Is Sorbifer Durules a diuretic or not? Sorbifer Durules instructions for use, contraindications, side effects, reviews

According to medical literature, ferric iron is absorbed better than divalent (note by site author).

Preparations containing Iron (Ferrum, abbreviated to Fe in the table):

Maltofer - official instructions for use. The drug is a prescription, the information is intended only for healthcare professionals!

Antianemic drug

pharmachologic effect

Iron supplement. Contains iron in the form of polymaltose iron(III) hydroxide complex. This macromolecular complex is stable and does not release iron in the form of free ions in the gastrointestinal tract. The structure of the active substance of the drug Maltofer® is similar to the natural iron compound ferritin. Due to this similarity, iron (III) moves from the intestine into the blood through active transport. Absorbed iron binds to ferritin and is deposited in the body, mainly in the liver. Then, in the bone marrow it is included in hemoglobin.

Iron, which is part of the polymaltose complex of iron (III) hydroxide, does not have pro-oxidant properties, unlike simple iron salts.

There is a correlation between the severity of iron deficiency and the level of its absorption (the greater the severity of iron deficiency, the better the absorption). The most active absorption process occurs in the duodenum and small intestine.

Pharmacokinetics

Data on the pharmacokinetics of the drug Maltofer® are not provided.

Indications for use of the drug MALTOFER®

• treatment of latent and clinically pronounced iron deficiency (iron deficiency anemia);
• prevention of iron deficiency during pregnancy, lactation, in women childbearing age, in children, adolescents, and adults (for example, vegetarians and the elderly).

Dosage regimen for tablets, drops and syrup for oral administration:

The drug is taken orally during or immediately after meals.

Drops and syrup can be mixed with fruit, vegetable juices or soft drinks. Chewable tablets can be chewed or swallowed whole.

The daily dose of the drug depends on the degree of iron deficiency (table):

* Due to the need to prescribe very small doses for these indications, it is recommended to use Maltofer® drops for oral administration.

** Due to the need to prescribe small doses for these indications, it is recommended to use the drug Maltofer® drops for oral administration or Maltofer® syrup.

The duration of treatment for clinically pronounced iron deficiency (iron deficiency anemia) is 3-5 months, until hemoglobin levels normalize. After this, the drug should be continued at a dose intended to treat latent iron deficiency for several more months, and for pregnant women, at least until childbirth to restore iron reserves.

The duration of treatment for latent iron deficiency is 1-2 months.

In the case of clinically pronounced iron deficiency, normalization of hemoglobin levels and replenishment of iron reserves occurs only 2-3 months after the start of treatment.

Dosage regimen for 5 ml bottles:

Maltofer oral solution in single-dose vials is intended for oral administration.

The daily dose can be taken all at once during or immediately after meals.

The drinking solution can be mixed with fruit and vegetable juices or soft drinks. The weak color of the drink does not change its taste and does not reduce the effectiveness of the drug.

The daily dose of the drug depends on the degree of iron deficiency.

Children over 12 years of age, adults and nursing mothers:

Treatment of clinically significant iron deficiency (iron deficiency anemia): 1 bottle 1-3 times a day for 3-5 months until blood hemoglobin levels normalize. After this, taking the drug should be continued for several more months in order to restore iron reserves in the body at a dosage of 1 bottle per day.

For the treatment of latent iron deficiency and for the prevention of iron deficiency: 1 bottle per day for 1-2 months.

Pregnant women:

Treatment of clinically significant iron deficiency (iron deficiency anemia): 1 bottle 2-3 times a day for 3-5 months until blood hemoglobin levels normalize. After this, the drug should be continued at a dosage of 1 bottle per day, at least until delivery to restore iron reserves.

For the treatment of latent deficiency: 1 bottle per day for 1-2 months.

In the case of clinically pronounced iron deficiency, normalization of hemoglobin levels occurs only 2-3 months after the start of treatment.

Dosage regimen for the injection form of the drug:

The drug is administered intramuscularly.

Before the first administration of a therapeutic dose, it is necessary to conduct an intramuscular test: adults are administered from 1/4 to 1/2 of the dose of the drug (from 25 to 50 mg of iron), children - half the daily dose. With absence adverse reactions within 15 minutes after administration, the remainder of the initial dose of the drug can be administered.

During the injection, it is necessary to ensure the availability of means to provide emergency care with the development of anaphylactic shock.

The dose of the drug is calculated individually and adapted in accordance with the general iron deficiency using the following formula:

Total iron deficiency (mg) = body weight (kg) × ( normal level Hb - patient's Hb level) (g/l) × 0.24* + iron reserves (mg)

With body weight less than 35 kg: normal Hb = 130 g/l, which corresponds to deposited iron = 15 mg/kg body weight

With a body weight of more than 35 kg: normal Hb level = 150 g/l, which corresponds to deposited iron = 500 mg

* Factor 0.24 = 0.0034×0.07×1000 (iron content in hemoglobin = 0.34% / blood volume = 7% of body weight / factor 1000 = conversion from g to mg)

Total number of ampoules to be administered = total iron deficiency (mg)/100 mg.

Table for calculating the total (total per course of treatment) number of ampoules for administration:

If the required dose exceeds the maximum daily dose, then the administration of the drug should be fractional.

Adults are prescribed 1 ampoule daily (2.0 ml = 100 mg of iron).

For children, the dose is determined depending on body weight.

Maximum permissible daily doses:

Children weighing up to 6 kg - 1/4 ampoule (0.5 ml = 25 mg iron)

Children weighing from 5 to 10 kg - 1/2 ampoule (1.0 ml = 50 mg iron)

Adults - 2 ampoules (4.0 ml = 200 mg iron)

If there is no therapeutic response from hematologic parameters after 1–2 weeks (eg, an increase in Hb levels of approximately 0.1 g/dL per day), then the initial diagnosis should be reconsidered. The total dose of the drug per course of treatment should not exceed the calculated number of ampoules.

Injection technique

Injection technique is critical. As a result of improper administration of the drug, there may be painful sensations and coloring of the skin at the injection site. The ventrogluteal injection technique described below is recommended instead of the generally accepted one (in the upper outer quadrant of the gluteus maximus muscle).

The length of the needle should be at least 5-6 cm. The lumen of the needle should not be wide. For children, as well as for adults with low body weight, the needles should be shorter and thinner.

Instruments are disinfected using the usual method.

Before inserting the needle, you should move the skin about 2 cm in order to properly close the puncture channel after removing the needle. This prevents the injected solution from penetrating the subcutaneous tissue and staining the skin.

Place the needle vertically in relation to the surface of the skin, at a greater angle to the point of the iliac joint than to the point of the femoral joint.

After the injection, slowly remove the needle and press the area of ​​skin adjacent to the injection site with your finger for about 5 minutes.

After the injection, the patient needs to move.

Side effect

From the outside digestive system: very rare (≥ 0.001%< 0.01%) - симптомы раздражения ЖКТ, такие как ощущение переполнения, давления в эпигастральной области, тошнота, запор или диарея; возможно темное окрашивание стула, обусловленное выделением невсосавшегося железа (клинического значения не имеет).

Contraindications to the use of oral forms of the drug MALTOFER®

• excess iron (for example, hemosiderosis and hemochromatosis);
• impaired iron utilization (for example, lead anemia, sideroachrestic anemia);
• non-iron deficiency anemias (for example, hemolytic anemia or megaloblastic anemia caused by vitamin B12 deficiency).

Contraindications to the use of the injection form of the drug MALTOFER®

• anemia not associated with iron deficiency (for example, hemolytic anemia, megaloblastic anemia caused by vitamin B12 deficiency, disorders of erythropoiesis, bone marrow hypoplasia);
• excess iron (i.e. hemochromatosis, hemosiderosis);
• impaired iron utilization (for example, sideroachrestic anemia, thalassemia, lead anemia, cutaneous porphyria tarda);
• Osler-Rendu-Weber syndrome;
• chronic polyarthritis;
• bronchial asthma;
• infectious kidney diseases in the acute stage;
• uncontrolled hyperparathyroidism;
• decompensated cirrhosis of the liver;
• infectious hepatitis;
• I trimester of pregnancy;
• intravenous administration;

Use of the drug MALTOFER® during pregnancy and breastfeeding

In controlled studies in pregnant women after the first trimester of pregnancy, no undesirable effects of the drug on the mother and fetus were noted. There is no data on the undesirable effect of the drug on the fetus in the first trimester of pregnancy.

special instructions

When prescribing the drug to patients diabetes mellitus It should be taken into account that 1 ml of drops for oral administration contains 0.01 XE, 1 ml of syrup - 0.04 XE, 1 chewable tablet - 0.04 XE.

Maltofer® does not stain tooth enamel.

Overdose

To date, neither intoxication nor signs of iron overload have been reported in cases of drug overdose.

Drug interactions

No interactions with other drugs have been identified.

Conditions for dispensing from pharmacies

Storage conditions and periods

List B. The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C. The shelf life of oral drops and chewable tablets is 5 years; syrup - 3 years.

Sorbifer Durules - official instructions for use. The drug is a prescription, the information is intended only for healthcare professionals!

Clinical and pharmacological group:

Antianemic drug

pharmachologic effect

Antianemic drug. Iron is an essential component of the body, necessary for the formation of hemoglobin and the occurrence of oxidative processes in living tissues.

Durules technology provides a gradual release of the active ingredient (iron ions) over a long period of time. The plastic matrix of Sorbifer Durules tablets is completely inert in the digestive juice, but completely disintegrates under the action of intestinal peristalsis, when the active ingredient is completely released.

Ascorbic acid helps improve iron absorption.

Pharmacokinetics

Suction

Durules is a technology that ensures a gradual release of the active substance (iron ions), a uniform supply medicinal product. Taking 100 mg 2 times a day provides 30% greater absorption of iron from Sorbifer Durules compared to conventional iron preparations.

Absorption and bioavailability of iron are high. Iron is absorbed primarily in duodenum and proximal jejunum.

Distribution

Plasma protein binding - 90% or more. Deposited in the form of ferritin or hemosiderin in hepatocytes and cells of the phagocytic macrophage system, a small amount - in the form of myoglobin in muscles.

Removal

T1/2 is 6 hours.

Indications for use of the drug SORBIFER DURULES

• Iron-deficiency anemia;
• iron deficiency;
• prevention of iron deficiency anemia during pregnancy, lactation, and in blood donors.

Dosage regimen

I take the drug orally. Film-coated tablets should not be split or chewed. The tablet should be swallowed whole and washed down with at least half a glass of liquid.

Adults and adolescents are prescribed 1 tablet 1-2 times a day. If necessary, for patients iron deficiency anemia, the dose can be increased to 3-4 tablets per day in 2 doses (morning and evening) for 3-4 months (until the iron depot in the body is replenished).

During pregnancy and lactation, for the purpose of prevention, 1 tablet per day is prescribed; For treatment, 1 tablet is prescribed 2 times a day (morning and evening).

Treatment should be continued until the optimal hemoglobin level is achieved. To further replenish the depot, you may need to continue taking the drug for another 2 months.

Side effect

From the digestive system: nausea, vomiting, abdominal pain, diarrhea, constipation (data frequency side effects may increase with increasing dose from 100 mg to 400 mg); rarely (<1/100) - язвенное поражение пищевода, стеноз пищевода.

Allergic reactions: rare (<1/100) - зуд, сыпь.

From the side of the central nervous system: rarely (<1/100) - головная боль, головокружение.

Other: rarely (<1/100) - гипертермия кожи, слабость.

Contraindications to the use of the drug SORBIFER DURULES

• esophageal stenosis and/or other obstructive changes in the digestive tract;
• increased iron content in the body (hemosiderosis, hemochromatosis);
• impaired iron utilization (lead anemia, sideroblastic anemia, hemolytic anemia);
• children under 12 years of age (due to lack of clinical data);
• hypersensitivity to the components of the drug.

The drug should be used with caution in case of gastric and duodenal ulcers, inflammatory bowel diseases (enteritis, diverticulitis, ulcerative colitis, Crohn's disease).

Use of the drug SORBIFER DURULES during pregnancy and breastfeeding

It is possible to use the drug Sorbifer Durules during pregnancy and lactation according to indications.

special instructions

When using the drug, darkening of the stool is possible, which has no clinical significance.

Overdose

Symptoms: abdominal pain, vomiting and diarrhea mixed with blood, fatigue or weakness, hyperthermia, paresthesia, pale skin, cold clammy sweat, acidosis, weak pulse, decreased blood pressure, palpitations. In case of severe overdose, signs of peripheral circulatory collapse, coagulopathy, hyperthermia, hypoglycemia, liver damage, renal failure, muscle cramps and coma may appear after 6-12 hours.

Treatment: in case of overdose, consult a doctor immediately. It is necessary to rinse the stomach, inside a raw egg, milk (to bind iron ions in the gastrointestinal tract); deferoxamine is administered. Symptomatic therapy.

Drug interactions

Sorbifer Durules may reduce the absorption of concomitantly administered enoxacin, clodronate, grepafloxacin, levodopa, levofloxacin, methyldopa, penicillamine, tetracyclines and thyroid hormones.

The simultaneous use of Sorbifer Durules and antacid preparations containing aluminum hydroxide and magnesium carbonate may reduce the absorption of iron. The maximum possible time interval should be maintained between taking Sorbifer Durules and any of these drugs. The recommended minimum time interval between doses is 2 hours, except when taking tetracyclines, when the minimum interval should be 3 hours.

Sorbifer Durules should not be combined with the following drugs: ciprofloxacin, doxycycline, norfloxacin and ofloxacin.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature of 15° to 25°C. Shelf life - 3 years.

Instructions for medical use

medicine

Sorbifer ® Durules ®

Tradename

Sorbifer ® Durules ®

International nonproprietary name

Dosage form

Film-coated tablets

Compound

One tablet contains

active substances: iron (II) sulfate dry 320 mg (equivalent to 100 mg iron (II)), ascorbic acid 60 mg,

Excipients: povidone (K-25), polyethene powder, carbomer 934 R, magnesium stearate,

shell composition: hypromellose, macrogol 6000, titanium dioxide E 171, iron (III) yellow oxide E 172, solid paraffin.

Description

Tablets are lenticular-shaped, slightly biconvex, ocher-coated, yellow in color, engraved “Z” on one side, with a characteristic odor.

Pharmacotherapeutic group

Hematopoiesis stimulants. Iron supplement. Fe++ preparations for oral administration.

ATX code B03A A

Pharmacological properties

Pharmacokinetics

“Durules” is a special production technology that ensures a gradual release of the active substance (iron ions) and a uniform supply of the drug. Iron is absorbed primarily in the duodenum and proximal jejunum. Taking 100 mg twice a day provides 30% greater absorption of iron from Sorbifer Durules compared to conventional iron supplements. Absorption and bioavailability of iron are high. Connection with plasma proteins - 90% or more. Deposited in the form of ferritin and hemosiderin in hepatocytes and cells of the phagocytic macrophage system, a small amount - in the form of myoglobin in muscles. The half-life is 6 hours.

The presence of ascorbic acid in the preparation creates more favorable conditions for the absorption of iron in the intestines. At the molecular level, ascorbic acid mobilizes iron from the crystalline core of ferritin in vitro, reducing Fe 3+ to Fe 2+ . At the intracellular level, ascorbic acid enhances iron-induced ferritin translation by promoting the conversion of iron regulatory protein (IRP) from its RNA-bound form to aconitase.

Pharmacodynamics

Iron is an essential component of the body, necessary for the formation of hemoglobin and the implementation of oxidative processes in living tissues. The active substance is contained in a biologically indifferent plastic matrix with a spongy structure. When passing through the gastrointestinal tract from the porous matrix of the tablets (within 6 hours), a continuous release of ferrous ions occurs. The film coating of the tablet and the porous matrix provide long-term release of iron ions. The film coating of the tablet, which completely disintegrates under the action of intestinal peristalsis and releases the active ingredient, helps prevent the tablet from dissolving in the stomach. The slow release of iron ions does not lead to the creation of a high local concentration, which avoids irritation of the mucous membrane of the gastrointestinal tract.

Ascorbic acid slows down the breakdown of ferritin by blocking autophagy of ferritin by ferritin lysosomes and transformation into hemosiderin.

Ascorbic acid accelerates the absorption of iron in the gastrointestinal tract, reducing unbound heme iron (III) to iron (II) in the stomach.

Indications for use

Iron-deficiency anemia

Latent iron deficiency in the body (without anemia), associated with excessive iron losses (bleeding, including uterine bleeding, constant donation), poor nutrition

Conditions accompanied by an increased need for iron in the body (prevention during pregnancy, lactation and in blood donors)

Directions for use and doses

The tablet should be taken whole, without chewing, and at least half an hour before meals, with half a glass of water.

Adults and teenagers over 12 years old:

For patients with grade II-III iron deficiency anemia, if necessary, on the recommendation of a doctor, the dose can be increased to 3-4 tablets 2 times a day (morning and evening) with a duration of use of 3-6 months.

During pregnancy:

The drug is used in cases of established iron deficiency (iron deficiency anemia and latent iron deficiency in the body)

Prophylactic dose: 1 tablet per day.

Therapeutic dose: 1 tablet 2 times a day (morning and evening).

Treatment should be carried out until hemoglobin levels normalize and continue until the iron depot is completely saturated for another 2 months. Individual long-term therapy (with or without interruptions) is indicated for regularly occurring significant iron loss (for example, with heavy menstruation).

Side effects

The frequency of side effects from the digestive system increases with increasing doses from 100 to 400 mg per day.

Often (>1/100)

Nausea, abdominal pain, diarrhea, constipation

Rarely (<1/100)

- ulcerative lesions of the esophagus, stenosis of the esophagus

Allergic reactions (itching, rash, hyperemia)

Hyperthermia

Contraindications

Hypersensitivity to the active or any other inactive component of the drug

Esophageal stenosis and/or other obstructive changes in the digestive tract

Increased iron content in the body (hemosiderosis, hemochromatosis)

Repeated blood transfusions

Impaired iron utilization (lead anemia, sideroblastic anemia, hemolytic anemia)

Children under 12 years of age (due to lack of clinical data)

Drug interactions

- ciprofloxacin: Concomitant use reduces the absorption of ciprofloxacin by approximately 50%, so there is a risk that the content of ciprofloxacin in the blood plasma will be lower than necessary for a therapeutic effect.

- levofloxacin: simultaneous use reduces the absorption of levofloxacin.

-moxifloxacin: Concomitant use reduces the bioavailability of moxifloxacin by almost 40%, therefore, if simultaneous use is required, it is necessary to ensure the longest possible period between taking moxifloxacin and Sorbifer Durules.

- norfloxacin: Concomitant use reduces the absorption of norfloxacin by approximately 75%.

- ofloxacin: Concomitant use reduces the absorption of ofloxacin by approximately 30%.

When using Sorbifer Durules concomitantly with the following drugs, dosage adjustment of these drugs may be required. The recommended minimum time interval between taking Sorbifer Durules and these drugs should be at least 2 hours:

- calcium or dietary supplements containing magnesium carbonate, as well as aluminum or calcium hydroxide, antacids containing magnesium carbonate, together with iron salts they form a complex that reduces the absorption of each other.

- captopril: Concomitant use reduces the area under the plasma concentration-time curve for captopril by approximately 37%, presumably due to chemical reactions in the gastrointestinal tract.

- zinc: simultaneous use reduces the absorption of zinc salts.

- clodronate: Concomitant use may reduce the absorption of clodronate.

- deferoxamine: with simultaneous use, the absorption of deferoxamine and iron is reduced due to the formation of a compound.

- levodopa: When used concomitantly, ferrous sulfate reduces the bioavailability of single doses of levodopa by approximately 50% and of single doses of carbidopa by 75%, possibly due to the formation of a chelate.

- methyldopa: When used concomitantly, the bioavailability of methyldopa is reduced, possibly due to the formation of a chelate.

- penicillamine: Concomitant use of penicillamine and iron salts reduces their absorption, possibly due to the formation of a chelate.

- risedronate: carried out in vitro Studies have shown that preparations containing iron form compounds with risedronate. Although no drug interaction studies have been conducted in vivo, it can be assumed that the simultaneous use of these drugs reduces the absorption of risedronate.

- tetracyclines: with simultaneous use, the absorption of tetracyclines and iron is reduced. If simultaneous use is necessary, the recommended minimum time interval between taking Sorbifer Durules and these drugs should be at least 3 hours. When taken orally, iron inhibits the enterohepatic circulation of oxytetracyxine (doxycycline), as well as when administered intravenously.

- thyroid hormones: with the simultaneous use of iron and thyroxine preparations, a decrease in the absorption of thyroxine is possible, which reduces the effectiveness of replacement therapy.

-cimetidine: with simultaneous use, a decrease in gastric acid production caused by cimetidine reduces iron absorption. Therefore, the intervals between taking these drugs should be at least 2 hours.

-chloramphenicol: When taken simultaneously, the clinical effect of iron treatment may be delayed.

When taking the drug simultaneously with tea, coffee, eggs, dairy products, wheat bread, porridge or foods rich in plant fiber, iron absorption may be reduced.

special instructions

Iron supplements can cause poisoning in children. When using the drug, darkening of the stool appears, which has no clinical significance.

The drug is used with caution for gastric and duodenal ulcers, inflammatory bowel diseases (enteritis, diverticulitis, ulcerative colitis, Crohn's disease), chronic liver and kidney diseases.

Comprehensive laboratory and instrumental monitoring of the effectiveness of treatment is recommended to be carried out every 7-14 days, depending on the course of anemia.

Pregnancy and lactation

The drug can be used during pregnancy and lactation.

Features of the effect of the drug on the ability operate a vehicle or potentially dangerous machinery.

Does not affect.

Overdose

Symptoms: abdominal pain, vomiting and diarrhea (sometimes with blood), fatigue, weakness, hyperthermia, paresthesia, pale skin, cold clammy sweat, acidosis, weak pulse, decreased blood pressure, palpitations. Signs of peripheral circulatory collapse, coagulopathy, hyperthermia, hypoglycemia, liver damage, renal failure, muscle cramps and coma may appear after 6-12 hours.

Treatment: gastric lavage, milk and raw eggs orally, drugs that provoke vomiting, symptomatic therapy.

If necessary, perform a gastric lavage with a solution of deferoxamine at a concentration of 2 g/l, then 5 g of deferoxamine is dissolved in 50-100 ml of water and this solution is left in the stomach.

In case of severe intoxication: in a state of shock and/or coma and in case of increased serum iron levels (> 90 mmol/l in children, > 142 mmol/l in adults), intensive care should be started immediately and deferoxamine should be administered (15 mg/l). kg/h intravenously slowly, maximum 80 mg/kg/24 hours). Too high an infusion rate may result in hypotension.

In less severe cases of intoxication, deferoxamine can be administered intramuscularly (50 mg/kg, total dose not more than 4 g).

Release form and packaging

30 and 50 tablets are placed in brown glass bottles, sealed with a polyethylene cap and equipped with an accordion shock absorber for glass bottles. The bottle, together with instructions for medical use in the state and Russian languages, is placed in a lithographed cardboard box.

Storage conditions

Store at a temperature not exceeding 25 °C.

Keep out of the reach of children!

Shelf life

Do not use after expiration date.

Conditions for dispensing from pharmacies

Over the counter

Manufacturer

JSC "EGIS PHARMACEUTICAL PLANT"

1106 BUDAPEST, st. Keresturi, 30-38 HUNGARY

Latin name: Sorbifer Durules
ATX code: B03AA07
Active substance:
Ferrous sulfate and ascorbic acid
Manufacturer: JSC "EGIS", Hungary
Conditions for dispensing from a pharmacy: On prescription

"Sorbifer Durules" is used in the treatment of iron deficiency anemia. Iron promotes the production of hemoglobin, which provides cells with oxygen. And the ascorbic acid contained in the composition helps the absorption of iron in the intestines.

Indications for use

"Sorbifer Durules" is used in the presence of iron deficiency anemia, when the amount of iron obtained from foods is too small, or there is a need to regularly replenish it during prolonged bleeding. And also as a preventive measure during pregnancy and lactation, with heavy menstruation and blood donors. The drug is also prescribed if there is a need for increased amounts of iron - for children and the elderly.

Composition of the drug

One tablet contains: 320 mg ferrous sulfate (including 100 mg iron) and 60 mg ascorbic acid. It also contains: hypromellose, titanium dioxide, magnesium stearate, carbomer 934P, yellow iron oxide, paraffin, polyethylene powder, macrolog 6000 and povidone.

Medicinal properties

The plastic shell with which the tablets are coated is resistant to gastric juice, but is destroyed in the intestines, thereby providing a slow release of iron ions over a period of six hours. This prevents excessive concentration of iron in the intestines and the occurrence of irritating effects of active substances on its mucosa.

Thus, Sorbifer Durules is absorbed 30% better when compared with other iron-containing medications. More than 90% of the active substance binds to blood proteins. Partial elimination from the body occurs in approximately six hours.

Release forms

Price from 360 to 480 rub.

“Sorbifer Durules” is marketed in the form of convex yellowish tablets with the letter Z printed on one side. A grayish core is hidden under the shell. Tablets are packed in 30 pcs. or 50 pcs. in dark glass jars, closed with a plastic lid with a shock-absorbing accordion-shaped protrusion. The jar is included in a box along with instructions.

Mode of application

According to the manufacturer's instructions, Sorbifer Durules tablets should be swallowed, but not chewed or split in half, so as not to destroy the shell. It is better to drink them with half a glass of water. Milk, coffee, tea, eggs, juice, bread, vegetables and herbs impair the absorption of iron, so it is better not to take the medicine after meals.

In the presence of iron deficiency anemia, the daily dose for children over twelve years of age and adults is one tablet. twice a day. If side effects occur, you need to reduce the dosage to one tablet. in a day.

With reduced iron levels during pregnancy from one to six months and for preventive purposes, one tablet is used. in a day.

In the last three months of pregnancy and during breastfeeding, take one tablet. twice a day.

How many days to continue treatment depends on the decision of the doctor, who takes into account data from regularly prescribed studies on hemoglobin levels. Sufficiently high iron deficiency requires taking the drug for approximately three to six months. And after the indicators return to normal, you need to take the drug for at least two more months to form the necessary reserves of the element.

During pregnancy and breastfeeding

The use of Sorbifer Durules during pregnancy and lactation is permitted with regular measurement of the amount of active substance in the blood.

Contraindications

• Intolerance to any of its components
• Esophageal stenosis and other gastrointestinal pathologies
• Thrombophlebitis and thrombosis
• Iron levels above normal (with hemochromatosis or hemosiderosis)
• Diabetes mellitus
• Kidney stones and other serious disorders in their work
• Poor absorption of iron (with other types of anemia: sideroblastic, hemolytic and lead).

Sorbifer Durules should be used under strict control of hemoglobin levels and only as prescribed by a doctor for the following diseases:

• Gastric and duodenal ulcers
• Ulcerative colitis
• Enterite
• Crohn's disease
• Diverculitis.

Precautionary measures

Since Sorbifer Durules is effective only for the treatment of iron deficiency anemia, it is not advisable to take it if there is a lack of iron caused by impaired absorption. Prescribing the drug must be preceded by blood tests to check iron levels. You should also not take Sorbifer Durules together with other iron-containing medications.

Cross-drug interactions

Using the drug together with tetracyclines and D-penicillamine will reduce the absorption of the active element. The same effect will result from combining the drug “Sorbifer Durules” with antacids that contain magnesium, calcium and aluminum salts. Therefore, it would be best to take these drugs at least two hours apart. And simultaneous use of medication with ascorbic acid can, on the contrary, lead to exceeding normal levels.

Side effects

After taking the medicine, the functioning of the gastrointestinal tract may be disrupted, which is manifested by nausea, abdominal pain, diarrhea, and constipation.

Overdose

The consequences of exceeding prescribed doses are similar to the manifestations of side effects: nausea, vomiting, abdominal pain, bloody diarrhea, feeling tired, low pulse, cold sweat, pale skin, tachycardia.

Conditions and shelf life

As indicated in the instructions, the temperature at the place where the drug is stored should not exceed 25°C. Do not use after three years from the date of manufacture.

Analogs

"Ferrum Lek"

Lek, Slovenia
Price: 141–1100 rub.

The main active ingredient of Ferrum Leka is iron hydroxide polymaltosate. Ferrum Lek is sold in the form of chewable tablets, syrup and solution for intramuscular injection.

Pros:

• Ferrum Lek syrup can be drunk with fruit and vegetable juices. The syrup can also be mixed with baby food, which makes taking the medicine more enjoyable for children.
• Intramuscular injections ensure rapid entry of the Ferrum Lek drug into the blood. This is especially true in case of heavy blood loss.

Minuses:

• It is not recommended to use Ferrum Lek injection solution in the first twelve weeks of pregnancy. In subsequent stages of pregnancy and during breastfeeding - only if absolutely necessary
• Taking Ferrum Leka can lead to side effects: abdominal pain, nausea, diarrhea.

Vifor Inc, Switzerland
Price: RUR 252–932

The active component of the drug "Maltofer" is iron hydroxide polymaltosate. "Maltofer" is available in the form of chewable tablets with a heterogeneous white-brown structure, 10 tablets each. in blister, drops for oral administration and syrup.

Pros:

• "Maltofer" is used to normalize the level, even if anemia is not recorded
• You can take Maltofer during the entire period of pregnancy and lactation
• "Maltofer" can be drunk directly during meals or immediately after finishing them.

Minuses:

• After taking the tablets, side effects of the drug "Maltofer" may occur in the form of headache, nausea, diarrhea
• Chewable Maltofer tablets are not recommended for children under twelve years of age.
• Patients suffering from diabetes can take Maltofer under close supervision.

Ranbaxy Laboratories Ltd., India
Price: RUR 87–185

The active components of the drug "Fenuls" are divalent iron and multivitamins. "Fenuls" is available in the form of capsules of ten tablets. in a blister.

Pros:

• "Fenuls" replenishes the body's daily need for vitamin B1, which improves the contractile functions of the myocardium
• Vitamin B2 contained in Fenuls improves blood supply to the cells of the cornea and retina, activates the activity of the gastrointestinal tract
• "Fenuls" is allowed during pregnancy and lactation in compliance with the indicated dosages.

Minuses:

• The manifestation of side effects of Fenuls is expressed in the form of dizziness, dyspepsia and allergic reactions
• Fenuls is contraindicated for hemochromatosis and hemosiderosis.

Sorbifer is a modern antianemic drug that is used for iron deficiency conditions of varying severity. The medicine is sold in pharmacies with a prescription.

Composition and release form

Sorbifer is available in the form of yellow tablets that have a hard shell. The shape of the tablets is convex on both sides. On one side there is an engraving in the form of the letter Z. When cut, the tablet has a gray color and a distinct odor.

The drug is packaged in bottles or cardboard packs of 30 or 50 tablets in each package.

Composition of Sorbifer:

• Ferrous sulfate (320 mg).
• Ascorbic acid (60 mg).

There are also additional components: magnesium stearate, polyethylene powder, povidone K-25, carbomer 934R.

The tablet shell has its own composition: yellow iron oxide, hypromellose, solid paraffin, macrogol 6000, solid paraffin, titanium dioxide.

Indications for use

Sorbifer is prescribed for iron deficiency and associated anemia. It is also used for prevention during pregnancy, breastfeeding or blood donation.

Instructions for use and dosage of Sorbifer

Take the tablets orally without chewing. You can drink plenty of water (at least half a glass). The dosage for adults is 1 tablet once or twice a day. If iron deficiency anemia develops rapidly and is in the acute phase, the dose of Sorbifer can be increased to 3-4 tablets. You should drink them in the morning and evening (2 doses in total). The course of treatment is several months (on average, 3-4 months) until sufficient accumulation of iron in the body.

During pregnancy and lactation, Sorbifer is taken to prevent iron deficiency. The preventive dosage is one tablet per day. If it is necessary to treat this group of patients with the drug, the dose is 2 tablets per day.

During therapy, hemoglobin levels should be constantly monitored, and if satisfactory levels are achieved, the dosage of the drug may be reduced or discontinued.

The average duration of treatment and prevention with Sorbifer for pregnant and lactating women is 2 months.

Contraindications

According to the instructions for use, Sorbifer should not be taken if you have the following diseases:

• Hemosiderosis, hemozromatosis and other conditions indicating increased iron content in the body.
• Obstruction or stenosis of the esophagus, other gastrointestinal pathologies.
• Dysfunction of iron utilization (with lead, hemolytic or sideroblastic anemia).
• Sensitivity to the components of the drug.

Special instructions for use and warnings

Take Sorbifer with extreme caution for enteritis, ulcerative colitis, Crohn's disease and other diseases of the duodenum and intestinal inflammation.

With prolonged therapy with the drug, darkening of the stool is possible. This is not a clinical disorder and therefore does not require corrective action.

How does Sorbifer work?

The drug was created using innovative Durules technology, which allows for the gradual release of iron, as the main active component of the drug.

Using a plastic matrix in tablets, which is completely inert in the stomach and quickly disintegrates in the intestines, the active substance is released gradually and completely, and ascorbic acid promotes better absorption of iron.

Side effects of Sorbifer

The most pronounced side effects can be observed from the gastrointestinal tract and esophagus: nausea, constipation, or vice versa - diarrhea, abdominal pain, ulcer or stenosis of the esophagus. The intensity of the side effect increases with increasing daily dosage of the drug.

Local allergic reactions – itching, rash – can rarely be noticed.

From the nervous system, sometimes headaches appear. General weakness and hyperthermia of the skin may also be noted.

Interaction of Sorbifer with other drugs

The drug reduces the rate of absorption of enoxacin, levodopa, methyldopa, grepafloxacin, penicillamine, levofloxacin, clodronate, and thyroid hormones when taken simultaneously.

Also, it should not be combined with antacid medications that contain magnesium carbonate or aluminum hydroxide, since Sorbifer reduces the absorption of iron. It is necessary to maintain a minimum 2-hour interval between taking these drugs, and with antibiotics (ciprofloxacin, tetracycline, norfloxacin, ofloxacin, doxycycline, etc.) the interval should be at least 3 hours.

Interaction with alcohol

During therapy with Sorbifer, you should refrain from drinking alcohol, since the latter enhances the effect of the active components on the human body.

Overdose

The following symptoms may indicate an overdose of Sorbifer:

• Sudden vomiting.
• Abdominal pain.
• Paresthesia.
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• Reduced pressure.
• Pale skin.
• Diarrhea with blood.
• Active heartbeat.
• Hypoglycemia.
• Muscle cramps.
• Kidney failure.
• Hyperthermia.
• Hypoglycemia.
• Coma.

Treatment of these conditions is symptomatic. Gastric lavage, milk and raw eggs are recommended to bind iron ions. In some cases, deferoxamine is administered.

Use of Sorbifer during pregnancy and lactation

If there are appropriate indications, treatment of pregnant and lactating women with this drug is acceptable and justified.

Sorbifer for newborns and children

The drug is not prescribed to children under 12 years of age.

Storage conditions and shelf life

Sorbifer tablets are stored for 3 years from the date of release in a place inaccessible to children. The optimal temperature is 15-25 degrees.

Some facts about the product:

Instructions for use

Price in online pharmacy website: from 376

Description

Sorbifer Durules is a pharmaceutical product belonging to the group of drugs containing iron. The main purpose of the drug is the treatment of anemia caused by a deficiency or disorder of iron absorption in the body.

Available form, composition

Available in the form of coated tablets, convex on both sides, light yellow in color. One side part is marked with the letter “Z”; inside there is a grayish tablet with a specific odor.

Compound

Active ingredients: iron sulfate 320 mg (equivalent to the amount of divalent iron - 100 mg), ascorbic acid - 60 mg.

And other inactive ingredients of the constituent part.

Pharmacodynamics

Iron is the most important biologically significant ingredient involved in hematopoiesis and reactions that change the degree of oxidation of substances in the body. Sorbifer Durules is used to prevent iron deficiency. After all, this element is the structural basis of some proteins, as well as hemoglobin, which carries oxygen from the lungs to the bloodstream, to organs and tissues. The pharmaceutical method involves the release of iron ions in several stages over a long period of time. The matrix structure of Sorbifer Durules plastic is inactive in gastric juice, but dissolves under the action of contractions of the intestinal walls, which activate the active ingredient.

Ascorbic acid promotes the absorption of ferrous sulfate from the duodenum. Vitamin C is involved in the complex processes of creating blood, where red blood cells form and mature. After oral administration of the drug Sorbifer Durules, the active component almost instantly enters the general bloodstream, spreading through the tissues and becoming involved in metabolism.

Pharmacokinetics

Sorbifer Durules technology provides for a smooth release of the active ingredient and its uniform distribution.

The absorption and bioavailability of iron ions is very high. Iron is absorbed to a large extent in the duodenum or proximal mesenteric small intestine. More than 90% bound to plasma proteins. It accumulates in liver parenchyma cells and mononuclear phagocyte cells; a small proportion is found in the muscular system. The process of half elimination of the substance from the body reaches 6 hours.

Indications

Instructions for use of Sorbifer Durules provide for its use in case of iron deficiency and the development of hematological syndrome, with a disorder of hemoglobin synthesis due to iron deficiency.

To prevent pathology, it is used by pregnant women and while feeding the baby with breast milk. Almost always, this period of a woman’s life is accompanied by signs of low iron content in the body.

The pharmaceutical product is indicated for blood donors.

Contraindications for use

There is a range of pathologies and physiological conditions in which the use of Sorbifer Durules is unacceptable:

• Obstructions of the digestive system, in which the process of moving food is disrupted (reduction of the internal lumen of the esophagus caused by injuries, tumors and other reasons).
• Pathologies that are accompanied by an increase in the concentration of iron in the body (with excessive deposition of hemosiderin in tissues, with hereditary disorders of the metabolism of iron-containing pigments and its excessive accumulation in tissues)
• When there is a disorder in the process of iron utilization in the body in diseases leading to the destruction of red blood cells, lead, sideroblastic anemia.
• In case of individual hypersensitivity to the components of the pharmaceutical product.
• Children under 12 years of age, since clinical trials on the safety of the drug for children have not been conducted.

With special caution, the medicine is prescribed in the presence of ulcerative pathologies on the walls of the stomach or duodenum, in case of inflammatory processes of the intestines (inflammation in the small intestine, pathologies of the large intestine, Crohn's disease, the presence of diverticula in the intestine). Before starting therapy with Sorbifer Durules, it is necessary to exclude these pathologies.

Pregnancy and breastfeeding

The pharmaceutical product is not contraindicated during pregnancy and breastfeeding.

Adverse reactions

During therapy, undesirable reactions may occur: stool disorders, vomiting, discomfort in the epigastric region and pharynx, pain in the epigastric zone. The occurrence of adverse reactions increases in the gastrointestinal tract due to an increase in dosage to 400 mg.

Undesirable reactions such as esophageal ulcers, reduction of the internal lumen of the esophagus, and allergic manifestations (rash on the skin, itching) are less frequently recorded. Redness of the skin, cephalalgia, dizziness and loss of vitality are also observed.

Direction of administration, dose

The instructions for the pharmaceutical product describe the doses and order of administration of Sorbifer Durules. For adults, the therapeutic dose is 1 tablet 1-2 times a day. In severe cases of pathology, the attending doctor may increase the dose to 3-4 tablets per day, divided into 2 doses.

For preventive purposes, 1 tablet per day is prescribed for pregnant women; for therapeutic purposes, 1 tablet twice a day. On average, the duration of treatment lasts up to 2 months. The medicine is discontinued after stabilization of the normal level of hemoglobin in the blood.

Take the medicine 40 minutes before eating or 2 hours after eating. Swallow the tablets without chewing, washing them down with a sufficient amount of liquid.

Overdose

If the dose of pharmaceutical medication required for treatment is exceeded, severe pain is noted in the epigastric zone, blood pressure decreases significantly, a distinct heartbeat and low pulse appear, body temperature decreases, and sensitivity is impaired.

In case of severe overdose, blood clotting disorders, increased body temperature, severe disorders of liver and kidney function, convulsions and coma are noted, which develop within a period of 6-12 hours.

Overdose therapy is carried out in a hospital setting. Gastric lavage is prescribed. Raw eggs and milk are used to bind iron ions in the stomach and intestinal tract. Treatment is carried out according to symptoms.

Interaction with other medications

Iron absorption is reduced when the drug is used together with antacid medications containing magnesium carbonate and aluminum hydroxide. It is necessary to observe a time interval between the use of medications of up to 2 hours, and when using Sorbifer Durules together with tetracyclines, the interval increases to 3 hours.

The pharmaceutical product does not combine with ciprofloxacin, doxycycline, norfloxacin and ofloxacin.

special instructions

Sometimes there is a change in the shade of stool (darkening is not clinically significant)

Release form

Coated tablets of 30, 50 tablets in a dark glass bottle. Instructions are included in the cardboard packaging.

Dispensed by pharmacies

Sold from pharmacies using a prescription.

Storage

The pharmaceutical product is stored in a dry place at 15–25 °C, away from the reach of children.

Best before date

The shelf life is no longer than 3 years, subject to storage rules. After the expiration date, use is unacceptable