Ferric Citrate

Ferric Citrate is indicated in-

• The control of serum phosphorus levels in adult patients with chronic kidney disease on dialysis.
• The treatment of iron deficiency anemia in adult patients with chronic kidney disease not on dialysis.

Ferric iron binds dietary phosphate in the Gl tract and precipitates as ferric phosphate. This compound is insoluble and is excreted in the stool. By binding phosphate in the Gl tract and decreasing absorption, ferric iron lowers the phosphate concentration in the serum. Ferric iron is reduced from the ferric to the ferrous form by ferric reductase in the Gl tract. After transport through the enterocytes into the blood, oxidized ferric iron circulates bound to the plasma protein transferrin, and can be incorporated into hemoglobin.

Hyperphosphatemia in Chronic Kidney Disease on Dialysis:

• Starting dose is 2 tablets orally 3 times per day with meals
• Adjust dose by 1 to 2 tablets as needed to maintain serum phosphorus at target levels, up to a maximum of 12 tablets daily. Dose can be titrated at 1-week or longer intervals.

Iron Deficiency Anemia in Chronic Kidney Disease not on Dialysis:

• Starting dose is 1 tablet orally 3 times per day with meals
• Adjust dose as needed to achieve and maintain hemoglobin goal, up to a maximum of 12 tablets daily or as directed by the physician.

Use in Children & Adolescents: The safety and efficacy of Ferric Citrate have not been established in Children & Adolescents.

Oral drugs such as Doxycycline & Ciprofloxacin have to be separated from Ferric Citrate.

Ferric Citrate is contraindicated in patients with iron overload syndrome (Hemochromatosis).

Most common adverse reactions are discolored feces, diarrhoea, constipation, nausea, vomiting, cough, abdominal pain and hyperkalemia.

There are no available data on Ferric Citrate use in pregnant women & Lactating mother.

Iron absorption from Phoscon may lead to excessive elevations in iron stores. May increase in serum ferritin and transferrin saturation (TSAT) levels. Patients may require a reduction in dose or discontinuation of intravenous iron.

Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6 years of age. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center in hospital immediately.

No data are available regarding overdose of Ferric Citrate in patients. In patients with Chronic Kidney Disease, the maximum dose studied was 2,520 mg ferric iron per day.

Oral Iron preparations

Store below 30°C, away from light and in a dry place. Keep out of the reach of children.