Buy Totema ampoules 10 ml, 20 pcs
  • Buy Totema ampoules 10 ml, 20 pcs


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Clinical Pharmacology

Combined antianemic drug.

Contains iron, which is necessary for the synthesis of heme, which is part of hemoglobin, myoglobin, flavoproteins, iron-ferritin and iron-transferrin complexes, various enzymes; participates in a number of redox reactions.

Copper and manganese are trace elements and are cofactors of some enzymes. The absorption of trace elements is the more intense, the greater the iron deficiency in the body.

When taking the drug, there is a gradual regression of the clinical and laboratory symptoms of anemia.


Treatment and prevention of iron deficiency anemia in adults and children from 3 months of age, caused by various reasons:

  • bleeding;
  • increased need for iron (pregnancy);
  • lack of iron intake from food or violation of its absorption.


Excipients: glycerol - 2.52 g, dextrose (glucose) - 80 mg, sucrose - 3 g, anhydrous citric acid - 27.4 mg, sodium citrate dihydrate - 30 mg, sodium benzoate - 20 mg, polysorbate 80 - 24 mg, caramel dye TPS (E150c) - 50 mg, tutti-frutti flavoring - 20 μl, purified water - up to 10 ml.

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Dosage and Administration

For the treatment of anemia, adults are prescribed the drug at the rate of 100-200 mg of iron (2-4 amp.) / Day; children older than 3 months - at the rate of 5-7 mg / kg of body weight / day in 2-4 doses.

The use of the drug is carried out under the control of the iron content in the blood serum, the total iron-binding ability of the serum before the start of treatment and thereafter with a frequency of 1 every 2 months.

With the preventive purpose, adults and pregnant women (starting from the 4th month of pregnancy) are prescribed 50 mg (1 amp.) / Day. Children, depending on the age of the drug is prescribed in a dose comprising from 1/4 to 1/2 of the daily therapeutic dose of adults.

The duration of treatment is determined individually. The average duration of the drug intake is from 3 to 6 months (until the body stores iron).

Rules of use of the drug

Shake before use.

It is necessary to tear a piece of cardboard from the pack along the dotted line, bend it in half to safely break the tip of the ampoule. Break the ampoule from two sides, pour the contents of the ampoule into a glass, dissolve in plain or sweetened water.

Take inside before eating.

Adverse reactions

From the digestive system: 

  • staining of feces black (is the norm);
  • heartburn; nausea;
  • vomiting;
  • diarrhea;
  • constipation;
  • epigastric pains;
  • darkening of tooth enamel.

Other: allergic reactions.

Precautions should be prescribed the drug for diabetes.

Use in children

Drug interactions

Simultaneous use of the drug Totema® leads to a decrease in the absorption of bisphosphonates, ciprofloxacin, tetracyclines when taken orally.

Salts, oxides and hydroxides of magnesium, aluminum and calcium violate the absorption of iron salts. Totema should be taken® not earlier than 2 hours after taking these drugs.

It is impossible to combine the drug with other iron preparations, including administered parenterally.

Pregnancy and Lactation

The use of the drug is allowed during pregnancy and lactation according to indications in recommended doses.

Special instructions

Monitoring the effectiveness of treatment should be carried out no earlier than 3 months after the start of treatment.

Excessive consumption of tea inhibits iron absorption.

To avoid darkening of the tooth enamel, avoid prolonged exposure of the drug solution in the oral cavity.

Patients with diabetes should take into account that 10 ml of the drug contains 3 g of sucrose.

In 1 ampoule of the drug contains 1/4 XE, in the maximum daily dose (in 4 ampoules of the drug) 1 XE.

During treatment with iron preparations, patients may experience black feces, however, this does not require medical intervention. During treatment with iron preparations, fecal occult blood test may give a false positive result.

Influence on ability to drive motor transport and control mechanisms

There is no evidence of a negative effect of the drug on the ability to drive vehicles and other mechanisms.


Symptoms: weakness, hyperthermia, convulsions, nausea, vomiting, constipation, diarrhea, epigastric pain. Cases of necrosis of the gastrointestinal tract and shock are described.

Treatment: gastric lavage with 1% sodium bicarbonate solution (baking soda). When the serum iron concentration is more than 5 mcg / ml, deferoxamine is administered IV slowly: for children - 15 mg / kg / h, for adults - 5 mg / kg / h (up to 80 mg / kg / day); in case of mild intoxication: children - 1 g every 4-6 hours, adults 50 mg / kg (up to 4 g / day); conduct symptomatic therapy; in the event of shock, anti-shock therapy is performed.

  • Brand name: Totema
  • Active ingredient: Iron Gluconate, Manganese Gluconate, Copper Gluconate

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