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LEDISEPT-FARMEKS

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Daniel Cichi

Family medicine24 years of experience

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance.

His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation.

Patients commonly consult Dr Daniel Cichi for:

  • acute symptoms: fever, infections, flu-like illness, cough, sore throat, shortness of breath;
  • chest discomfort, palpitations, dizziness, fatigue, and blood pressure concerns;
  • digestive problems: abdominal pain, nausea, diarrhoea, constipation, reflux;
  • muscle, joint, and back pain, minor injuries, post-traumatic symptoms;
  • chronic conditions: hypertension, diabetes, high cholesterol, thyroid disorders;
  • review and interpretation of lab tests, imaging reports, and medical documents;
  • medication review and treatment adjustment;
  • medical advice while travelling or living abroad;
  • second opinions and guidance on whether in-person care is needed.
Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.
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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use LEDISEPT-FARMEKS

INSTRUCTIONS for medical use of the medicinal product Balance 4.25% glucose 1.25 mmol/l calcium

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INSTRUCTIONS for medical use of the medicinal product Balance 4.25% glucose 1.25 mmol/l calcium

Balance 4.25% glucose 1.25 mmol/l calcium

Composition:

active substances: calcium chloride dihydrate; sodium chloride; sodium (S)-lactate solution (sodium (S)-lactate); magnesium chloride hexahydrate; glucose monohydrate (anhydrous glucose).

Description:

"Balance 4.25% glucose 1.25 mmol/l calcium" is supplied in a two-chamber bag. One chamber contains an alkaline lactate solution, and the other chamber contains an electrolyte solution based on glucose. Mixing of the solutions of both chambers occurs by opening the middle seam between the two chambers, resulting in the formation of a neutral ready-to-use solution.

Before mixing:

1 liter of acidic electrolyte solution based on glucose contains:

Calcium chloride dihydrate0.3675 g
Sodium chloride11.279 g
Magnesium chloride hexahydrate0.2033 g
Glucose monohydrate (anhydrous glucose)93.5 g (85.0 g)

1 liter of alkaline lactate solution contains: sodium (S)-lactate solution 15.69 g (sodium (S)-lactate 7.85 g)

After mixing:

1 liter of neutral, ready-to-use solution contains:

Calcium chloride dihydrate0.1838 g
Sodium chloride5.640 g
Sodium (S)-lactate solution (sodium (S)-lactate)7.85 g (3.925 g)
Magnesium chloride hexahydrate0.1017 g
Glucose monohydrate (anhydrous glucose)46.75 g (42.5 g)

ions:

Ca2+1.25 mmol
Na+134 mmol
Mg2+0.5 mmol
Cl-100.5 mmol
(S)-lactate35 mmol
Glucose235.8 mmol

Excipients:

water for injection, hydrochloric acid, sodium hydroxide, sodium bicarbonate.

Pharmaceutical form.

Solution for peritoneal dialysis.

Main physical and chemical properties:

A two-chamber bag containing a clear colorless aqueous solution.

Ready-to-use solution:
Theoretical osmolality509 mOsm/l
pH ≈7.0

Pharmacotherapeutic group.

Solution for peritoneal dialysis. Hypertonic solutions.

ATC code V05D B.

Pharmacological properties.

Pharmacodynamics.

"Balance 4.25% glucose 1.25 mmol/l calcium" is an electrolyte solution containing glucose and lactate buffer, intended for intraperitoneal use in the treatment of terminal stage renal failure of various genesis using continuous ambulatory peritoneal dialysis (CAPD).

Pharmacokinetics.

Uremic products (such as urea, creatinine, and uric acid), inorganic phosphates, and electrolytes such as sodium, potassium, calcium, and magnesium are removed from the body into the dialysis solution by diffusion and convection.

Non-clinical data on safety.

Non-clinical studies on the toxicity of the "Balance 4.25% glucose 1.25 mmol/l calcium" solution were not conducted.

Clinical characteristics.

Indications.

Terminal (decompensated) stage of chronic renal failure of various origins, subject to treatment with peritoneal dialysis.

Contraindications.

The "Balance 4.25% glucose 1.25 mmol/l calcium" solution should not be used in patients with lactic acidosis, severe hypokalemia, severe hypocalcemia, hypovolemia, and arterial hypotension.

Special precautions for use.

Before using the "Balance 4.25% glucose 1.25 mmol/l calcium" solution for peritoneal dialysis, it is necessary to familiarize yourself with the instructions for medical use.

Interaction with other medicinal products and other types of interactions.

The use of this solution for peritoneal dialysis may lead to a decrease in the effectiveness of other medicinal products, as they may penetrate into the dialysate and be excreted from the body together with it.

Special features of use.

The solution for peritoneal dialysis should not be administered intravenously.

Method of administration and dosage.

This solution is intended exclusively for intraperitoneal use.

Continuous ambulatory peritoneal dialysis (CAPD):

Adults: If there are no other prescriptions, the patient is prescribed 2000 ml of solution per exchange, four times a day.

Automated peritoneal dialysis (APD):

If an apparatus (slip-safe cyclator) is used for intermittent or continuous cyclic peritoneal dialysis, it is recommended to use bags of a larger volume, which allows for more than one exchange of the solution.

Handling (operation method)

The ready-to-use solution should be used immediately.

"Stay-safe" system for continuous ambulatory peritoneal dialysis (CAPD)

The bag with the solution is preheated to body temperature.

"Slip-safe" system for automated peritoneal dialysis (APD)

To start the treatment procedure, it is necessary to insert the slip-safe system connectors with the prescribed solution into the free ports of the cyclator tray.

Adverse reactions.

"Balance 4.25% glucose 1.25 mmol/l calcium" is an electrolyte solution, the composition of which is similar to that of blood.

Potential adverse reactions associated with the peritoneal dialysis solution

Endocrine system disorders: secondary hyperparathyroidism with possible bone metabolism disorders (unknown).

Potential adverse reactions of peritoneal dialysis as a method

Infections and invasions: peritonitis (very common), indicated by clouding of the dialysate being drained.

Shelf life.

The shelf life in the original packaging for sale is 2 years.

Storage conditions.

Store at a temperature not below 4 °C.

Incompatibility.

The medicinal product should be used only as prescribed by a doctor to avoid the risks of incompatibility and contamination.

Packaging.

2000 ml or 2500 ml in a two-chamber bag "stay-safe" system; 4 bags in a cardboard box with a sticker in Ukrainian or with labeling in Ukrainian and other languages;

Release category.

By prescription.

Manufacturer.

Fresenius Medical Care Deutschland GmbH.

Location of the manufacturer and address of the place of its activities.

Frankfurter Strasse 6-8, 66606 St. Wendel, Germany.

Applicant.

Fresenius Medical Care Deutschland GmbH.

Location of the applicant.

Else-Kroener-Strasse 1, 61352 Bad Homburg v.d.H., Germany.

Alternatives to LEDISEPT-FARMEKS in other countries

The best alternatives with the same active ingredient and therapeutic effect.

Alternative to LEDISEPT-FARMEKS in Польша

Dosage form: Капсулы, не менее 10^8 КОЕ + не менее 10^8 КОЕ
Manufacturer: ADM Denmark A/S
Prescription not required

Alternative to LEDISEPT-FARMEKS in Испания

Dosage form: ВАГИНАЛЬНЫЙ СУППОЗИТОРИЙ/КАПСУЛА/ТАБЛЕТКА, 1x10^8/1x10^8 КОЕ
Active substance: lactobacillus
Manufacturer: Casen Recordati S.L.
Prescription not required
Dosage form: ВАГИНАЛЬНЫЙ ПОЛУЖИДКИЙ ПРЕПАРАТ, 10 мг
Active substance: циклопирокс
Manufacturer: Galenicum Derma S.L.U.
Prescription required
Dosage form: ВАГИНАЛЬНЫЙ РАСТВОР, 10% повидон-йод
Active substance: Повидон-йод
Prescription not required

Online doctors for LEDISEPT-FARMEKS

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for LEDISEPT-FARMEKS – subject to medical assessment and local rules.

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Doctor

Daniel Cichi

Family medicine24 years of experience

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance.

His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation.

Patients commonly consult Dr Daniel Cichi for:

  • acute symptoms: fever, infections, flu-like illness, cough, sore throat, shortness of breath;
  • chest discomfort, palpitations, dizziness, fatigue, and blood pressure concerns;
  • digestive problems: abdominal pain, nausea, diarrhoea, constipation, reflux;
  • muscle, joint, and back pain, minor injuries, post-traumatic symptoms;
  • chronic conditions: hypertension, diabetes, high cholesterol, thyroid disorders;
  • review and interpretation of lab tests, imaging reports, and medical documents;
  • medication review and treatment adjustment;
  • medical advice while travelling or living abroad;
  • second opinions and guidance on whether in-person care is needed.
Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.
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Roman Raevskii

General medicine7 years of experience

Dr. Roman Raevskii is a licensed general practitioner in Spain, offering online medical consultations with a strong focus on prevention, early diagnosis, and personalized care. He combines evidence-based clinical expertise with a patient-centered approach to deliver comprehensive support.

Dr. Raevskii provides medical care in the following areas:

  • Diagnosis and management of common conditions: hypertension, diabetes, respiratory and digestive disorders.
  • Oncological consultations: early cancer detection, risk evaluation, and treatment navigation.
  • Supportive care for oncology patients – pain control, symptom relief, and side effect management.
  • Preventive medicine and health screenings.
  • Development of tailored treatment plans based on clinical guidelines.

With a patient-centred approach, Dr. Raevskii helps individuals manage both chronic illnesses and complex oncological cases. His consultations are guided by current medical standards and adapted to each patient’s needs.

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Iryna Reznychenko

Gynecology26 years of experience

Dr Iryna Reznychenko is an obstetrician-gynaecologist, paediatric gynaecologist, and certified lactation consultant. She provides online consultations for women at all stages of life – from adolescence to menopause. Her work combines medical care for gynaecological conditions with dedicated support for breastfeeding challenges, both physical and emotional.

Areas of expertise:

  • interpretation of test results and personalised treatment planning
  • menstrual irregularities, PCOS, endometriosis
  • abnormal uterine bleeding, endometrial hyperplasia, cervical dysplasia
  • care during perimenopause and menopause, hormonal balance, cancer prevention
  • breastfeeding issues: nipple pain, cracked skin, blocked ducts, low milk supply
  • support during the postpartum and lactation period
Dr Reznychenko offers a clear, attentive and professional approach. Her consultations help prevent minor discomforts from developing into more serious concerns – all in a convenient online format.
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Andreea Mateescu

Pediatrics8 years of experience

Dr Andreea Mateescu is a board-certified paediatrician with 7 years of clinical experience. She graduated from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and completed her paediatric residency at INSMC Alessandrescu-Rusescu. She also holds additional training in general ultrasound diagnostics.

Dr Mateescu focuses on providing high-quality, evidence-based medical care for children, with a strong emphasis on prevention, healthy development, and long-term wellbeing. She believes that clear, empathetic communication with both children and parents is essential for building trust and ensuring effective care.

Online consultations with Dr Mateescu are suitable for:

  • preventive check-ups and monitoring of growth and development;
  • vaccination planning, including personalised and catch-up schedules;
  • assessment of psychomotor, emotional, and physical development;
  • diagnosis and management of acute and chronic paediatric conditions;
  • nutritional guidance for infants and children, including formula selection when medically indicated;
  • care for children with complex or rare conditions;
  • practical guidance and ongoing support for parents.
Dr Mateescu works with patience, empathy, and professionalism, ensuring that each child receives attentive, individualised care. Her goal is to support healthy, balanced development while helping parents feel confident and well-informed at every stage of their child’s care.
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Tomasz Grzelewski

Dermatology21 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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Hocine Lokchiri

General medicine21 years of experience

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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Salome Akhvlediani

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  • Fever, infections, cough, sore throat, and digestive issues.
  • Preventive care – vaccinations, regular check-ups, and health monitoring.
  • Allergies, asthma, and skin conditions.
  • Nutritional advice and healthy development support.
  • Sleep difficulties, fatigue, and behavioural concerns.
  • Ongoing care for chronic or complex health conditions.
  • Guidance for parents and follow-up after medical treatment.

Dr Akhvlediani combines professional care with a warm, attentive approach – helping children stay healthy and supporting parents at every stage of their child’s growth.

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Tetiana Fursenko

Otolaryngology (ENT)5 years of experience

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Common concerns addressed during consultation:

  • Nasal congestion, runny nose, sinusitis, rhinitis, and hay fever.
  • Ear pain, otitis (middle ear infections), earwax buildup, hearing loss.
  • Sore throat, tonsillitis, pharyngitis, chronic throat irritation.
  • Hoarseness, loss of voice, laryngitis.
  • Allergic rhinitis, sneezing, nasal itching, seasonal allergies.
  • Snoring, mouth breathing, enlarged adenoids.
  • Frequent colds, lingering post-viral symptoms.
  • Foreign objects in the ear or nose.
  • ENT-related check-ups and chronic condition follow-up.

Dr. Fursenko helps patients manage symptoms early, avoid complications, and receive timely treatment. Online ENT consultations are a convenient way to access care for both urgent and recurring conditions — from anywhere.

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Jonathan Marshall Ben Ami

Family medicine9 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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  • Chronic pain lasting more than 3 months.
  • Migraines and recurring headaches.
  • Neck, back, lower back, and joint pain.
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  • High blood pressure and metabolic conditions such as diabetes.
  • Preventive care and routine health check-ups.

Online consultations last up to 30 minutes and include a detailed symptom review, personalised treatment planning, and medical follow-up when needed.

Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

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