Likferr100 solution 20mg / ml, 5ml No. 5

iron deficiency states (including iron deficiency and acute post-hemorrhagic anemia) in patients with the need for rapid iron replacement;

in patients who cannot tolerate oral iron supplementation;

the presence of gastrointestinal diseases in which oral iron preparations cannot be used.

IV (slow jet or drip), as well as in the venous section of the dialysis system. The drug is not intended for intramuscular administration. Simultaneous administration of the full (cumulative) therapeutic dose of the drug is unacceptable.

Before the introduction of the first therapeutic dose, a test dose must be prescribed. If during the observation period there are phenomena of intolerance, the administration of the drug should be stopped immediately. Before opening the ampoule, inspect it for possible sediment and damage. Only a brown solution without sediment can be used.

Drip introduction

It is preferable to administer Likferr100Ѓ during drip infusion in order to reduce the risk of a pronounced decrease in blood pressure and the risk of the solution getting into the peri-venous space. Immediately before infusion, Likferr100Ѓ must be diluted with 0.9% sodium chloride solution in a ratio of 1:20 - for example, 1 ml (20 mg of iron) in 20 ml of 0.9% sodium chloride solution. The resulting solution is injected at the following rate: 100 mg of iron - not less than 15 minutes; 200 mg - within 30 minutes; 300 mg - within 1.5 hours; 400 mg - within 2.5 hours; 500 mg - within 3.5 hours. The administration of the maximum tolerated single dose of 7 mg iron / kg should be performed for at least 3.5 hours, regardless of the total dose of the drug.

Before the first drip of a therapeutic dose of Likferr100Ѓ, a test dose must be administered: 1 ml of Likferr100Ѓ (20 mg iron) for adults and children weighing more than 14 kg and half the daily dose (1.5 mg iron / kg) for children with body weight less than 14 kg, within 15 minutes. In the absence of undesirable effects, the remainder of the solution should be injected at the recommended rate.

Inkjet introduction

Likferr100Ѓ can also be administered as an undiluted solution IV slowly, at a rate of 1 ml of Likferr100Ѓ (20 mg iron) per minute - for example, 5 ml of Likferr100Ѓ (100 mg iron) is administered over 5 minutes. The maximum volume of the drug should not exceed 10 ml of Likferr100Ѓ (200 mg of iron) per injection.

After the injection, the patient is advised to fix the arm in an extended position for a while.

Before the first jet injection of a therapeutic dose of Likferr100Ѓ, a test dose should be administered: 1 ml of Likferr100Ѓ (20 mg iron) for adults and children weighing more than 14 kg and half the daily dose (1.5 mg iron / kg) for children with body weight less than 14 kg, within 1-2 minutes. In the absence of adverse events during the next 15 minutes of observation, the remainder of the solution should be injected at the recommended rate. After the injection, the patient is advised to fix the arm in an extended position.

Introduction to the dialysis system

Likferr100Ѓ can be injected directly into the venous section of the dialysis system, strictly following the rules described for intravenous injection.

Dose calculation

Before the introduction, it is necessary to individually calculate the total iron deficiency in the body according to the following formula:

Total iron deficiency (mg) = body weight (kg)? (Normal Hb - patient Hb (g / l)? 0.24 + deposited iron (mg).

For patients weighing less than 35 kg:

- the amount of deposited iron = 15 mg / kg;

- normal index Ќb = 130 g / l.

For patients weighing more than 35 kg:

- the amount of deposited iron = 500 mg;

- normal index Ќb = 150 g / l.

Coefficient 0.24 = 0.0034? 0.07? 1000 (iron content in hemoglobin = 0.34%; blood volume = 7% of body weight; coefficient 1000 = conversion from grams to milligrams).

Then you should calculate the cumulative (course) dose of Likferr100Ѓ, which will need to be administered to replenish the iron deficiency in the body, according to the following formula:

The total volume of the drug (ml) = Total iron deficiency (mg) / 20 mg / ml.

The approximate values ??of the total iron deficiency and the total volume of the drug for administration during the course of therapy are shown in the table.

Table

The total volume of the drug Likferr100Ѓ for treatment

The frequency of administration is determined by the doctor, but not more often than every other day.

Adults, incl. elderly (over 65 years old) patients: 5-10 ml of Likferr100Ѓ (100-200 mg of iron) 1-3 times a week.

Children: there is only limited data on the use of the drug in children. If necessary, it is recommended to inject no more than 0.15 ml of Likferr100Ѓ (3 mg iron) / kg 1-3 times a week, depending on the Hb index.

The maximum tolerated single dose for adults, incl. elderly (over 65) patients

For jet injection: 10 ml of Likferr100Ѓ (200 mg of iron), duration of administration is at least 10 minutes.

For drip administration: depending on the indications, a single dose can reach 500 mg of iron. The maximum allowable single dose is 7 mg iron / kg and is administered once a week, but not more than 500 mg of iron.

As a rule, higher doses are associated with a higher incidence of adverse events.

In the case when the total therapeutic dose exceeds the maximum permissible single dose, a fractional administration of the drug is recommended.

If after 1Ц2 weeks after the start of treatment with Likferr100Ѓ there is no improvement in hematological parameters, it is necessary to reconsider the initial diagnosis.

Calculation of the dose for replenishing the iron content after blood loss or donation of autologous blood

The dose of Likferr100Ѓ required to compensate for iron deficiency is calculated using the formula below.

If the amount of lost blood is known: intravenous administration of 200 mg of iron (10 ml of Likferr100Ѓ) leads to the same increase in Hb concentration as a transfusion of 1 unit of blood (400 ml with a Hb concentration of 150 g / l).

The amount of iron to be replenished, mg = the number of units of blood lost? 200 or the required volume of Likferr100Ѓ, ml = number of units of blood lost? ten.

When reducing the Hb content: the previous formula should be used, provided that the iron depot does not need to be replenished.

The amount of iron to be replenished, mg = body weight, kg? 0.24? (normal Hb - Hb of the patient), g / l.

For example: body weight - 60 kg, Hb deficiency = 10 g / l - the required amount of iron = 150 mg, the required volume of Likferr100Ѓ = 7.5 ml.

Patients with chronic renal disease on hemodialysis and receiving additional treatment with erythropoietin

The drug is administered strictly intravenously. The injection itself should be carried out as slowly as possible, the duration of administration increases as the dose is increased. The procedure is not particularly difficult for hemodialysis patients, because they usually have suitable I / O access. The drug is administered in 0.9% sodium chloride solution for at least 15 minutes during the last 2 hours of the hemodialysis session.

Absolute iron deficiency (phase of correction of anemia)

- 30-50 mg iron / dialysis session

or

- 1000 mg of iron for 6-10 weeks.

Maintenance phase

Different doses are prescribed, in different modes:

- 10-25 mg iron / dialysis session

or

- 100 mg iron / once a month (depending on the concentration of serum ferritin).

Hemoglobin correction phase

- 150 mg of iron to increase the concentration by 10 g / l.

hypersensitivity to the components of Likferr100Ѓ;

anemia not associated with iron deficiency;

the presence of signs of iron overload (hemosiderosis, hemochromatosis) or a violation of the process of its utilization;

I trimester of pregnancy (see 'Application during pregnancy and lactation').

With care: bronchial asthma; eczema; polyvalent allergy; allergic reactions to other parenteral iron preparations (due to the high risk of developing allergic reactions - see 'Special instructions'); liver failure; acute infectious diseases; low serum iron binding capacity and / or folic acid deficiency; diabetes mellitus (see 'Special instructions'); age up to 18 years (due to insufficient data on safety and effectiveness).