Powder white or mayzhe white color.

Description of the renewed roschin: bezbarvny or slightly zhovtuvatiy rozchin.

Desferal® is a chelating agent. The drug is active in the form of (desferroxamine = DFO), which fixes the complex with ions of trivalent salt and aluminum. The complexation constants are likely to become 10 3 l і 10 25. The compatibility of DFO to such bivalent ions such as gold, zinc, calcium is often lower (complexation constants are 10 14 and lower). Chelation infusion at a molar ratio of 1: 1, so that 1 g of DFO theoretically can call 85 mg of trivalent ion or 41 mg of trivalent aluminum.

The chelating power of DFO allows you to get rid of it in the blood plasma, or in cells, which can be used with the ferroxamine (FO) complex. Excretion of ferrioxamine by means of a head-on is visualization of blood plasma, at that time when an intrahepatic effect of the intestine is displayed. Zalizo can be chelated with feritin and hemosidirin, but at clinically significant concentrations of DFO, it is more common. However, DFO does not see any transferrin, hemoglobin or other hemoglobin. DFO is also a built-in mobile and alumina-soluble aluminoxamine complex (A10). Oskіlki hurt the complex, FO and A1O, more vivodat to the body, DFO stimulates the vision of the body and aluminum digests and intestines and as a result of a decrease in pathological metal deposition in the organs.

Vsmoctuvannya.

Deferoxamin shvidko to get wet with an internal (i / m) bolus or a pediatric (s / c) drip injection. soaktuvannya DFO from the shlunkovo-intestinal tract with the presence of non-mucous mucous membrane is seen in an insignificant world. Send to receive in the middle of 1 g DFO the absolute bioavailability of the drug should be less than 2%. When dіalіzі vmoktuvannya DFO From the empty queue into the systemic bloodstream, it will fall into the fall, if the drug is administered at once from a period of time.

Rozpodil.

Healthy volunteers have maximum concentration DFO in blood plasma (C m ah ) After 30 minutes, the drug was administered intramuscularly at a dose of 10 mg / kg, and the average dose was 15.5 μmol / L (8.7 μg / ml). After 1 year of writing DFO the concentration of the drug in blood plasma decreased to 3.7 μmol / l (2.3 μg / ml). Pislya internal (i / v) two-year infusion 2 g DFO (Close to 29 mg / kg) healthy volunteers in the blood plasma reached an equally important concentration of speech, which was in the middle 30.5 µmol / l. rospodil DFO It should be seen as quickly as possible: the middle period should become 0.4 years old. ringing DFO with little bloodshed in vitrobecome less than 10%.

Metabolism.

In case of ailments due to too much of a metabolism in the body DFO. Bulo viyavleno, scho biotransformation DFO including onset reactions: transamination and oxidation with acid metabolism; (3-oxidation with acid metabolism; decarboxylation і N -hydroxylation from the statements of neutral metabolites.

Vivedennya.

Vivedennya DFO and FO the body of healthy volunteers is given the intramuscular injection of the drug in 2 phases. In the first phase of the phase ("phase of growth"), a period is created for DFO = 2.4 years for FO. A friend has a regular phase ("phase of elimination") for a period of 6 hours for both sides. DFO і 1% - in the FO viewer.

Specific features of pharmacokinetics in specific groups of patients

In patients with hemochromatosis, the maximum concentration in the blood plasma began after 1 year after intramuscular injection DFO at a dose of 10 mg / kg and a mean of 7.0 μmol / L (3.9 μg / ml) for DFO i 15.7 μmol / l (9.6 μg / ml) for FO. The average value of the period for DFO and FO They were imported for 5.6 and 4.6 years, as applicable. After 6 years, 17% of the dose is taken from the section near the viglyad. DFO і 12% in FO viewers.

With trivial i / v infusion DFO we have a disease with thalsemia in a dose of 50 mg / kg for 24 years, the concentration is important DFO in blood plasma was 7.4 μmol / l (4.1 μg / ml). decrease in concentration DFO in blood plasma, it was biphasic from the middle period to 0.28 years and the late period to 3 years. Zagalny cleansing is 0.5 l / year / kg, and the volume of rose in an equally important mill is 1.35 l / kg. magnitude AUC to DFO metabolite, which side will play the main role in the impact of the value, to become 54% of the value AUC DFO. The clear period of the date (semi-elimination) of the metabolism for the duration of 1.3 years.

In ailments, hemodialysis was carried out with a drive of nirkovy deficiency and was eliminated DFO in a dose of 40 mg / kg i.v. for 1 year, concentration DFO in blood plasma in the end of the period of infusion was 152 μmol / l (85.2 μg / ml), as the infusion was carried out in two sessions of hemodialysis. Also internal introduction DFO after an hour hemodialysis session, the concentration of the drug in the blood plasma is 13-27% lower. concentration Fo in all droplets they became approximately 7.0 µmol / L (4.3 µg / ml), and the concentration of AI - 2-3 µmol / L (1.2-1.8 µg / ml). Pislya fixing infusion DFO the concentration of the drug in the blood plasma quickly decreased from the period of 20 min. Mensha chastina dozi is small longer trivial period for 14 years. Concentration of AI in the blood plasma of the prodvuval of growth for 48 years after the end of the infusion DFO і reached approximately 7 μmol / L (4 μg / ml). For a hemodialysis session, the concentration of AI in blood plasma decreased to 2.2 μmol / l (1.3 μg / ml).

Lіkuvannya chronic re-entanglement with zalizom, including:

• post-transfusion hemosiderosis with great thalassemia, sideroblastic anemia, autoimmune hemolytic anemia and other chronic anemias;
• idiopathic (primary) hemochromatosis in vipads, if phlebotomy is not sorely carried out through such supporters as anemia, heart disease, hypoproteinemia;
• Adjustment of the opening of a hairline in case of a weak skin porphyry in case of ill-health of phlebotomy.

Lіkuvannya gosstry otruunnya zalizom.

Likuvannya of chronic re-entanglement of aluminum in ailments with a thermal stage of nirk deficiency (which is on the basis of susceptible hemodynamics) during advancing camps:

• enmeshment of the cyst system, enrichment of aluminum;
• diabetic encephalopathy;
• anemia, tied with the addition of aluminum.

Diagnostics of re-entangling with zinc or aluminum.

Sensitivity is increased to active speech, behind a vignette is quiet vipadk, if successful desensitization is allowed to carry out the conversation;

Vagitness (1 trimester);

Period of lactation.

It is necessary to take care when you are stuck with Desferal® in ailments with severe nirk deficiency.

If you have one pererakhovanih ailment, before taking the drug obov'yazkovo consult a doctor.

Experimental studies have shown the possibility of teratogenic action of deferoxamine. Until the present hour, there was no sign of any kind of genius among children, the people of the bridegroom They were treated with Desferal® for an hour of vaginosti. However, the use of the drug for vaginosis, especially in the first trimester, is possible only when absolutely necessary.

Inadvertently, it penetrates into breast milk; in the skin vipadku after the ochіkuvanu ochіkuvanu cinnamon for a mother with a potential risik for a child.

Lіkuvannya chronic re-entanglement with zaliz

Main metoyu pіdtrimuyuchoї terapії complexing spolukami Je vstanovlennya rіvnovagi mіzh nadhodzhennyam i vivedennyam zalіza that zapobіgannya viniknennyu hemosiderosis, in one hour yak at cob terapії vulits of perevantazhennyam zalіzom Bajan domogtisya negative balance zalіza, dwellers postupovo skorotiti zbіlshenі stocks zalіza i zapobіgti toksichnі efekt. In children and older adults, it is recommended to repair the drug with Desferal® for the first 10-20 blood transfusions, or if the feritin level is reached in thousands of ng / ml. Excessive salinity or overwhelming doses of Desferal can be susceptible to growth. When the therapy with Desferal® is carried out in children up to 3 years old, it is necessary to control their growth; Dobova dose of the drug is not to blame for a change of 40 mg / kg.

The dose and the method of administration of the Desferal® preparation should be taken individually and individually during the course of fallowing in the fallow period at the stage of turnover, re-entangled with zalizom. Slide the minimum effective dose of the drug. To assess the reaction to the therapy with complex-forming spoluks, a couple of the next steps are taken to see the symptoms and to initiate a reaction to the growing dose of Desferal®. When the optimal dosage for Desferal® is established, the value of excretion of nirkami slid vimiruvati with an interval in decilka tizniv is established. An average additional dose of Desferal can also be obtained from urahuvannya instead of feritin in the blood supply ^ and the meaning of the "therapeutic index", which is a reference to the average additional dose of the drug Desferal® (in mg / kg) to the concentration of total ... The value of the given "therapeutic index" is guilty of less than 0.025. The average dose is adjusted to be in the range from 20 to 60 mg / kg.

Patients who have feritin in their blood below 2000 ng / ml, a dose of about 25 mg / kg / dob is required; with utrimanny feritin from 2000 to 3000 ng / ml, a dose of about 35 mg / kg / day is required. Patients with big viskim vm_stom feritin in syrovatz blood can be given a dose of up to 55 mg / kg / dob. It is not recommended to regularly change the average dose of 50 mg / kg, for a vignette of vipadks, if more intensive chelating drugs are required, and the patient has already begun to grow. As soon as feritin falls below 1000 ng / ml, the risk of toxic drug Desferal® increases. It is necessary to especially reliably support these patients and mothers on the basis of the possibility of lowering the foreign dose. Doses, when administered, є with average additional doses of the drug when it is administered. However, if more patients take Desferal® less than 7 times per day, then every day the dose is administered, change the average dose. For example, if an average dose of 40 mg / kg (280 mg / kg per day) is needed, if patients spend 5 nights per day, then the dose is administered at 56 mg / kg (280 mg / kg: 5).

Bulo has been shown that regular therapy with Desferal® has been shown to improve the average triviality of life in patients with thalassemia.

More education for the addition of a portable lightweight infusion pump lasting 8-12 years, it is necessary to complete it efficiently and especially handily for outpatient ailments. It can also be introduced for 24 years. Daniy has introduced the drug Desferal® with a dose of 5-7 times per week. Desferal® is not suitable for s / c bolus injections.

Zasosuvannya at the sick of the kidnapped vik

We are sick of a sick person, and then signify the minimum effective dose of the drug.

Internally introduced before the hour of blood transfusion. Availability in / in the way Introduced before the hour of blood transfusion. It is especially cinnamon in the case of rotten tolerance, p / c introduction. Do not add Desferal® to a container with blood. Win can be introduced into the infusion system for additional help Y - a figurative z'udnuvalny adapter, which is located close to the intravenous introduction. The patient's infusion pump is guilty of vicoristovuvatsya for the introduction of the drug Desferal® yak zzvychay. Danish method the introduction is stagnant, so as internally dropwise before the hour of blood transfusion, a quantity of the drug Desferal® can be introduced. It is necessary to pass the patient and the nurse about those who cannot accelerate the process of infusion, as it can lead to a convulsive collapse.

Without interruption to the internal introduction. Implanted systems for intravenous injection can be carried out in quiet drops, if intensive therapy is carried out with complex-forming spoluks. We are ailing in the way of storing testimony, as we cannot continue to receive it, and we are also ailing, we suffer from heart failure after being overwhelmed by a zalizom. Dose the Desferal® drug to lie in the form of a turn of re-entanglement with zalizom. In case of intensive intravenous therapy with complex-forming spoludes, it is necessary to regularly begin to increase the rate of treatment with nirkas, while in the absence of such results, it is possible to reduce the dose of the drug. It is necessary to take care of the promising system, so that the desferal® preparation can be taken into the roof of the surplus, which can be present in the "dead" space of the system, through the possibility of developing the collapse.

Introduced internally. Oskіlki n / a introduction is more effective, before i / m injections should be inserted only in quiet drops, if s / c introduction is uncomfortable. An individual admissible dose should be taken from the level of intake of nirkami, at which the value of the dose should not remain in the direction of the introduction.

Overnight stasis to Vitamin S. Excessive salinity will give rise to non-stagnant vitamins C, even if it is oxidized by salinity. For the first month of regular use with Desferal®, as a supplement to the treatment with complex-forming spoluks, Vitamin C can be indicated at a dose of up to 200 mg / add in a bottle of priyomiv. Vitamin With an increase in the availability of a deposit for the approval of chelation complexes. For children at the age of up to 10 rockets of vitamin C, it is necessary to give birth to 50 mg;

for older children - 100 mg each. Further, there is an adjustment of the dose of vitamin C not to the increase in the increase in the amount of iron-containing complex with nirkami.

Lіkuvannya gosstry otruunnya zalizom

Desferal® stays in a complex with smaller standard approaches. Therapy with Desferal® is indicated for advanced patients:

- All patients who show not only mild past symptoms (for example, more than one episode of blues or ridkogo style)

- Patients with signs of lethargy, significant pain in the abdomen, hypotension or acidosis

- Patients, in those with X-ray pre-diagnosed organs black empty many tini appear (in most cases of ailments, symptoms of zalizom rejection appear in the general population)

- Whether it’s a patient with classy manifestations and a concentration of blood in the blood, which changes 300-350 mcg / dl, it is directly related to the extraordinary health of the blood. It is also possible to conservatively accept Desferal® in vials, if the concentration of blood in the blood is in the range from 300 to 500 onset without any symptoms.

It is important without interruption in / in the administration of Desferal® zi shvidkistu 15 mg / kg / year. The speed of the introduction is guilty, but it is reduced, as only allow the camp of a sick person (call it after 4-6 years), so, the amount of the drug administered intravenously for 24 years did not change 80 mg / kg.

Therapy with Desferal® should be continued until quietly, as long as there are no more changes than you should think:

- The guilty patient has visible signs or symptoms of systemic rejection with zalizom (such as acidosis and improvement of hepatotoxic manifestations)

- In the Ideal, the concentration of saline in syrovatz is scored, but normal or low (concentration of saline is lower than 100 μg / dl). It is unwise to accurately vary the concentration of blood in the blood in the presence of Desferal®, it is possible to use Desferal® therapy if all minds are declared and for thinking that the concentration of blood in the blood is not due to

- It is necessary to repeat the X-ray examination of the organs of the black empty among the patients with a combination of multiple tints for confirmation, as the stench is a marker of trivial absorption

- If the patient is on the cob of therapy with Desferal®, it is time for the wine-fermentation of the wine, then the amount of wine is guilty to come back to normal before the therapy with Desferal® (during the therapy of the wine-fermented preparation for the same

The efficiency of the treatment is found in the form of adequate dyuresis, which can prevent the formation of the iron-containing complex of ferrioxamine in the body. With the development of oliguria and anuria, there may be a need for peritoneal dialysis, hemodialysis or hemophilization.

The treatment of chronic re-entanglement of aluminum in ailments with the thermal stage of nirk deficiency

Complexes of hair and aluminum with the drug Desferal® are viable during dialis. In ailments with nirkovy lack of development of cych complexes of growth with stasis hemodialysis. Treatment with Desferal® should be carried out in quiet drops, if the symptoms of re-entanglement of aluminum are signs of impaired organ function. Nutrition about the sign of Desferal® drug should appear in the same way, if symptoms appear, if the concentration of aluminum in the blood is constantly changing, 60 ng / ml is a positive Desferal test, especially if Desferal® slid is administered 1 time per day at a dose of 5 mg / kg. Patients with aluminum concentration up to 300 ng / ml DFO -Test, Desferal® should be administered by pulling the rest of 60 minutes to a hemodialysis session. Patients with a concentration of aluminum in syrovatz blood, which change 300 ng / ml, should also inject the drug intravenously every 5 years before the hemodialysis session. For the first three-month course of treatment with Desferal® and for a later 4-month period "vimivannya", then a test with Desferal® should be carried out. Even after the results of two Desferal tests, carried out at an interval of 1 month, it will appear that the concentration of aluminum in the syrovatz blood changes the vivid rhyvnium no more than 50 ng / ml, it is recommended to use the drug further than the preparation.

Patients who are on an uninterrupted outpatient peritoneal dialysis(CAPD) for uninterrupted cyclic peritoneal dialis(CCPD), Desferal® can be administered intramuscularly, either intravenously or subcutaneously, or intracranially. In this vypadku it is recommended to introduce the inner urea itself. Introduce Desferal® slid 1 time per week with 5 mg / kg before the end of the day with a dialysis session.

Desferal test

The sample is based on the fact that, in the Desferal® standard, it does not show the appearance of hair and aluminum in the diet.

1. Desferalova test for revealing re-entangling by zalizom in ailments with normal function of nirok ... Introduce 500 mg of Desferal® intramuscularly. We'll take it for 6 years and start in the first place. Vidіlennya 1-1.5 mg (18-27 µmol) zaliza for a whole period, allowing you to allow the re-entanglement with zalizom; the size of an eye 1.5 mg (27 µmol) can be pathological. The test gave good results only with normal function of the laboratory.

2. Desferal test for detecting re-entangling of aluminum in ailments with a terminal stage of nirkovo deficiency. Conducting a test with the infusion drug Desferal® is recommended for those who are sick, for those who have a concentration of aluminum in their blood is 60 ng / ml, and the concentration of feritin in the blood is 100 ng / ml. Before the hemodialysis session, it is necessary to take shelter for analysis to determine the alumina concentration. With a hold of 60 minutes for a hemodialysis session, intravenously inject Desferal® with a dose of 5 mg / kg. On the ear of an offensive hemodialysis session (i.e., 44 years later, after the infusion of Desferal®), a blood sample should be taken for re-assignment of aluminum in syrovatz blood.

The desferal test is positive, as the concentration of aluminum in the blood is increased by 150 ng / ml in normal conditions. However, the test is negative because there is no evidence of excess aluminum.

Instructions for storing

For the pediatric introduction of the drug with a concentration of 95 mg / ml in vyshe for the first time. For intramuscular injection, a greater amount of concentration may be needed. 5 ml of water for ін'єкцій should be injected with a syringe at the vial, then 500 mg of powder should be added to Desferal®, and kindly rubbed. Vikoristovuvati can only be insight and bezbarvny or slightly zhovtuvati razchin. The 10% solution for Desferal® can be added to the small amount for infusion (0.9% sodium chloride solution, 5% glucose solution, Ringer's solution, Ringer's lactate solution), peritoneal dialysis solutions(Dianeal 137 Glucose 2.27%, Dianeal PD 4 Glucose 2.27%, CAPD / DPCA 2 Glucose 1.5%).

For the Desferal test and the chronic re-entanglement of aluminum, the Desferal dose, which is 5 ml in a bottle, is adequate (5 mg / kg) for a patient with a weight of 100 kg. I will look at the weight of the patient, the approximate volume of the dosage for Desferal® is taken from the bottle and added to 150 ml of 0.9% sodium chloride.

The drug Desferal® can also be administered before the diabetic period and administered intravascularly for an hour. CAPD (Without interruption of peritoneal dialis) і CCPD (Uninterrupted cyclic peritoneal dialis).

Introduced to the drug Desferal® in case of chronic re-entanglement with the help of a portable infusion pump is carried out by an offensive rank:

1. Collect water for the syringe.

2. Wipe the gum stopper of the bottle with Desferal® with alcohol and insert it instead of the syringe near the bottle.

3. Kindly shake off the bottle for the preparation.

4. Pick up the drug in the syringe.

5. Bring the podjuval tube to the syringe and get it from the “blizzard”. Store the empty space of the tube with the tip of the syringe.

6. Place the syringe in the infusion pump.

7. For infusion іglu- "blizzard" you can enter the skin of the abdomen, arms, upper part of the gomіlka, stegna. It is even more important to clean the shkіra with alcohol before the team, yak to introduce the head. Golku slid enter gliboko, to "krill", into the hand-molded shkirnu fold... Kinchik of the introduced golki is guilty of being wary of the ruins. As far as not to be seen, the tip of the head can be close to the school. In any case, try to insert the head again in the first place, after cleaning the shkiri with alcohol.

8. Then fix the head with plastic.

9. Patients are encouraged to wear the infusion pump on only their shoulders on a belt. Bagato paciєntіv vvazhayut for a beautifully new introduction yak nybіlsh zruchny.

It is impossible for Desferal® preparation to take longer than 24 years at room temperature (up to 23 ° C).

Lower induction of non-desired reactions, re-insured for the frequency of development. The frequency of development of unnecessary reactions is estimated by the following rank: even more often (≥ 1/10); often (≥ 1/100< 1/10); нечасто (≥ 1/1000 < 1/100); редко (≥ 1/10000 < 1/1000); очень редко (< 1/10000); частота неизвестна.

It means that the signs and symptoms that are described as an undesirable phenomenon, in reality, may be a manifestation of the main disease (re-entangling with a zalizom and / or aluminium).

Destruction from the side immune system Even worse - anaphylactic shock, anaphylactic reactions, Angioneurotic nagging.

Destruction from the side nervous system : Often - head b_l; even worse - neurological damage, Including zamorochennya; improving the manifestation of encephalopathy, tied with dialis in ailments with re-entangled aluminum; peripheral neuropathy; paresthesia; the frequency of miscarriage - convulsions. Damage from the side to the organ of the zoru Ridko - impurity (blurred) lightness, decreased healthiness, loss of lightness, damage to colonic sleepiness (chromatopsia), chicken (nichna) sleepiness (hemeralopia), hypochondrium defects, scotoma, retinopathy healthy nerve, Cataract, horny clouding.

Damage to the side of the hearing organ and labyrinthine damage: infrequently - sensorineural deafness, noise in the ears.

Destruction from the side of the Sudin Ridko - the turn of the decrease arterial vise. Destruction on the side of the heart Ridko - tachycardia, shock.

Destruction from the side of the mental system, infrequently - asthma; even more іdko - gostry respiratory distress, infiltration legends.

Destruction from the side herbal systems : Often - nudota; infrequently - blues, abdominal beats; even more rarely - diarrhea.

Damage from the side of the shkіri and pedshkіrnyh fabrics: often - kropiv'yanka; even more rarely - generalization visip.

Damage from the side of the skeletal-myazovoi ta with good fabrics Even more often - arthralgia, malgia; often - meeting the growth and reduction of cysts (metaphysical dysplasia); the frequency of abnormalities is myazov spasms.

Destruction from the side of the nirok and secular nobles: frequency of nevidoma - gosstra nirkova lack, urazhennya nirkovy canaliculi.

Out-of-the-box issues and damage in the introduction ", even more often - pain, swelling, infiltration, erythema, sverbіzh, scab / pick in the introduction; often - pirexia; infrequently - vesicular visip, muscular embryos, pechinnya.

Laboratory and instrumental data Even more rarely - changes in the picture of peripheral blood (including thrombocytopenia, leukopenia); the incidence of abnormalities is an increase in creatine in the blood.

The development of convulsions is important for patients with aluminized alumina, which are located on hemodialysis.

There has not been established a relationship between the diagnosis of transaminases in the increase of transaminase activity in the blood and the consumption of Desferal®. Vivedennya kompleksіv preparation with zalizom nirkami can produce to a reddish brown farbuvannyu sichі.

Likuvannya drug Desferal® re-entanglement of aluminum can lead to hypocalcemia and aggravation of hyperparathyroidism.

If you are because of the meanings in the instructions for the secondary effects, you will get lost, if you remembered whether you are side effects, Not mentioned in the instructions, see about the doctor.

One hour drug abuse with Desferal® and an abnormal phenothiazine with prochlorperazine can lead to a time-dependent loss of svidomosty. In ailments with re-entanglement of an important chronic interruption, they took the drug Desferal® in a combination with high doses of Vitamin C (more than 500 mg / dob), they blamed the heart damage. Tsі ruinous bully werewolves wrote to vіtamіnu S.

Scintigers, scintigrated in case of stagnation of galia-67, can be used through a scintiger vivedenny with a cross-section tied with the preparation Desferal® galia-67. Bazhano interrupt the administration of Desferal® 48 years before the scintigraphy.

Pharmaceutical business. Rozchin drug Desferal® is insane with rozchin heparin for ін'єкцій. Physiological solution to sodium chloride (0.9%) is not used as a rosemary of dry speech, but to the preparation of Desferal® in water for the first stage of physiological development of sodium chloride for all types of growth.

The intravenous injection of the drug can lead to hypotension and shock (pochvoninnya shkiri, vertebral collapse, tachycardia, kropivyanka).

The consumption of Desferal® in high doses can lead to loss of hearing and hearing, especially in individuals with a low amount of feritin in their blood. Neurosensory deafness, noise in the ears are diagnosed in one case for taking the dosage regimen and changing the dosage of the drug at a lower concentration of feritin (the average dosage of Desferal® to the blood concentration of feritin is 0.05). Damage to the disease was indicated in such patients for a one-time administration of the drug. The risk of adverse effects changes when low doses of Desferal® are consumed. In case of a diagnosis of damage, or hearing, the drug is inaccurately recognized. Call snakes, wiklicans with Desferal®, in case of early detection of werewolves when you see them. Likuvannya can be renewed, albeit in higher low doses and under strict control of the functions of hearing and sound. It is recommended to carry out ophthalmological pre-examination and audiometry in patients before the ear of therapy with Desferal® and skin 3 months before an hour of therapy, especially with a low feritin level.

Approximately half of the complexes with metal are caused by nirkami in patients with rewired hair and normal function of nirok. That is why it is necessary to take care of the drug in case of stagnation of the drug in ailments with severe nirk deficiency.

Desferroxamines of the complex of hair and aluminum are produced for additional hemodialysis. In ailments with nirkovyu deficiency, during hemodialysis, it is possible to achieve improvement in the development of cich complexes. In sick people with a lack of nirkov, as they recognize a session of an adaptable dialogue and decrease in the size of feritin in their blood, the risk of accusation of side effects of adversity. Supporting growth and destruction from the side knitted fabric(For example, metaphysical dysplasia) occurs when the drug is consumed in doses of 60 mg / kg, especially in quiet patients, in some ears of therapy for a seizure on the first 3 fateful life. The risk of development of the number of side effects will change, if the dose is adjusted to 40 mg / kg and lower. At the patients childish vik If you dispense Desferal®, it is recommended to control the weight of the skin and the growth of the skin for 3 months.

In the case of those who are ill with re-entangled zaliz, the drug Desferal® increases the anti-infectivity to infectious diseases, for example, Yersinia enterocolitica and Yersinia pseudotuberculosis. Even after an hour of treatment with Desferal®, an increase in temperature is indicated, in case of symptoms of a gastrointestinal enteritis / enterocolitis, diffuse abdominal pain Infections can be updated with Desferal®.

In ailments who dispense Desferal® in conjunction with re-entangled aluminum and / or alumina, they have seen the development of mucorosis (mucoromycosis) in some cases, with a lethal result. If there are any signs of illness, Desferal® is followed by mycological follow-up and immediately afterwards. Mucous infections can be diagnosed in ailments, since they do not take Desferal®, and talk about those who are considered to be factors, for example, hemodialis, diabet, Destruction of acid-puddles, malignant ailments of blood, stagnation of immunodepressants, or deterioration of immunity due to other factors, may play a role in the development of the process of infection. The appearance of the complex can be zoomed in from the red-brown barbed section. Do not overhaul the recommended dosage for Desferal®. For pediatric administration, do not use the drug Desferal® in a concentration of 10%. miscellaneous reactions... With the possibility of only i / m the introduction for the reduction of the drug can be known in higher concentrations.

Preparations of 10% of the differences are guilty but we will be able to see through and without barriers (or just a little bit). Vikoristovuvati can only be clear-cut. Opaque or kalamutnі razchini slіd wikidati. Before the procedure, the introduction of the drug Desferal8 should be put especially respectfully.

When s / c infusion, the head should not be inserted close to the dermis.

Є In the case of heart failure in case of one-hour treatment with Desferal® and Vitamin C in high doses (more than 500 mg / dose), ailments with severe chronic reversal of zalizom. Writing to Vitamin With normalization of indicators of heart activity.

It is planned to immediately consume Desferal® and Vitamin S, it is necessary to follow the onset safety rules:

It is not a sign of vitamins We are sick because of our heart failure;

Likuvannya with vitamin You can fix only the end of the first month of regular use with Desferal®;

Vitamin C can be used only with regular treatment with Desferal®; the introduction of the best way to fix it without a bar by sending an ear of infusion to the drug Desferal®;

Do not change the dose of Vitamin C 200 mg, divided into several doses;

Before the hour of the combined therapy, regular monitoring of heart activity.

Before the ear of treatment with Desferal® and skin for 3 months during the course of treatment, it is recommended to specialize ophthalmologic and advanced hearing, especially with a low concentration of feritin in the blood. Rizik the development of hearing loss in patients with thalassemia can be reduced, as the average dosage of Desferal® (in mg / kg) to the concentration of feritin in the blood (in μg / l) is taken up to 0.025 mg / l.

In pediatric practice, in the course of treatment with Desferal®, it is necessary to control the mass of the skin and the growth of the skin for 3 months.

In patients with encephalopathy, tied with too much aluminum, the intake of Desferal® in high doses can lead to an aggravated neurological symptomatology (sudomi), which, in a very concentrated manner, is tied to high levels of aluminum. The drug Desferal® can accelerate the development of dementia associated with hemodialysis. For obvious reasons, in advance of the treatment of clonazepam for the diagnosis of neurological acceleration. In addition, the excess of aluminum can lead to a decrease in the level of calcium in the blood and hyperparathyroidism.

Patients who, on the background, have a loss of the drug Desferal®, there is a loss of damage to the side of the central nervous system, including damage to the vision or hearing, do not drive a car or drive a car for hours.

At a temperature of 30 ° C.

Zberigati is out of reach for children.

18 months

Do not fix the term for endowment.