Disch G, Classen H G, Spätling L, Leifert U, Schumacher E
Department of Pharmacology and Toxicology of Nutrition, University of Hohenheim, Stuttgart-Hohenheim, Germany.
Arzneimittelforschung. 1996 Mar;46(3):302-6.
Since in vitro experiments had excluded interactions between Fe-gluconate (Fe-gluc) and magnesium-L-aspartate hydrochloride (MAH) in aqueous solutions the present in vivo studies seemed to be justified. Animal studies: Rats were kept on magnesium-(Mg)- and iron-(Fe)- sufficient and deficient diets. The intragastral administration of Fe-gluc significantly increased plasma Fe after 3 h, either given alone, or in combination with MAH (inducing hypermagnesemia). Same results were obtained when fortified diets were offered to Fe/Mg-deficient animals. Human studies: The combination of Fe-gluc (2 x 50 mg Fe per day, per os) plus MAH (2 x 7.5 mmol Mg per day, p.o.) was well tolerated by healthy volunteers. Single dose experiments revealed that Fe-gluc alone and in combination with MAH increased plasma Fe levels during 3 h to the same extent. Two groups of pregnant women with moderately reduced hemoglobin levels either received Fe-gluc (out-patients) or its combination with MAH (at least temporarily hospitalised because of preterm labor). Treatments were well tolerated. Hemoglobin levels did not further decrease, as expected without Fe supplements, during the course of pregnancy, thus indicating the therapeutic availability of the electrolytes in both study groups. Progesterone-induced constipation is frequently observed during pregnancy; hence stool softening reported by 50% of the women receiving Fe-gluc plus MAH (versus 33% in the Fe-gluc group) can be regarded as desirable effect. It is concluded that MAH does not interfere with the enteral absorption of Fe-gluc when both electrolytes are orally administered together. Taking both electrolytes together instead of 2 to 3 h apart from each other, as actually recommended, means a less complicated dosage regimen and probably improves compliance.
由于体外实验已排除葡萄糖酸铁(Fe-gluc)与盐酸L-天冬氨酸镁(MAH)在水溶液中的相互作用,因此目前的体内研究似乎是合理的。动物研究:将大鼠分别置于镁(Mg)和铁(Fe)充足及缺乏的饮食环境中。单独或与MAH联合(诱导高镁血症)胃内给予葡萄糖酸铁后3小时,血浆铁显著增加。给铁/镁缺乏的动物喂食强化饮食时也得到了相同的结果。人体研究:健康志愿者对葡萄糖酸铁(每天口服2×50mg铁)加MAH(每天口服2×7.5mmol镁)的组合耐受性良好。单剂量实验表明,单独的葡萄糖酸铁及其与MAH联合使用在3小时内使血浆铁水平升高的程度相同。两组血红蛋白水平中度降低的孕妇分别接受葡萄糖酸铁(门诊患者)或其与MAH的组合(因早产至少短期住院)。治疗耐受性良好。在妊娠期间,血红蛋白水平并未如预期在不补充铁的情况下进一步下降,因此表明两个研究组中电解质都具有治疗有效性。妊娠期间经常观察到孕酮引起的便秘;因此,接受葡萄糖酸铁加MAH的女性中有50%报告大便软化(葡萄糖酸铁组为33%)可被视为有益效果。结论是,当两种电解质一起口服时,MAH不会干扰葡萄糖酸铁的肠道吸收。将两种电解质一起服用,而不是像实际建议的那样间隔2至3小时服用,意味着给药方案更简单,可能会提高依从性。