Instructions for use SORBIFER™ DURULES® (SORBIFER™ DURULES®)

Instructions for use SORBIFER™ DURULES® (SORBIFER™ DURULES®)

Sorbifer™ Durules® should not be combined with the following drugs:

• ciprofloxacin
  : when used together, the absorption of ciprofloxacin is reduced by 50%, thus there is a danger that its plasma concentration will not reach a therapeutic level;
• levofloxacin
  : when used together, the absorption of levofloxacin is reduced;
• moxifloxacin
  : when used together, the bioavailability of moxifloxacin is reduced by 40%. When using moxifloxacin and Sorbifer™ Durules® simultaneously, the maximum possible time interval of at least 6 hours should be maintained between taking these drugs;
• norfloxacin
  : when used together, the absorption of norfloxacin is reduced by approximately 75%;
• ofloxacin
  : when used together, the absorption of ofloxacin is reduced by approximately 30%;
• mycophenolate mofetil
  : a sharp decrease in absorption of mycophenolate mofetil by 90% was observed when combined with drugs containing iron.

Combinations to avoid

— Iron (salts) (parenteral route of administration)

Lipotymia, even shock, is possible, which is explained by the rapid release of iron from its complex form and saturation of transferrin.

Therefore, the combined use of oral and parenteral iron supplements should be avoided; the same goes for repeated blood transfusions.

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Combinations to Consider

— Acetohydroxamic acid

Reduced absorption of both drugs as a result of complexation.

Combinations to be used with precautions

— Bisphosphonates

Reduced absorption of bisphosphonates due to the formation of poorly absorbable complexes with iron.

It is recommended to maintain an interval between taking iron salts and bisphosphonates (from 30 minutes to 2 hours or more, if possible, depending on the bisphosphonate).

— Entacapone

Reduced absorption of entacapone and iron by chelation with entacapone.

It is recommended to maintain an interval between the intake of iron salts and entacapone (if possible, more than 2 hours).

— Strontium

It is recommended to maintain an interval between taking iron and strontium salts (if possible, more than 2 hours).

— Proton pump inhibitors

May reduce absorption of oral iron. Therefore, dose adjustment or replacement with intravenous iron may be required.

— Nonsteroidal anti-inflammatory drugs (eg, salicylates and phenylbutazone)

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When administered orally, an irritating effect on the mucous membrane of the gastrointestinal tract may occur.

— Dimercaprol

Forms a toxic complex with iron and should not be used simultaneously with iron supplements.

— Cholestyramine

Iron absorption is impaired.

The potential interactions mentioned above can be reduced by maintaining at least a 2-hour interval between doses of each drug.

Oral administration of ferrous sulfate preparations may result in a false-positive stool occult blood test.

When using Sorbifer™ Durules® together with the following drugs, it may be necessary to change their dose.

The maximum possible time interval of at least 2-3 hours should be maintained between taking Sorbifer™ Durules® and any of these drugs:

— Dietary supplements containing calcium or magnesium, and antacids containing aluminum, calcium or magnesium

:

• they form complexes with iron salts, thus impairing each other's absorption.

— Captopril

:

• When used concomitantly with captopril, its area under the concentration-time curve decreases by an average of 37%, probably due to a chemical reaction in the gastrointestinal tract.

— Zinc:

with simultaneous use, the absorption of zinc salts decreases.

— Clodronate and risendronate

:

• in vitro
  studies have shown that preparations containing iron form a complex with clodronate.
  Although in vivo
  have not been conducted, it can be assumed that the absorption of clodronate is reduced when used together.

— Deferoxamine

:

• When used together, the absorption of both deferoxamine and iron is reduced due to the formation of complexes.

— Levodopa, carbidopa

:

• when ferrous sulfate is co-administered with levodopa and carbidopa - probably due to the formation of complexes - the bioavailability of levodopa in healthy volunteers is reduced by 50%, and carbidopa by 75%.

— Methyldopa (levorotatory)

:

• When iron salts (iron sulfate and gluconate) are used together with methyldopa - probably due to the formation of chelate complexes - the bioavailability of methyldopa decreases, which may worsen its hypotensive effect.

— Penicillamine

:

• when penicillamine is used together with iron salts - probably due to the formation of chelate complexes - the absorption of both penicillamine and iron salts is reduced.

— Alendronate

:

• in an in vitro
  , preparations containing iron formed complexes with alendronate, reducing the absorption of the latter.
  In vivo
  results are not available.

— Tetracycline

:

• when used together, the absorption of both tetracycline and iron is reduced, therefore, when used in combination, the maximum possible time interval should be maintained, which is at least 3 hours between doses. The use of iron-containing drugs worsens the enterohepatic cycle of doxycycline, both when taken orally and when administered intravenously, so the combined use of these drugs should be avoided.

— Thyroid hormones

:

• When iron-containing drugs and thyroxine are used together, the absorption of the latter may decrease, which can lead to the failure of replacement therapy.

— Cimetidine

:

• when used together with Sorbifer™ Durules® with cimetidine, the decrease in gastric acidity caused by cimetidine reduces iron absorption. Therefore, when used in combination, the maximum possible time interval should be maintained, which is at least 2 hours.

— Chloramphenicol

:

• The effect of treatment with iron supplements appears later. The formation of red blood cells is suppressed and hemoglobin levels decrease.

When Sorbifer™ Durules® is used with tea, coffee, eggs, dairy products, wholemeal bread, cereals or foods rich in fiber, iron absorption may be reduced.

Interactions associated with ascorbic acid

Increases the concentration of salicylates in the blood (increases the risk of developing crystalluria), ethinyl estradiol, benzylpenicillin, and tetracyclines

.
Reduces the concentration of oral contraceptives
.
Increases the activity of norepinephrine
.
Reduces the anticoagulant effect of coumarin derivatives, heparin
.
Improves the absorption of iron preparations
, as well as iron from food (due to the conversion of ferric iron to divalent iron).
Increases the overall clearance of ethyl alcohol
.
May affect the effectiveness of disulfiram
in the treatment of chronic alcoholism.
The simultaneous use of ascorbic acid and deferox
does not increase the excretion of iron.

Acetylsalicylic acid, oral contraceptives, fresh juices and alkaline drinks

reduce the absorption and assimilation of ascorbic acid.

Ascorbic acid increases renal excretion of amphetamine

.

Plasma ascorbate concentration decreases with smoking

and taking
oral contraceptives
.

Concomitant use of acetylsalicylic acid

and ascorbic acid may interfere with the absorption of ascorbic acid. The renal excretion of salicylate is not affected and does not lead to a decrease in the anti-inflammatory effect of acetylsalicylic acid.

Concomitant use of aluminum-containing antacids

may increase urinary excretion of aluminum. The simultaneous administration of antacids and ascorbic acid is not recommended, especially in patients with renal failure.

Combined use with amygdalin

(alternative therapy) may cause cyanide toxicity.

Concomitant use of ascorbic acid with deferoxamine

increases urinary iron excretion and may lead to cases of cardiomyopathy and heart failure in patients with idiopathic hemochromatosis and thalassemia receiving deferoxamine who are subsequently given ascorbic acid. Ascorbic acid should be used with caution in these patients and cardiac function monitored.

Ascorbic acid may interfere with the biochemical determination of creatinine, uric acid and glucose in blood and urine samples.

Contraindications

• drug allergy;
• hemosiderosis and hemochromatosis ;
• other types of anemia ;
• thrombosis and thrombophlebitis ;
• diabetes mellitus and fructose intolerance ;
• stenosis of the gastrointestinal tract;
• urolithiasis and other serious kidney diseases;
• children (up to 12 years old);
• parallel use of drugs containing iron, problems with the absorption of iron in the body.

For inflammation and peptic ulcers of the gastrointestinal tract, the drug is used only as directed and under the supervision of a physician.

Consequences of drinking alcohol

The consequences of synchronizing the medication with alcohol is the progression of anemia due to the lack of a therapeutic effect from the drug.

Main symptoms:

• increased fatigue;
• increased heart rate;
• unstable blood pressure;
• dyspnea;
• asthenia (neuropsychological weakness).

When drinking alcohol-containing drinks, it is possible that side effects that accompany the use of iron-containing medications may increase:

• constipation (constipation) or diarrhea;
• dizziness;
• cephalgic syndrome (headache).

Clinical consequences are manifested by changes in blood parameters:

• erythropenia (low red blood cell count);
• thrombocytosis (increased platelet count);
• leukocytosis (increased white blood cells);
• hyperglycemia (increased glucose concentration).

If you are prone to allergic reactions, skin rashes may appear.

Side effects

The most common side effects are:

• constipation, diarrhea, nausea and pain in the epigastric region;
• redness and itching of the skin, possible Quincke's edema ;
• hyperglycemia;
• taking the drug promotes the formation of stones and sand in the kidneys;
• thrombocytosis, erythrocytopenia, leukocytosis;
• deviations from the normal content and metabolism of zinc and copper in the body are possible;
• headache, weakness, rapid heartbeat, dizziness;
• blackening or darkening of stool.

Sorbifer during pregnancy and lactation

Sorbifer during pregnancy is prescribed for anemia .

According to the instructions, in the initial stages of pregnancy (the first six months), it is recommended to take one tablet of the drug once a day. Last trimester and when breastfeeding - 1 tablet twice a day.

Treatment is continued until the level of iron in the blood normalizes. As prescribed by the doctor, the medication can be extended up to 6 months.

Price Sorbifer Durules (where to buy)

How much does it cost to buy the drug in Ukraine? On average, the price of 30 tablets is about 70 UAH. The cost of 50 tablets is about 80 UAH.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Sorbifer Durules tablets p.p.o.
  30 pcs. CJSC Pharmaceutical Plant EGIS 402 rub. order
• Sorbifer Durules tablets p.p.o. 50 pcs. ZAO Farm.zavod EGIS

  502 rub. order

Pharmacy Dialogue

• Sorbifer durules (tablet p/o 100mg+60mg No. 30)Egis

  RUR 414 order

• Sorbifer durules (tablet p/o 100mg+60mg No. 30)Egis

  RUB 404 order

• Sorbifer durules (tablet p/o 100mg+60mg No. 50)Egis

  RUR 544 order

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Pharmacy24

• Sorbifer Durules No. 30 tablets ZAT FZ Egis, Ugorshchina
  81 UAH. order
• Sorbifer Durules No. 50 tablets ZAT FZ Yegis, Ugorshchina

  107 UAH order

PaniPharmacy

• Sorbifer durules tablets Sorbifer durules tablets. p/o No. 30 Hungary, Egis

  92 UAH order

• Sorbifer durules tablets Sorbifer durules tablets. p/o No. 50 Hungary, Egis

  112 UAH order

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Analogues of Sorbifer Durules

Level 4 ATC code matches:
Ferrogradumet

Hemofer

Tardiferon

Feroplekt, hemoferon, feron forte, globigen, actiferin, gemsinerad-td, totema, ranferol-12.

The price of analogues is slightly lower than that of the original.

Which is better: Maltofer or Sorbifer?

The drugs are almost identical; there is an opinion that maltofer is better absorbed and has fewer side effects. Everything is individual.

Which is better: Sorbifer or Fenyuls?

Fenyuls contains half as much iron as Sorbifer. Helps with minor anemia. The original copes with the symptoms of the disease faster.