teferrol and Anemia--Hypochromic

Absolute iron deficiency is treated by correcting the causative lesion and then, traditionally, administering sufficient amounts of ferrous salt to return the haemoglobin level to normal and replenish body stores. The bioavailability of ferric compounds has been questioned and accordingly their therapeutic role remains controversial. A special problem is posed by regular blood donation, where the frequency of phlebotomy is limited by the haemoglobin level, which, in turn, requires maintenance of an adequate supply of iron from dietary sources. Since this latter situation may not always occur, it would be of practical benefit to have a form of supplementation that is effective and can be taken without side effects. These issues were prospectively examined in a consecutive series of otherwise healthy blood donors who developed absolute iron deficiency anaemia and were then randomly allocated to receive 60 mg of this metal as ferrous sulphate twice a day (Group 1: n = 51), 100 mg as chewable ferric polymaltose daily (Group 2: n = 53), or the latter product twice a day (Group 3: n = 55). Serial studies showed that 80% of patients in Groups 1 and 3 had reached normal haemoglobin levels by 12 weeks, but this figure was only 50% in Group 2. Similarly, the proportion of patients improving their percentage saturation of transferrin to within the normal range was significantly better in Groups 1 and 3 than in Group 2 (P < .01). However, body iron stores, reflected in serum ferritin level, was significantly better in Group 1 (P < .01); there was no difference in this respect between Groups 2 and 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Anemia, Hypochromic; Biological Availability; Blood Donors; Female; Ferric Compounds; Ferritins; Ferrous Compounds; Hematinics; Hemoglobins; Humans; Iron; Male; Prospective Studies

The bioavailability of iron on Fe(III)-hydroxide-polymaltose complex was compared intraindividually with that of Fe (II)-ascorbate (iron absorption) and a Fe (II)-sulphate quick release preparation (haemoglobin regeneration test). The study was carried out in a population of 16 healthy male volunteers, phlebotomized in weekly intervals until development of an iron deficiency anaemia in order to establish a test population with only small variations of their individual body iron status. Intestinal iron absorption in fasting state as measured by 59Fe whole body retention and simultaneous estimation from plasma iron tolerance curves was low for the 59Fe (III)-complex (1.2 +/- 0.1% (means +/- SD] as compared to the 59Fe (II)-ascorbate (43.7 +/- 7.1% (means +/- SD]. Iron administration together with a test meal did not affect the absorption from the 59Fe (II)-ascorbate, whereas the 59Fe (III)-complex showed a significant increase in absorption (8.8 +/- 4.7% (means +/- SD]. Haemoglobin (Hb) regeneration after 100 mg of iron as Fe (III)-complex and Fe (II)-sulphate administered during 28 days with meals amounted to a mean of 0.68 +/- 0.2 g/l and 1.1 +/- 0.3 g/l (means +/- SD) of total daily Hb-increase and a net-Hb-increase of 0.31 +/- 0.37 g/l and 0.79 +/- 0.36 g/l (means +/- SD), respectively. There was also a small but significant rise in serum ferritin during the oral treatment in both treatment groups. The results of Hb-regeneration after treatment with the Fe (III)-complex were in the range which could be expected from the absorption measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Anemia, Hypochromic; Ascorbic Acid; Biological Availability; Ferric Compounds; Ferrous Compounds; Food; Humans; Intestinal Absorption; Iron; Iron Radioisotopes; Male

Skin reactions against injected or implanted foreign materials are not rare. Siderosis is a disease characterized by the accumulation of iron in various tissues. Brownish-gray discoloration of the skin can be seen as a side-effect on the injection area after the parenteral iron treatment. Here, we present cutaneous siderosis case developed after multiple intramuscular iron injection on the gluteal region for iron-deficiency anemia. Development of cutaneous siderosis after intramuscular iron injection rarely has been reported in the literature before.

Topics: Anemia, Hypochromic; Buttocks; Dermatitis; Female; Ferric Compounds; Hematinics; Humans; Injections, Intramuscular; Middle Aged; Siderosis

To assess the effects of iron supplementation on iron status, cognitive function, affective behavior and scholastic performance in adolescents with varying iron status.. Adolescents of both sexes with varying iron status were allocated to four treatment groups by using inclusion criteria. Three of the four groups (iron deficient anemic, iron deficient and control supplement) received iron(III) hydroxide polymaltose complex (IPC, Maltofer) containing 100 mg of elemental iron 6 days a week for 8 months, while the fourth group (control placebo) was given a placebo. Hematological parameters, cognitive function, affective behavior and scholastic performance were assessed at baseline, 4 months and 8 months of supplementation.. Cognitive and scholastic performance test scores for the three supplemented groups increased from baseline to 4 months and from 4 months to 8 months (with concomitant increases in hematological parameters), whereas no increase was observed in the placebo group. No increase was seen in affective behavior scores for any of the groups during or after supplementation.. IPC supplementation for eight months yielded significant improvements in cognitive function and scholastic performance in Indian adolescents with and without iron deficiency and anemia.

Topics: Adolescent; Adolescent Behavior; Affect; Anemia, Hypochromic; Blood Cell Count; Cognition; Educational Status; Female; Ferric Compounds; Hematinics; Hemoglobins; Humans; India; Iron; Male; Nutritional Status; Prospective Studies

The bioavailability or iron from iron(III)hydroxide polymaltose complex (ferric polymaltose, Fe-PM) was studied in human volunteers with normal or depleted iron stores as well as in patients with iron deficiency anemia. From an oral iron dose of 100 mg neutron activated Fe-PM, starved subjects with depleted iron stores absorbed significantly less (p < 0.003) 59Fe (3.91 +/- 2.24%, mean +/- SD) as compared to the reference, aqueous 59Fe(II) ascorbate solution (13.8 +/- 6.19%). Using non-radiolabeled, commercial Fe-PM no postabsorptive serum iron increase was found after oral Fe-PM (100 mg Fe dosage) in a group of 7 patients with haemorrhagic or posthaemorrhagic iron deficiency anemia. In addition, almost no haemoglobin increase was observed in 9 patients during a 4-weeks treatment period when given Fe-PM (100-300 mg Fe/d) on empty stomach, whereas subsequent treatment with ferrous sulfate (100-200 mg Fe/d) was therapeutically effective (0.15-0.23 g/dl Hb-increase/d). When given 100 or 300 mg Fe/d Fe-PM together with meal, 3 out of 6 patients showed a higher iron utilization rate (3.4-11.9%/d) than given without meal (0.5-7.5%/d). In vitro incubation studies demonstrated that Fe-PM is very stable at neutral pH. A small release of iron from the high molecular weight complex was found only at low pH (< 2). However, high amounts of ionic iron were measured in the reaction tubes after incubating solutions of Fe-PM together with ascorbic acid. This finding could explain the somewhat higher bioavailability of Fe-PM when given with vitamin C containing meals.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Oral; Adult; Anemia, Hypochromic; Biological Availability; Ferric Compounds; Ferrous Compounds; Hematinics; Hemorrhage; Humans; Hydrogen-Ion Concentration; Iron; Iron Radioisotopes; Neutron Activation Analysis

Topics: Anemia, Hypochromic; Child, Preschool; Drug Combinations; Female; Ferric Compounds; Humans; Infant; Male

This paper reports a study of the pharmacokinetics of ferrous sulphate and ferric-hydroxide-polymaltose complex (Hw 6400, Ferrum Hausmann) administered orally and intravenously to anaemic and non-anaemic rats of both sexes. Radiolabelled ferrous sulphate and ferric-hydroxide-polymaltose complex was used to study iron utilization after oral administration. Measurements of radioactivity in serum, packed red cells, whole blood, liver, kidney, spleen, bone and in some cases in the gastrointestinal tract were made following a range of dosages between 0.84 and 41.9 mg Fe/kg. No significant difference in bioavailability or iron utilization was found between the two iron preparations. Pharmacokinetic measurements following i.v. administration showed different distribution volumes, iron clearance and elimination constants for the two preparations. This difference in pharmacokinetic behaviour following oral administration, particularly in the case of non-anaemic rats, was confirmed by the observation that a 10- to 20 fold smaller dose of FeSO4 than of iron-polymaltose complex was required to achieve the same rise in serum iron. It is therefore not justifiable to draw conclusions about the bioavailability of chemically different iron preparations (iron salts and iron hydroxide complexes) on the basis of AUC values for serum iron increases observed in non-anaemic animals or human subjects.

Topics: Administration, Oral; Anemia, Hypochromic; Animals; Female; Ferric Compounds; Ferrous Compounds; Injections, Intravenous; Intestinal Absorption; Iron; Kinetics; Male; Rats; Rats, Inbred Strains; Tissue Distribution

Topics: Administration, Oral; Anemia, Hypochromic; Biological Availability; Erythrocytes; Ferric Compounds; Hematinics; Humans; Iron

Free iron in the circulation in contrast to iron complexed with protein or carbohyrdate, is intensely toxic. The annual morbidity and mortality from accidental overdose with iron salts is significant and has directed attention to the evaluation of safer forms of therapy. Comparative studies between oral ferrous sulphate and iron polymaltose in rats established an LD100 of 350 mg/kg for the salt, whereas neither morbidity nor mortality could be produced in doses exceeding 1 000 mg/kg for the complex. Bio-availability of iron from salt and complex for haemoglobin synthesis was then compared both in rats and in man with a twin-isotope technique. In experimental animals and in the human studies, venesected individuals were used to reproduce the iron deficiency state where treatment would be indicated. It was concluded that bioavailability is comparable for therapeutic doses of ferrous sulphate and iron polymaltose in iron-deficient subjects. The marginally lower absorption of complex was offset by a greater degree of gastrointestinal tract tolerance; the wide margin of safety may be of importance in reducing the danger of accidental iron overdose.

Topics: Anemia, Hypochromic; Animals; Biological Availability; Ferric Compounds; Ferrous Compounds; Hemoglobins; Humans; Intestinal Absorption; Iron; Iron Radioisotopes; Male; Maltose; Polysaccharides; Rats; Sulfates