higher the acidity, the better the substance is absorbed. Sharp drug enhancement acidic environment in the stomach can lead to exacerbation of ulcerative formations.
2. Systemic disorders of iron absorption. A person may be genetically predisposed to impaired absorption of iron from the gastrointestinal tract. Sometimes dysfunctions occur against the background of hormonal imbalance suffered intestinal virus etc. In any case, if the patient’s body does not absorb iron well from the intestines, there is no point in taking the drugs orally. It is necessary to administer the substance intravenously or intramuscularly so that the patient receives full dose element. Problems with absorption occur with pancreatitis, enteritis and similar disorders.
3. Partial removal of the stomach or small intestine. When the natural physiology of the gastrointestinal tract is disrupted, the absorption of certain elements, including iron, is significantly impaired. To increase the effectiveness of therapy, specialists in case of surgical removal tissue injections are prescribed.
4. Complete removal of the stomach. The indications are the same as described above.
5. Intolerance to iron salts. This allergy can be circumvented if the beneficial element is immediately administered intravenously or intramuscularly.
6. Ulcerative type colitis.

Most often, ampoules are used if the patient suffers from traumatic anemia (lost a lot of blood, as a result of which hemoglobin levels have sharply decreased). To quickly restore vital supplies and reduce risk fatal outcome, doctors use the parenteral method of administering the drug.

Important. The need for injections must be determined by a doctor.

For low degrees of malabsorption (impaired absorption of iron or other substances), oral tablets may still be prescribed rather than injections, simply supplementing the course of tablets with drugs to increase stomach acidity. In case ulcerative exacerbation, intolerance to components and colitis, be sure to switch to parenteral administration.

If you suffer from one of the listed disorders, you must inform your doctor in a timely manner. Then he will choose the right one for you parenteral drug. If you remain silent about the presence of gastrointestinal problems or allergic reactions, the consequences can vary from a decrease in the effectiveness of therapy to death in the case of anaphylactic shock.

Benefits of injections

Iron is better absorbed when given intramuscularly or intravenously. If, when absorbed through the stomach, part of the element is filtered by the liver, then with direct administration the natural filtration is much lower. This is the main advantage of ampoules with the substance, but there are other advantages:

1. Safety for allergy sufferers. If administered directly into the blood, iron does not enter into chemical reactions, iron salts are not formed. But it is iron salts that often cause rashes and other allergic manifestations.
2. Possibility of quickly replenishing microelements. If the patient replaces the tablets with an iron supplement, which is administered intravenously, the rate of receipt of the substances is accelerated tens of times. When taken orally, the substance must travel from oral cavity to the blood, passing through the esophagus. To achieve the maximum concentration of the drug you have to wait 2-3 hours. When using injections, the absorption rate is 15-20 minutes.
3. Use small dosages. It is enough to make one injection of 1-5 ml (depending on the drug) to give the patient a daily dose of the drug. If you use tablets, you have to drink several capsules with a dosage of 50 mg.
4. No side effects in the oral cavity. If you take drugs orally, then on the tongue and on inside teeth are often formed gray plaque. At parenteral use There are no such side effects, which allows you not to worry about your appearance.
5. Saving. Ampoules with an equal amount of the drug usually cost less than boxes of blister packs. The fact is that the packages themselves cost less, plus in the manufacture of tablets they use more excipients than when creating solutions for injections.

However, it cannot be said that the use of injections is the most convenient and optimal treatment option. This method of drug administration also has a number of disadvantages. They are presented below.

Disadvantages of parenteral administration

The injections are painful, leave marks on the arms and can be scary in children. That's not all negative aspects intravenous (intramuscular) administration. The disadvantages of this method include:

1. Inconvenience in using the drug. It cannot be introduced at work, at school, at university. We have to wait until the patient is home. It is very difficult to give an injection correctly in a public setting, and not everyone understands why the patient resorts to using injections.
2. The need to see a doctor or give injections yourself. Both options are bad. If you get injections from a doctor, you will have to spend time making an appointment, waiting, traveling to the nearest medical department. If the patient gives injections independently, main drawback– the need to first learn how to do it correctly. If a person is not trained in basic injection skills, he may not get into a vein or muscle at all, but may give injections that will be accompanied by severe pain and discomfort.
3. Painful sensations. At oral administration There are no inconveniences: you can only choke on the tablet if you don’t wash it down with water. But when the injection procedure is carried out, if the skin is broken, even with a thin needle, unpleasant sensations may occur. They become much stronger if the injection was performed incorrectly and a bruise occurs. The hematoma can remain at the injection site for several days, during which time it causes discomfort.
4. Psychological discomfort. Emotional people, children will negatively perceive the need to constantly inject. For them, one injection is already a test, and if a specialist prescribes a whole course of injections as part of therapy, this can cause complete rejection of the prescribed treatment.
5. Additional costs for syringes. Although disposable tools cost very little, the process of purchasing them, as well as the small additional costs, can be annoying for many.

The main disadvantage of injections is the problems when using syringes. Unprepared patients with no contraindications to oral administration are always prescribed tablets to make the therapy process easier.

How best to administer: intravenously or intramuscularly

Each method of drug administration has its own characteristics. They are taken into account when prescribing the solution.

Intramuscular drugs are most easily absorbed by the body. To saturate the body, 1 ml of solution is enough. But the injections can be too painful. The body absorbs the substance faster than with venous administration.

Intravenous use is less painful, but the effect is achieved 1.5-2 times slower. To carry out one injection, 2.5-3 times more solution is required than when injecting the drug into the muscles. This is a more gentle type of injection.

Duration of therapy and permissible dosages

Treatment is carried out until the content of the substance in the blood is restored. There are several stages of injections:

1. Primary. The patient uses the ampoules according to the dosage.
2. Secondary. The concentration of the substance in the blood has already been achieved; all that remains is to stabilize the reserves and prevent them from being absorbed. Usually the dosage is reduced by 2-3 times according to the doctor’s indications.

Important. One course lasts up to six months in the case of oral administration. However, since injections work better, the period of treatment with their help can be shortened.

Injections during pregnancy

In case of pregnancy, specialists rarely prescribe injection treatment. There are no contraindications to administering the drug orally. Injections can be prescribed only in the following cases:

• serious blood loss as a result of threatened miscarriage;
• severe toxicosis, accompanied by vomiting, due to which the body does not receive the full range of necessary substances.

Even if injections are prescribed, the period of their use does not last long: the patient remains in the hospital and receives injections for several days, after which she can switch to home use tablets or capsules.

Possible side effects

A small papule or bruise may occur at the injection site. They dissolve quickly, but cause pain when touched.

Other possible problems after injections:

1. A rapidly developing allergic reaction. May lead to anaphylactic shock.
2. DIC syndrome.
3. Exceeding the permissible concentration of iron in the body. Leads to dizziness, nausea and other health problems.
4. The appearance of abscesses in the area where the needle was inserted.

Important. Side effects are less likely to occur when professional conduct injections.

Possibility of allergic reactions

In the case of intravenous and intramuscular administration, there is a high risk of an allergic reaction. Some patients develop anaphylactic shock within a short time.

You can prevent an allergy attack only by first checking your body for a tendency to it. A specialist should determine the level of sensitivity of the body to iron supplements.

If an allergy is detected, you will have to abandon the specific medicine and find an analogue. Often an allergic reaction develops not to the iron itself, but to excipient, which is contained in the solution.

Contraindications to the use of injections

Injections are prohibited for certain body conditions. Stop using this method introduction will be necessary if:

• the body is too sensitive to influences, which is why bruises constantly appear on the surface of the skin after injections;
• the body is oversaturated with iron;
• non-disposable, non-sterilized syringes are used;
• there is a suspicion of an allergic reaction from the body.

It is strictly forbidden to exceed the dosage. If when taking tablets it is calculated as 2 mg of the drug per kg of weight, then when using a solution the calculations are different. The patient should not use more than one ampoule per day.

List of drugs for intravenous and intramuscular administration

List of medications containing iron:

1. "Ferrum Lek" is a drug for intramuscular administration. Ampoules contain 2 ml of solution. Dextran and iron hydroxide are the main and only components of the substance. If you are allergic to dextran, you will have to avoid the drug. Prescribed by weight, one ampoule contains iron content equivalent to 100 mg tablets (maximum dose).
2. "Venofer" is available in 5 ml ampoules. One ampoule is the equivalent of a tablet with a dosage of 100 mg. In addition to iron, the composition includes sucrose compound products. May be observed allergic reactions with sucrose intolerance.
3. "Ferkoven." The ampoule is minimal, with a volume of only 1 ml. The composition contains cobalt compounds and carbohydrate complexes. Easily administered intravenously.
4. "Jectofer." It is considered a combination type medicine because it contains citric acid. “Jectofer” is injected into the muscles, the solution is produced in 2 ml containers.
5. "Ferrlecite." Available with sodium and iron gluconate in the composition. It can be in the form of an ampoule of 1 ml for injection into the muscles or 5 ml (injected into a vein).

The drug must be prescribed by a specialist according to the prescription. The ampoule may not be sold without a prescription.