Totema® is a combination antianemic medication containing divalent iron in the form of the organic salt iron gluconate hydrate, as well as manganese gluconate and copper gluconate.
Mechanism of Action
Iron is the central atom of the heme groups incorporated into hemoglobin and is therefore essential for the formation of hemoglobin.
Iron, which is a component of numerous cellular structures and participates in the activity of many enzymatic systems (cytochromes, catalases), plays a very important role in oxygen transport and oxidative metabolic processes, and is also an essential element for the human body, being particularly necessary for ATP production, DNA synthesis, and electron transport.
Pharmacodynamic Effects
Iron supplements help correct iron deficiency in the body and prevent it from occurring if there is an increased need for iron or insufficient iron stores.
Indications for Totema®
Totema® is indicated for use in adults, children, and infants older than 3 months:
Treatment of iron-deficiency anemia;
Prevention of iron deficiency in at-risk groups:
During pregnancy;
In children aged 3 months and older born to mothers with iron deficiency;
When dietary iron intake is insufficient;
In blood donors.
Dosage regimen
Treatment of iron-deficiency anemia
Adults: 100 to 150 mg of elemental iron per day, i.e., 2 to 3 ampules per day, taken all at once or in several doses.
Prevention of Iron Deficiency
Adults, including blood donors: 50 mg of elemental iron per day, i.e., 1 ampule per day.
Pregnant women: 50 mg of elemental iron per day, i.e., 1 ampule per day during the last two trimesters of pregnancy (or starting in the fourth month).
Special Patient Groups
Patients with renal insufficiency generally do not require a dose adjustment.
Patients with liver failure generally do not require a dose adjustment.
Children
Treatment of Iron-Deficiency Anemia
Infants 3 months and older and children: 3 mg of elemental iron per 1 kg of body weight per day, not to exceed 60 mg.
Prevention of Iron Deficiency
Children aged 3 months to 5 years: 2 mg of elemental iron per 1 kg of body weight per day, but not more than 30 mg.
The dosing regimen for children 6 years of age and older is the same as that for adults.
Duration of use
Treatment should continue long enough to resolve anemia (normalization of hemoglobin and mean corpuscular volume) and/or restore iron stores (serum ferritin, transferrin saturation).
In cases of iron-deficiency anemia, hemoglobin levels should be checked 4 weeks after the start of treatment. The timing of subsequent laboratory tests will depend on the severity of the anemia. The duration of treatment for children and adults is determined on an individual basis. Treatment usually lasts 3 to 6 months, depending on the depletion of iron stores; treatment may be extended over time if the cause of the anemia has not been resolved. Treatment should be continued for an additional 3 months after hemoglobin levels have returned to normal.
Directions for use
Inside.
Shake the ampoule before opening it.
Dissolve the contents of the ampoule in plain or sweetened water.
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