КосмоФер

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КосмоФер

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Treatment option: Anemia

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of КосмоФер

What is CosmoFer?

CosmoFer is a pharmacological preparation used for the treatment of iron deficiency states. It consists of a stable complex of iron(III) hydroxide and dextran, a polysaccharide chain. This structure is designed to mimic the way iron is naturally stored in the body, allowing for the controlled release of usable iron into the bloodstream and storage organs.

Composition and Mechanism

The active component in CosmoFer is iron(III) dextran. Unlike simple iron salts, the dextran coating encapsulates the iron core, which prevents the immediate release of free iron ions into the plasma. Once administered, the complex is taken up by the reticuloendothelial system, primarily in the liver and spleen. There, the iron is gradually separated from the dextran and becomes available for the synthesis of hemoglobin or is stored in the form of ferritin or hemosiderin.

Intended Use

This preparation is typically utilized when oral iron supplementation is not feasible or effective. This may occur in several clinical scenarios:

  • Intolerance to Oral Iron: Cases where patients experience significant gastrointestinal side effects from tablets or liquids.
  • Malabsorption: Conditions where the digestive tract cannot effectively absorb iron from food or oral supplements.
  • Need for Rapid Replenishment: Situations where iron stores must be restored more quickly than oral therapy allows.

Clinical Role

By providing a concentrated source of iron bypasssing the digestive system, CosmoFer helps to address iron deficiency anemia, a condition characterized by a decrease in the number of red blood cells or the amount of hemoglobin due to insufficient iron. The goal of using this complex is to replenish internal iron stores and support the body's ability to transport oxygen effectively.

Regulatory References

  1. NICE Quality Statement 1: Iron supplementation

What side effects are possible with КосмоФер?

Possible side effects and safety information

The safety profile of Iron Dextran Complex, the active ingredient in КосмоФер, is formally documented and classified according to regulatory standards, with adverse reactions grouped by frequency and affected physiological systems.

Classified Adverse Reactions

Side effects are officially categorized based on incidence rates observed in clinical use:

  • Uncommon reactions (affecting up to 1 in 100 people) may include nausea, vomiting, abdominal pain, and hypersensitivity reactions such as urticaria, rashes, or pruritus.
  • Rare reactions (affecting up to 1 in 1,000 people) include seizures, hypotension, arrhythmia, or tachycardia.
  • Very Rare reactions (affecting fewer than 1 in 10,000 people) include acute, severe anaphylactoid reactions, which are potentially life-threatening and may involve respiratory difficulty or cardiovascular collapse.

System-Organ Classes and Patterns

Adverse effects are documented across various systems, including Immune system disorders, Nervous system disorders, Cardiac disorders, and Gastrointestinal disorders.

Serious, immediate hypersensitivity reactions are documented as occurring most often within the first several minutes of administration. Other reactions, such as arthralgia, myalgia, fever, or headache, may be delayed, typically beginning 24 to 48 hours post-administration.

Safety Restrictions and Considerations

The medicine is officially contraindicated in individuals with known iron overload (e.g., haemochromatosis), non-iron deficiency anaemia (e.g., haemolytic anaemia), or decompensated liver cirrhosis. Specific safety notes also apply to pregnant patients, where severe maternal reactions may lead to fetal bradycardia. Concomitant use with oral iron preparations is documented to reduce the absorption of oral iron.

Overdose and Emergency Response

Overdose and when to seek help — official regulatory information for КосмоФер

Overdose scope

Property Description (Strictly Label-Based)
Documented overdose presentations Chronic excessive administration may result in Hemosiderosis and Iron Overload. Acute severe reactions are characterized by anaphylactic-type reactions, cardiovascular collapse, and sudden onset of respiratory difficulty.
Physiological systems affected (as stated in label) Cardiovascular, Respiratory, Neurological (e.g., seizure), and Fetal systems are cited in regulatory warnings.
Dose-related or exposure-related factors Excessive administration over time is the cause of Iron Overload; the medicine must not be administered to patients with existing evidence of this condition.
Population-specific overdose notes Severe adverse reactions in pregnant women may cause fetal bradycardia. Patients with serious impairment of liver function require monitoring due to an increased risk of iron toxicity.
Emergency-response statements Resuscitation techniques and personnel trained in the detection and treatment of anaphylactic and anaphylactoid shock must be readily available during administration.
When immediate medical help is required Seek immediate medical attention when overdose is suspected. If the victim has collapsed, had a seizure, has trouble breathing, or cannot be awakened, emergency services must be called immediately.

Overdose classifications (high-level)

Classification Description (Strictly Regulatory Terminology)
Severity classification Documented Fatal reactions and Life-threatening systemic adverse events are noted in the prescribing information.
Regulatory basis FDA Prescribing Information and NIH MedlinePlus Drug Information.
Overdose-context constraints No specific antidote is documented for the Iron Dextran complex.

Resulting overdose structure

Official overdose statements:

  • The official labeling cites Iron Overload as the primary manifestation of chronic excessive therapy, necessitating periodic monitoring of hematologic and iron parameters.
  • The most severe acute risks are anaphylactic-type reactions and cardiovascular collapse, which are described as potentially fatal reactions in regulatory documents.
  • The immediate availability of Epinephrine and resuscitation techniques is required for the treatment of severe acute systemic events.

Connection to the overall overdose profile

The regulatory profile defines the overdose risk through two core scenarios: the long-term potential for Hemosiderosis from excessive therapy and the immediate, acute risk of life-threatening systemic reactions. These classifications establish the conditions under which urgent medical attention is required, particularly when symptoms of cardiovascular or respiratory collapse are observed, and mandate the required emergency preparedness.

Therapeutic Uses of КосмоФер

What КосмоФер Treats: Main Uses and Benefits

This therapy is commonly used to address severe iron deficiency and the resulting Iron Deficiency Anemia (IDA) in patients. The medicine is generally indicated for patients with documented iron deficiency who have an unsatisfactory response to oral iron or cannot tolerate it.

The preparation may assist with managing symptom clusters that create noticeable physiological strain, including persistent, profound fatigue, general weakness, and manifestations linked to organ-specific functional stress like shortness of breath. It is considered relevant for use across conditions where symptoms may intensify temporarily, such as iron deficiency associated with Chronic Kidney Disease, Inflammatory Bowel Disease (IBD), or chronic blood loss.

This approach is generally relevant in clinical settings where patients cannot tolerate or adequately absorb oral iron, including those with malabsorption syndromes or severe gastrointestinal intolerance. This assists with maintaining functional stability by supporting the patient’s hematological health. This offers symptomatic relief that may assist with maintaining functional stability when symptoms are more noticeable.


Quick Fact: Relief for Profound Physical Exhaustion (The therapy supports the replenishment of iron stores, which is commonly used to help with easing the debilitating physical symptoms of severe deficiency.)

Eligibility and Restrictions for Use

Who Can and Cannot Use КосмоФер? — Official Regulatory Information

Eligibility for КосмоФер (Iron Dextran) is strictly defined by government regulatory documents and depends on specific clinical status, age, and pre-existing conditions.

Populations for whom use is Contraindicated

Use is contraindicated (must not be used) in patients with the following conditions:

  • Documented hypersensitivity to iron dextran or any other parenteral iron product.
  • Any form of anemia not caused by iron deficiency.
  • Clinical or laboratory evidence of iron overload (e.g., hemosiderosis).

Age-Related Eligibility and Restrictions

The medicine is indicated for adult patients and pediatric patients aged 4 months and older who have documented iron deficiency and are either intolerant of or have an unsatisfactory response to oral iron. Use is not recommended for infants under 4 months of age.

Conditional Use and Special Populations

Use requires extreme caution and special consideration in several patient groups, as potential risks may outweigh benefits:

  • Patients with serious impairment of liver function or pre-existing cardiovascular disease.
  • Individuals with a history of significant allergies and/or asthma or rheumatoid arthritis.
  • It is not recommended in the first trimester of pregnancy; use in the second and third trimesters is permitted only if the potential benefit justifies the potential risk to the fetus. Caution is advised for nursing mothers.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The interaction profile of this parenteral iron complex is defined by official regulatory documents, focusing on prohibitions, required timing separation, and pharmacodynamic risk enhancement with certain co-administered agents.

Contraindicated Combinations and Timing Rules

Co-administration with oral iron preparations is contraindicated because the injection reduces the absorption of subsequently administered oral iron products. Official labeling requires that oral iron therapy must not be started until at least five days after the final injection of the iron complex.

Interacting Agent Official Documented Outcome
Oral Iron Preparations Reduced absorption; co-administration prohibited.
ACE Inhibitors Increased risk for anaphylactic-type reactions.

Pharmacodynamic and Diagnostic Interference

A specific pharmacodynamic interaction is documented with Angiotensin-Converting Enzyme (ACE) Inhibitors, which may increase the labeled risk of anaphylactic-type reactions. Furthermore, the product is known to officially interfere with certain clinical procedures. This interference includes altering the results of specific serum iron determinations, potentially causing falsely elevated values of serum bilirubin and falsely decreased values of serum calcium. The medicine is also documented to interfere with Technetium-99m labeled bone-seeking agents used in bone scans.

Population-Specific Notes

The risk of serious hypersensitivity reactions is officially noted as increased for patients with a history of drug allergy and those with inflammatory conditions such as rheumatoid arthritis.

Mechanism of Action

How КосмоФер works

This section explains the biological mechanism of action of КосмоФер, focusing on how its components interact with the body's iron metabolism and synthesis pathways, which drive its core physiological effects.


Controlled Iron Release via the Reticuloendothelial System

This domain covers the drug's initial processing, where the stable iron-dextran complex is taken up by specialized immune cells (macrophages) in the reticuloendothelial system (RES). The complex is broken down inside these cells, which facilitates the sustained release of bioavailable elemental iron (Fe^3+) into the bloodstream. This route of administration utilizes the reticuloendothelial system, an iron processing pathway distinct from intestinal absorption.


Substrate Supply for Hemoglobin Synthesis

This mechanism focuses on the transport and utilization of the released iron, which binds to transferrin to be carried to the bone marrow. Here, the iron is taken up by erythroid precursor cells and rapidly incorporated into the protoporphyrin ring to drive the synthesis of heme and ultimately hemoglobin (Hb).


Restoring Oxygen-Transport Capacity and Iron Reserves

The final physiological consequence of the mechanism is the increased production of functional red blood cells, which contributes to the overall oxygen-transport capacity of the circulatory system. Any surplus iron is sequestered and stored as ferritin and hemosiderin in tissues like the liver and spleen, establishing iron reserves within the body’s storage pool.

Dosage and Administration Information

The administration of КосмоФер (Iron Dextran) follows a calculated, parenteral course of therapy. The medicine is primarily administered via Intravenous (IV) infusion, which is the preferred method, although slow IV injection and deep Intramuscular (IM) injection are also recognized methods.

Administration Scope

Entity Instruction
Dosing Schedule The Total Cumulative Dose is not fixed but is individually calculated based on the patient's current hemoglobin level and body weight. The maximum daily dose for intermittent use is 100 mg.
Preparation Requirements For infusion, the solution must be diluted only in 0.9% sodium chloride or 5% glucose solution.
Age-group Rules The medicine is not recommended for use in children under 14 years.

Instruction Classifications

The overall use of the medicine is characterized by a specific protocol.

Classification Description
Frequency Pattern Intermittent administration (typically two or three times a week) or a Single-Course Total Dose Infusion (TDI).
Use-context Constraints The Total Dose Infusion method is restricted to hospital use only. Concomitant administration of oral iron supplements should be avoided.

Resulting Procedural Structure

The clinical protocol follows a standardized sequence:

  • Test Dose Mandatory: A small 25 mg iron test dose must be given before the full therapeutic dose is administered.
  • Delivery Rate: The IV injection rate must not exceed 10 mg of elemental iron per minute.
  • Course Conclusion: Administration is complete once the total calculated iron deficit has been delivered.

Connection to the overall use protocol: The protocol structures the use of КосмоФер as a precisely calculated, dose-limited course of parenteral therapy. This framework mandates an individualized total dose and requires a preliminary test dose, ensuring the delivery method, rate, and total amount strictly adhere to documented procedures.

Recent Clinical Evidence

Research evidence / Overview of studies

The research evidence for [Drug Name] is primarily focused on its use in chronic neuropathic pain. [Drug Name] is a compound that clinical research has focused on its potential association with changes in chronic neuropathic pain.


Efficacy in Neuropathic Pain

  • Core Studies: Large-scale, randomized controlled trials (RCTs) have investigated outcomes related to changes in pain intensity and the timing of initial observation in patients with chronic neuropathic pain.
  • Key Findings: Phase III trials reported a statistically significant difference in pain scores compared to placebo, based on the [Pain Scale Used] over a 12-week treatment period. The primary studies investigated the effect size observed in this indication.
  • Long-term Data: Follow-up studies of up to one year examined the persistence of the observed change, with data describing the course of symptom intensity over longer timeframes.

Pharmacokinetics and Combination Use

  • Absorption Profile: In some studies, the medication was administered with food to investigate its absorption profile. Other factors, such as age and body weight, were also explored as potential influences on pharmacokinetics.
  • Combination Therapy: Further research explored whether combining this drug with gabapentin was associated with a change in the overall outcome for some patients. These studies focused on patients whose pain was not adequately managed by monotherapy.

Safety and Special Populations

  • Renal Impairment: Studies have evaluated the use in patients with mild to moderate kidney impairment; clinical research highlights the potential for changes in drug clearance in severe renal disease.
  • Adverse Events: Compared to some older treatments, studies reported different adverse event profiles for this medication. The most frequent adverse events reported in the clinical trials were noted.

Other Indications Investigated

Research has explored whether an effect was observed against nerve pain following shingles (post-herpetic neuralgia). These investigations are currently described in the clinical literature, and the findings are part of the broader evidence base.

Key Studies & References Clinical Guideline for the Management of Neuropathic Pain (Relevant National Society)

Frequently Asked Questions (FAQ)

Common questions about КосмоФер (FAQ)


Q: Is КосмоФер considered a type of iron supplement or a medicine?

A: Official drug information classifies this medication as a parenteral iron preparation, also known as a hematinic agent or a mineral supplement. Its purpose is the treatment of documented iron deficiency.

This means it is used to replenish the body’s depleted iron stores.


Q: Does КосмоФер also boost my B12 or other vitamins, or just iron?

A: The active ingredient in this medication is the iron(III)-hydroxide dextran complex, which functions primarily as a source of elemental iron.

According to the official product description, the medication does not list B12 or any other vitamins as components. Its documented mechanism focuses only on supporting the body's iron metabolism.


Q: Can receiving КосмоФер cause my iron levels to become too high (iron overload)?

A: Official regulatory documents warn that excessive therapy with any injectable iron product could potentially lead to the excess storage of iron, which is known as hemosiderosis or iron overload.

This approach supports the goal of correcting the iron deficit while managing the risk of iron accumulation, with iron parameters monitored periodically.


Q: Can КосмоФер be given to people with severe kidney problems?

A: Official guidelines state that this product is contraindicated in patients who have acute renal failure. Caution is also advised when treating patients who have serious kidney infections or other serious kidney-related health problems. Official prescribing information notes that patient status, including kidney function, is reviewed as part of the administration protocol.


Q: Is КосмоФер safe for people who have a history of many different allergies?

A: The official labeling indicates that the risk of hypersensitivity reactions is enhanced for patients who have a history of drug allergy, multiple drug allergies, severe asthma, or atopic allergies. Official guidance states that patients with significant allergies are considered a special risk population, requiring enhanced caution during the screening and administration process.


Q: Why is a past allergic reaction to any injectable iron a warning for КосмоФер?

A: Regulatory documentation states that the product is contraindicated if a patient has a known serious hypersensitivity to other parenteral iron products.

This caution is in place due to the potential for cross-reactivity between different types of injectable iron formulations.


Q: What if I have a chronic or active bacterial/viral infection; can I still receive КосмоФер?

A: The official product information specifies that this product is contraindicated if the patient has an acute or chronic bacterial or viral infection.

This is because official documents indicate that the administration of injectable iron may potentially worsen certain bacterial or viral infections.


Q: Is it true that people with rheumatoid arthritis or lupus need extra caution with КосмоФер?

A: According to official regulatory sources, the risk of experiencing a hypersensitivity reaction is increased in patients who have certain immune or inflammatory conditions.

These specifically include conditions such as systemic lupus erythematosus (Lupus) and rheumatoid arthritis.


Q: Are there any known issues with giving КосмоФер to older adults?

A: Official safety reviews, including sections on geriatric use, indicate that no overall differences in safety or effectiveness have been observed between older adult patients and younger adult patients. Administration protocols reflect the need for the dosage and therapy course to be individualized based on the patient’s overall health status.


Q: Can I breastfeed after receiving a КосмоФер infusion?

A: Official regulatory documents note that special caution is required when the product is administered to a nursing woman.

This is because traces of the iron dextran complex are known to be excreted into human milk.


Q: Is a metallic taste in the mouth a common side effect of КосмоФер?

A: A change in taste, which may include a metallic taste in the mouth, is listed in product summaries as a possible adverse reaction.

The incidence rate of this specific side effect is noted as being unknown.


Q: What does it mean if I feel dizziness or flushing during the infusion?

A: Dizziness and flushing (a warm, reddening sensation) are listed in official documents as common adverse reactions that may occur during the infusion process. Patients are typically monitored closely during the administration process.


Q: Does КосмоФер cause permanent skin staining at the injection site?

A: Official documentation mentions that if the product is administered via deep intramuscular injection, the deep intramuscular procedure is used to minimize the risk of subcutaneous staining. Additionally, if the product leaks outside the vein during intravenous administration (extravasation), this can also lead to skin staining.


Q: Does КосмоФер interact with alcohol consumption?

A: Regulatory safety information includes a note that the use of alcohol may potentially increase the risk of certain side effects. Information regarding alcohol consumption can be obtained from the prescribing healthcare provider.


Q: Are there any long-term health concerns associated with repeated use of КосмоФер?

A: Official regulatory information mentions that studies in some animal species using very large doses did produce a type of tumour called a sarcoma. However, the available data consistently indicate that the risk of sarcoma formation in humans following treatment is considered minimal.


Q: How long does the actual infusion of КосмоФер typically take?

A: The total time required depends on the specific method of administration. For a slow intravenous injection, the administration rate is limited to 50 mg per minute or less. A Total Dose Infusion (TDI), used for larger doses, is typically infused over a longer duration, such as 4 to 6 hours.


Q: How soon after the КосмоФер infusion should I start to feel more energetic?

A: The desired result of the treatment is the improvement in blood parameters, such as hemoglobin, which may take several weeks. While official documents describe this goal, they do not specify a precise time frame for when an individual patient will start to feel specific symptom relief, such as feeling more energetic.


Q: Why do I need to stay for observation for a period after receiving КосмоФер?

A: Regulatory documents state that each patient is to be observed for adverse effects for at least 30 minutes to one hour following administration. This observation period is mandated due to the known risk of serious and potentially fatal hypersensitivity reactions.


Q: How long after the last infusion will my doctor check my blood levels again?

A: Official prescribing information states that all patients are subject to periodic monitoring of their iron and blood parameters after treatment. Clinical summaries indicate that serum ferritin levels usually peak within about 7 to 9 days and return to baseline after roughly three weeks, suggesting monitoring often occurs sometime after this period.


Q: Does the treatment with КосмоФер correct the cause of my iron deficiency?

A: The official role of this product is to treat the iron deficiency by efficiently replacing the body’s iron stores. However, regulatory information emphasizes that the identification and elimination of the underlying cause of the iron deficiency is also considered essential to the patient's overall management.


Q: What is the process for receiving the small 'test dose' of КосмоФер?

A: As part of the official protocol, a small test dose of 25 mg is administered slowly before the full dose. The protocol requires the patient to be observed for a set period, which is typically 15 minutes to 1 hour, to monitor for any reactions before the rest of the medication is given.


Q: Does the injection site hurt, and is there a way to prevent pain during the IV insertion?

A: Soreness or pain at the injection site is documented as a possible local adverse reaction following administration. Official labeling, however, does not detail specific steps or methods for preventing pain related to the IV insertion procedure itself.


Q: Is there an interaction between КосмоФер and my prescription medications?

A: Regulatory labeling explicitly documents specific interactions with certain classes of medications. These include Angiotensin-Converting Enzyme (ACE) Inhibitor drugs and any administration of oral iron preparations.

How should КосмоФер be stored and disposed of?

Storage and Disposal Requirements for CosmoFer

The official labeling for CosmoFer (iron(III)-hydroxide dextran complex) solution for injection specifies mandatory conditions for product integrity and environmental safety.


Storage Conditions

The medicine must not be frozen and generally does not require any special storage conditions, though some guidance specifies storing below 25 C. The ampoules must be visually inspected before use to confirm the solution is sediment-free and homogeneous. The product is for single use only. Once diluted, stability is demonstrated for 24 hours at 25 C.

Child Safety and Disposal

CosmoFer must be kept out of the reach and sight of children. Any unused product or waste material must be disposed of in accordance with local requirements for pharmaceutical waste.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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