Currently, more than half of the people of our planet suffer to some extent from IDA (iron deficiency anemia – a decrease in hemoglobin due to a lack of iron in the body), the treatment of which requires the prescription of specialized drugs. Such drugs include drugs containing a special metal – iron.
There are several classifications of iron preparations.
You can classify them depending on the method of administration:
When ferrous iron enters the body, it is absorbed in the small intestine and binds to a special iron carrier, apoferretin, forming a complex that can pass the intestinal barrier. In the cells of the gastrointestinal tract, the oxidation of ferrous iron to trivalent occurs. After that, the iron binds to the conveyor, which delivers it to the tissue. In the tissues of the body, this metal is released, which then goes to the bone marrow to build a hemoglobin molecule.
Principles of prescribing iron
In what form and to whom are iron preparations prescribed?
The most commonly prescribed drugs for oral administration, as they have several advantages:
- Better absorption of iron through the intestinal wall.
- With iron injections, abscesses and infiltrates are very often formed.
- Intramuscular injections cause a greater number of complications, the most common allergic reactions, up to anaphylactic shock.
- When administered parenterally, there is a high probability of iron deposits in the internal organs.
The first and most important rule is the correctly selected dose of the drug so that allergic complications do not arise and a therapeutic effect is achieved.
The second rule – tablets with iron deficiency anemia in any case can not be chewed or crushed, they should be drunk whole, washed down with a small amount of water. In no case can not drink pills milk products.
The third rule – bivalent iron preparations should be taken together with vitamin C, and trivalent – with special amino acids to achieve the most complete therapeutic effect.
Selection of drugs for the treatment of iron deficiency anemia
Iron is best absorbed in capsules, since the latter protects the metal from the damaging effects of gastric juice and allows it to act at the point of application. Therefore, these drugs are in the first place. Next are the pills and solutions.
The most effective are the following drugs:
Foreign-made capsules containing two iron ions (divalent), cyanocobalamin, folic acid, and pyridoxine. It is a combined drug for the treatment of both iron and folic deficiency anemia.
Its vitamins and folic acid reduce the manifestation of neurological disorders, and divalent iron quickly saturates hemoglobin.
Allowed for use by pregnant women (reduces the development of perinatal neurological disorders) and children after 3 years.
The average cost of capsules is within 400 rubles.
It contains 355 mg of fumarate iron, which stimulates the creation of new red blood cells in the bone marrow and hemoglobin saturation with iron. The capsule protects the teeth from the damaging action of iron and the active ingredient from the destructive action of saliva and gastric juice.
The drug is recommended for use during pregnancy to prevent the development of iron deficiency anemia in the child and the treatment of IDA in the mother. Capsules are also indicated for the treatment of anemia in a woman during lactation, as it is proven that iron is not secreted into milk and does not affect the baby.
The average cost of the drug is about 150 rubles.
Multivitamin complex, which contains ferrous iron, vitamins (B12 and C), as well as trace elements. Available in capsule form. Ascorbic acid (vitamin C) promotes better absorption of iron from the intestines, cyanocobalamin and folic acid help accelerate the maturation of young red blood cells.
The average cost of capsules is 600 rubles.
Tablets containing ferrous iron (its salt – fumarate) and ascorbic acid for better absorption of the metal in the intestine. It is used both for medicinal purposes for the treatment of iron deficiency anemia, and for prophylactic treatment in pregnant women and in blood donors.
Children under 12 years old should not use the drug due to the lack of clinical trials.
The average price ranges from 400-500 rubles.
Available as an intramuscular injection, chewable tablets, and syrup. In contrast to the above preparations, it contains trivalent iron. The difference lies in the slower penetration through the intestinal wall and, therefore, the effect also develops more slowly.
The drug is contraindicated in children under 12 years. Side effects at its reception are minimum.
The average price is 150-200 rubles for syrup and 300-500 rubles for chewable tablets.
Also contains three iron ions in the form of iron-hydroxide polymaltose complex. Indications for use in this case are hidden iron deficiency (the so-called preanemia, when there are no clinical symptoms yet, but blood iron is reduced) and prevention of anemic conditions in people at risk. Available in the form of chewable tablets, drops and syrup.
Children from 3 to 12 years old are recommended to use drops, due to the fact that for use in children a minimum dose is necessary.
The average price is within 300 rubles.
The composition includes powdered hemoglobin, ascorbic acid and dietary fiber. The drug is indicated for the prevention and treatment of iron deficiency anemia of varying severity, with frequent colds, with chronic fatigue and with various surgical interventions. Available in the form of capsules and a chocolate bar, which is perfect even for the youngest children.
The average price of such a drug is 700 rubles.
The drug in the form of a solution for oral administration. Ferric iron is surrounded by a special carrier protein, which helps protect the gastric mucosa from the irritating effect of the drug. Iron is absorbed into the blood through active transport, which eliminates the possibility of an overdose of the drug.
The price ranges from 700 to 900 rubles, depending on the number of ampoules.
A preparation containing ferric iron, copper and manganese. The latter, once in the body, help stimulate the work of cellular enzymes. Available in the form of solutions for internal use.
Indicated for the treatment of iron deficiency anemia from 3 months of age, allowed for use in pregnant and lactating women.
The average cost is around 500 rubles.
Multivitamin preparation, which besides bivalent iron contains a whole complex of vitamins of group B and vitamin C. The drug is available in capsules, which ensures the gradual release of their granules as the previous ones are discontinued.
The tool is indicated for chronic diseases involving blood loss and is aimed at long-term use.
The price of such a complex ranges from 150-250 rubles.
Iron preparations for intramuscular injection
Iron for intramuscular administration is used in case of intolerance to oral preparations and severe iron deficiencies that require its immediate replacement. Other indications include gastrointestinal surgery, pancreatitis, and intestinal inflammation (enteritis and ulcerative colitis).
Before full administration of the drug, it is necessary to test for tolerability. To do this, intramuscularly injected half or one third (for children) of the dose, the patient is supervised, in the absence of side effects, the rest of the volume is administered within 15 minutes.
The most popular and effective drugs for intramuscular injections are the following drugs.
The preparation containing trivalent iron is produced in the form of 2 ml ampoules. After the injection, after 30 minutes, up to 50% of the drug is in the systemic circulation. The dose of the drug is calculated by a special formula, depending on the severity of anemia.
The average cost is about 1000 rubles for 5 ampoules.
The drug for injection, containing ferrous iron (sulfate) and serine (an amino acid that promotes faster flow of iron into the systemic circulation).
The price is about 500 rubles per pack.
The solution for injection contains ferric iron in the form of an iron-hydroxide polymaltose complex. The maximum concentration of iron is determined in the blood every other day. This drug is prescribed to those patients who do not tolerate oral medications (through the mouth) for diseases of the gastrointestinal tract.
The average cost of the drug is about 900 rubles.
Preparation for intramuscular injections, containing a complex compound of ferric iron. The metal is located in the core of the complex and is protected by sucrose from premature release. Contraindications are children’s age.
The price of the funds is about 2000 rubles.
The active substance contains an iron-sucrose complex, which includes trivalent iron.
The average price of the drug is 2000 rubles.
Rules for taking drugs for the treatment of iron deficiency anemia
To maximize the effect of treatment, you must adhere to the following rules for taking medication:
- tablets and capsules can not be chewed, they need to be swallowed whole, washed down with plenty of water;
- medicines should not be washed down with juice, tea and dairy products;
- during the course of treatment, it is recommended to exclude from the diet or not to use dairy products two hours before and two hours after;
- long-term treatment, at least 3 months. After 3 months, a blood test looks and, with a positive trend, the treatment should be continued on a maintenance dose of the drug for another 3 months. The total course of treatment is about six months;
- iron preparations are not compatible with antibiotics (tetracyclines and lincosamides), as well as with antacids, since they do not allow the gland to be absorbed into the systemic circulation;
- It is imperative to monitor the tolerability of the drug, and if this drug causes side effects, it should be replaced by another;
- to speed up the absorption of the drug, it is recommended to take it together with succinic or ascorbic acid;
- Possible enhancement of systemic effects of iron preparations while their use with ACE inhibitors (captopril – is used to reduce pressure).
Medication side effects
If used improperly, not complying with the recommended dosage or individual intolerance of the drug, a number of side effects may occur, such as irritation of the gastrointestinal tract. This is manifested in the form of pain in the epigastric region, nausea, vomiting, belching or heartburn, appetite distortion.
Possible manifestation of allergic reactions in the form of itching, urticaria, polymorphic rash.
With long-term use of iron preparations it is possible to stain the enamel of the teeth black and to stain the stool.
In case of intramuscular administration, pain in the joints and lowering of arterial pressure are possible. If the injection technique is not followed, abscesses and infiltrates are formed.
Thus, in order to cure iron deficiency anemia, it is necessary to choose the right drug that would fit in this case. If you follow the correct technique of using iron supplements, after a few months you will feel better, the symptoms of anemia will decrease or disappear, and no unpleasant adverse symptoms will arise.