Totema oral solution 10 ml. ampoules №20


Iron deficiency anemia. Prevention and treatment of iron deficiency in pregnant women, preterm infants, twins or children born to women with iron deficiency, if the diet does not contain sufficient iron.



Composition and form of release
The totem is produced in ampoules. The preparation contains iron gluconate, manganese gluconate and copper gluconate.
Totema can be used to treat any form of iron deficiency anemia, regardless of its etiology. In addition, the drug is used to prevent iron deficiency in patients who are at risk: pregnant women, adolescents, women of reproductive age, children and the elderly in cases where it is not possible to compensate for the lack of this element with food.
Totem is not prescribed in cases where the patient has a history of intolerance to the main components of the drug, hemosiderosis, ulcerative lesions of the gastrointestinal tract, hemochromatosis, or he has recently suffered poisoning with lead salts. Totems are not used to treat anemias that are not associated with a lack of iron in the patient’s body.
Application during pregnancy and lactation
Totema can be used to treat and prevent iron deficiency in women during lactation and pregnancy. However, the drug is not recommended for women who are less than 4 weeks pregnant.

Method of application and dosage
The contents of the ampoule should be dissolved in plain or sweetened water or in any beverage other than tea, coffee, milk and alcoholic beverages.
Shake before use! The ampoule is opened by hand, breaking at both ends (this can be done without a file). The ampoule should be opened directly above the beverage container.
For oral use. It is desirable to take before meals, as this achieves maximum absorption of the components of the drug. Doses and timing of the drug Totem can be adjusted according to individual sensitivity of the gastrointestinal tract.
One ampoule contains 50 mg of elemental iron.
Treatment of iron deficiency and iron deficiency anemia
Adults are prescribed 100-200 mg of iron per day, ie 2-4 ampoules of the drug per day.
Children over 1 month of age are prescribed the drug at the rate of 5-10 mg of iron per 1 kg of body weight per day.
Prevention of iron deficiency in pregnant women
To prevent anemia during pregnancy, the drug is prescribed to pregnant women at the rate of 50 mg of elemental iron (ie 1 ampoule) per day during the second and third trimesters of pregnancy (or from the 4th month of pregnancy).
Duration of treatment.
The duration of treatment should be adequate to correct anemia and replenish iron stores, which are assessed by determining serum ferritin levels (normal ferritin level for women – 15-200 mcg / l, for men – 30-340 mcg / l).
Iron deficiency anemia: a course of treatment – from 3 to 6 months (depending on iron deficiency, which is determined by the level of ferritin). If necessary, the course of treatment can be extended if the cause of anemia has not been eliminated.
Treatment effectiveness should be monitored every three months: indicators should include peripheral blood counts (Hb, MCV – mean erythrocyte volume) and iron saturation parameters.

When using Totem in high doses, the patient may experience overdose symptoms, manifested by nausea, vomiting, epigastric pain and diarrhea. In the case of taking a significant amount of the drug, it is possible to develop necrotic changes in the mucous membrane of the gastrointestinal tract.
If an overdose is suspected, it is necessary to wash the stomach with 1% soda solution. If the level of iron in the patient’s blood has reached more than 5 mg / ml, then deferoxamine should be administered. In all other cases, the patient is prescribed symptomatic treatment and laxatives.
Side effects
When taking Totem, some patients may experience the development of various allergic reactions, such as itching, skin rashes, urticaria, vomiting, nausea, constipation and diarrhea.
Do not be alarmed if, during treatment with the drug, you notice that the feces turn black, this phenomenon is absolutely safe for the body and does not require discontinuation of the drug. In addition, taking the drug can contribute to darkening of the tooth enamel. To prevent the development of this phenomenon, it is recommended not to keep the solution in the mouth for a long time.
Storage conditions and periods
The totem should be stored in a place protected from sunlight. The shelf life of the drug is 3 years.