Comparing Sorbifer and Maltofer | Determining the best

Updated: 04/23/2021 15:12:57

Expert: Abramova Tsilya

According to WHO, two billion people on the planet suffer from anemia. These are mainly women and children - those for whom the lack of iron and other microelements is critical. In Russia, according to statistics from the Ministry of Health, anemia is detected in every third child and in more than half of pregnant women. Men suffer less often, however, they are not protected from this disease.

Iron supplements are used to treat iron deficiency anemia. In this article we will look at two products - Sorbifer Durules and Maltofer. Both drugs have shown to be effective in fighting the disease. Sorbifer acts quickly, but is less well tolerated. Maltofer works slowly, but is less likely to cause side effects. What causes this difference, read on.

Composition and release form

Dosage form: solution containing iron for oral administration in a bottle, additionally powder in a container.

Solution: a 15 ml bottle of dark aromatic solution contains 800 mg of iron protein succinylate (equivalent to 40 mg Fe).

Ferlatum contains auxiliary components:

• propylene glycol - 1000 mg,
• sorbitol - 1400 mg,
• sodium methyl parahydroxybenzoate - 45 mg,
• sodium propyl parahydroxybenzoate - 15 mg,
• sodium saccharinate - 15 mg,
• clove buds and wild cherry and some other flavorings,
• vanillin,
• fillers,
• distilled water - up to 15 ml.

Calcium folinate quinary hydrate - 0.235 mg (0.185 mg folinic acid equivalent) is placed in a container with whitish powder. And 99.8 mg of the auxiliary component - mannitol.

Developed in Italy, Ferlatum Fol is produced in Spain and Vietnam.

Instructions for use during pregnancy

A lack of iron, which is responsible for the transfer of oxygen in the blood, is especially undesirable during pregnancy - the fetus needs to “breathe”. Healthy foods contain enough iron, but deficiency is caused by: legume products containing phytins and phytates, drinking tea and coffee (they contain polyphenols, phosphates and oxalates), eating sorrel and excess vitamin C (forming iron-binding oxalates), treatment with tetracyclines, quinolones, intestinal inflammation caused by Helicobacter pylori, bleeding. Iron deficiency also occurs with a deficiency of B vitamins, that is, folates, also contained in the recommended drug.

If iron deficiency has occurred or is suspected, what to do:

• Iron preparation Ferlatum Fol should be taken before meals; The usual dose of the drug is a bottle per day.
• Squeezing the punch firmly, pour the contents of the container into the bottle of liquid and shake until dissolved.
• After removing the cap, drink the mixture directly from the bottle or dilute it with water; You can divide the dose into parts, but it is recommended to use the entire solution in one day.
• In case of accidental overdose, rinse the stomach immediately.

conclusions

Let's summarize:

1. Sorbifer and Maltofer are used to treat iron deficiency anemia. They increase hemoglobin levels, relieve symptoms of the disease and reduce the risk of complications.
2. Sorbifer contains divalent iron. It acts quickly, but more often causes side effects.
3. Maltofer is a ferric iron preparation. It is slow, but relatively safe.
4. Both remedies are used during pregnancy and breastfeeding. Allowed for children over 12 years old.

When treating anemia, it is important not only to take medications, but also to follow a diet. Add red meat and seafood, fresh fruits and vegetables to your diet. Move more, walk in the fresh air, play sports. This tactic will help cope with the disease and speed up recovery.

Cost in pharmacies

The price of a standard package of 10 bottles of Ferlatum Fol in pharmacies is about 478 - 808 rubles, and is unstable (the drug is quite new, subsequent batches tend to become cheaper).

The Italfarmaco-controlled company LIFEPHARMA produces Ferlatum Fol in a Spanish plant, the drug is popular in more than 30 countries around the world, and production has also been opened in Vietnam. LIFEPHARMA also produces similar iron-containing folic medicines Ferplex Fol, OligoferFol, Folidar Tablets and others. Italfarmaco produces Ferlatum folio-containing injectable iron preparation (without folates), the price of a package of 20 capsules is about 900 rubles.

Cheap analogs of Ferlatum Fol

The most popular analogues of the drug:

• Fenuls (FeNULLes, iron and multivitamins), 30 capsules, price 209 - 237 rub.
• Ferrum-Lek (Ferrum Lek, iron hydroxide polymaltosate), tablets 30 pieces, 100 mg each, price 256 - 322 rubles.
• Maltofer (iron hydroxide polymaltosate), 30 pieces of chewable tablets, price 311 -329 rub.
• Ferroplex (Ferroplex, iron sulfate and ascorbic acid), 100 tablets per package, price about 110 - 221 rubles.
• Sorbifer Durules (iron sulfate and ascorbic acid), price 347 - 540 rubles.

For many, Fenyuls helps to increase iron levels; for others, Ferrum-Lek and its analogue Maltofer, positioned as a dietary supplement. Ferroplex and Sorbifer contain sulfur necessary for the absorption of iron, but the composition with ascorbic acid often causes constipation or diarrhea.

You cannot rely only on laboratory data: iron salts, having dissolved in the blood, can appear in tests, but are quickly washed out in the urine. As a diet, it is recommended to eat plenty of red meat and liver, quince, pomegranate, gooseberries, nuts, and buckwheat.

The fact that iron has actually been absorbed, having become part of hemoglobin and the skin, is evidenced by a healthy complexion, tongue and palate, vigor and cheerfulness.

How do they work

Although the drugs belong to the same pharmaceutical group, they act differently. Experts from our journal reviewed the medical literature and found out how Maltofer differs from Sorbifer. Let's look at each tool in more detail.

Sorbifer

The drug contains divalent iron. For many years this form of element was considered optimal. Doctors conducted research and said that ferrous iron works effectively for anemia:

It is quickly absorbed in the digestive tract and enters the blood from the small intestine.

Within a short time (in 1-1.5 months) it restores iron reserves in the body and improves the patient’s condition.

Therapy with ferrous iron preparations has long been considered the gold standard. But medicine does not stand still, and today scientists say that this form of medicine is unsafe. It turned out that ferrous sulfate has significant disadvantages:

1. Irritates the mucous membrane of the digestive tract and leads to an exacerbation of certain diseases.
2. The process of iron absorption is passive and dose dependent. The more the drug is taken, the more it penetrates into the blood - and the higher the risk of overdose. According to statistics, poisoning with iron salts occurs in 1.6% of cases of all therapy. Mortality is high - up to 41.2% (Koltsov O.V., 2002).

Sorbifer Durules is a typical representative of his group. It acts quickly, easily penetrates the blood, but can also cause an overdose. This does not mean that you should stop using the drug. It is necessary when a quick effect is required - with severe iron deficiency anemia.

Thanks to a special technology, iron is released gradually. The active component is hidden under a plastic shell. It does not react to the presence of hydrochloric acid in the stomach, but completely disintegrates when it enters the small intestine. Ascorbic acid, which is part of the drug, improves iron absorption and increases the effectiveness of treatment.

The instructions for the drug indicate: Durules technology provides 30% more iron absorption compared to other drugs from this group. The bioavailability of the drug is high. Iron is absorbed mainly in the duodenum, and partially in the jejunum. 90% of the active substance binds to plasma proteins. Creates a depot in the liver, macrophages, and muscles. Completely eliminated within 12 hours.

Maltofer

Maltofer contains ferric iron. This is a new form of the drug, replacing divalent drugs. In the body, such iron is converted into its usual divalent form. This happens slowly - over 1.5-2 months, so the effect of the drug is not immediately noticeable. For this reason, Maltofer is not prescribed where rapid restoration of iron reserves is needed.

Malfer does not irritate the mucous membrane of the digestive tract and does not lead to an overdose. It is uniformly absorbed from the small intestine, used for the synthesis of hemoglobin in the bone marrow or forms a depot in the liver.

There is an international trend towards a transition from divalent forms of iron to trivalent ones. Increasingly, doctors prescribe Maltofer and other similar drugs for anemia. But here everything is not so clear. A review presented in The Scientific World Journal from 2012 shows that ferric iron preparations cannot yet completely replace ferrous iron. The hydroxide complex does not always cope with its task and cannot quickly restore iron reserves in the body. At the same time, it has been proven that new drugs are easier to digest and better tolerated, so in the future they may become first-line drugs in the treatment of anemia. While this issue is being discussed, doctors use both drugs in practice.

Totema or Ferlatum - which is better?

The main analogue of Ferlatum Fol is Tot'hema - a drug containing iron lactate. This salt of lactic acid with iron, like Ferlatum Fol, is actively absorbed by the body in case of iron deficiency, being absorbed mainly in the duodenum and colon. Their indications are similar: Totema is recommended for iron deficiency anemia, for HIV infection, as a therapeutic and prophylactic agent for pregnant and lactating women, children and adolescents, women of reproductive age and elderly people experiencing a lack of iron due to its additional consumption, losses, and lack of food .

The drug is poorly absorbed, 10−20% of the dose taken.

Main differences. There is more iron in Totem, but its absorption by the body is less stable. Quite a few contraindications: hypersensitivity to lactate, gastric and intestinal ulcers in the acute stage, lead poisoning. Totema is prescribed with caution to those suffering from diabetes (contains sucrose); tea, which suppresses the effect of the drug, is contraindicated.

Why do you need to take prenatal vitamins Femibion ​​1 when planning and in the early stages?

When Tivortin Aspartate will help, and whether it is worth replacing it with analogues, read more here.

Application diagram

Sorbifer and Maltofer have the same application scheme. They are prescribed for iron deficiency anemia, a condition caused by a lack of iron. The goal of therapy is to compensate for the macronutrient deficiency, remove the symptoms of the disease and prevent the development of complications.

Diagnosis of anemia is based on data from a general blood test. If the hemoglobin level in an adult falls below 120 g/l (110 g/l in pregnant women), the doctor prescribes iron supplements. In childhood, the specialist is guided by age norms. The difference lies only in the nuances of application:

Maltofer is prescribed for mild anemia, where hemoglobin does not fall below 90 g/l, as well as for erased forms of pathology. It acts slowly - the result is noticeable only after two months.

Sorbifer is used where you need to quickly achieve an effect. It can be prescribed for mild anemia, but it is better for moderate and severe anemia. The drug raises hemoglobin in a month.

Usually the doctor prescribes iron supplements in tablets. Maltofer in syrup form is suitable for children. The injection form is used when oral medications are contraindicated - for example, for diseases of the digestive tract.

The dosage and duration of treatment is determined by the doctor, taking into account the patient’s age and the severity of his condition. It monitors the effectiveness of therapy using a blood test. If after a month the hemoglobin does not increase, you need to look for another cause of anemia.

Reviews from pregnant women

In their reviews of Ferlatum, pregnant and postpartum women note:

• rapid improvement in well-being under the influence of Ferlatum Fol;
• improvement of tests (steady increase in hemoglobin in the blood);
• pleasant taste and good tolerance compared to analogues;
• the ability to avoid hospital stays and injections by taking Ferlatum Fol;
• absence of side effects that occur with analogues (kidneys, constipation);
• some people don't like the taste;
• sometimes they complain that the level of iron in the blood has not improved, like other iron supplements.

What is the best way to take iron vitamins:

Side effects and precautions

Clinical trials show that Sorbifer more often causes adverse reactions:

1. nausea;
2. vomit;
3. abdominal pain;
4. constipation;
5. ulcerative lesions of the esophagus;
6. headache;
7. skin redness;
8. weakness;
9. allergic rash.

Maltofer is better tolerated and rarely causes adverse reactions.

Both drugs cause black stool and darkening of tooth enamel. These phenomena are not dangerous and do not require discontinuation of the medication.

Sorbifer and Maltofer are approved for use during pregnancy and lactation. There is no evidence that these drugs can interfere with fetal development. But this does not mean that you can self-medicate. Only a doctor can prescribe any medications to pregnant and lactating women!

Sorbifer and Maltofer are not used in children under 12 years of age - there is no data on the safety of therapy.