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Ferric citrate

Generic Name: ferric citrate (FER ik SIT rate)
Brand Name: Auryxia

Medically reviewed on November 9, 2017.

What is ferric citrate?

Ferric citrate contains iron that binds to the phosphates you take in through food, which helps your body absorb fewer phosphates. This can lower the amount of phosphorus (a mineral) in your blood.

Ferric citrate is used to control phosphorus levels in adults with chronic kidney disease who are on dialysis.

Ferric citrate is also used to treat iron deficiency anemia in adults with chronic kidney disease who are not on dialysis.

Ferric citrate may also be used for purposes not listed in this medication guide.

Important Information

Keep this medicine out of the reach of children. An accidental overdose of ferric citrate by a child can be fatal.

Before taking this medicine

You should not use ferric citrate if you are allergic to it, or if you have:

To make sure ferric citrate is safe for you, tell your doctor if you have ever had:

  • liver disease;

  • a stomach or intestinal disorder;

  • stomach bleeding; or

  • stomach or intestinal surgery.

It is not known whether this medicine will harm an unborn baby. An overdose of iron can cause miscarriage, birth defects, or pregnancy-related diabetes. Tell your doctor if you are pregnant or plan to become pregnant while taking this medicine.

It is not known whether ferric citrate passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Your dose needs may be different during pregnancy or while you are nursing.

This medicine is not approved for use by anyone younger than 18 years old.

How should I take ferric citrate?

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not crush or chew a ferric citrate tablet. The pill may discolor your teeth or mouth.

Ferric citrate works best if you take it with meals.

Ferric citrate contains iron, which is absorbed and stored by your body while you are taking this medicine. To make sure your body is not storing too much iron, you will need frequent blood tests to check your iron levels.

Ferric citrate may be only part of a complete program of treatment that also includes a special diet. Follow the diet plan created for you by your doctor or nutrition counselor. Get familiar with the list of foods you should eat or avoid to help control your condition.

Store this medicine in the original container at room temperature away from moisture and heat.

Keep the bottle tightly closed and out of the reach of children. Accidental iron overdose is a leading cause of death in children younger than 6 years old.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of iron can be fatal to a child who accidentally consumes this medicine.

What should I avoid while taking ferric citrate?

Avoid taking other medicines at the same time of day with ferric citrate. If you also take an antibiotic called doxycycline, take it at least 1 hour before you take ferric citrate. If you take an antibiotic called ciprofloxacin, take it at least 2 hours before or 2 hours after you take ferric citrate.

Do not take a vitamin or mineral supplement that contains iron while you are taking ferric citrate, unless your doctor has told you to.

Ferric citrate side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe stomach problems (pain, vomiting, diarrhea); or

  • high potassium--nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common side effects may include:

  • diarrhea, constipation;

  • darker color in your bowel movements;

  • nausea, vomiting, stomach pain; or

  • cough.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Ferric citrate dosing information

Usual Adult Dose for Hyperphosphatemia of Renal Failure:

Initial dose: 2 tablets (2 grams ferric citrate) orally 3 times a day with meals
-Adjust dose in increments of 1 to 2 tablets per day as needed to maintain target serum phosphorous levels.
Average dose: 8 to 9 tablets per day
Maximum dose: 12 tablets per day

Comments:
-Monitor serum phosphorous and titrate dose accordingly.

Use(s): Control of serum phosphorous levels in patients with chronic kidney disease on dialysis

Usual Adult Dose for Anemia Associated with Chronic Renal Failure:

Initial dose: 1 tablet (1 gram ferric citrate) orally 3 times a day with meals
-Adjust dose as needed to maintain target hemoglobin levels.
Average dose: 5 tablets per day
Maximum dose: 12 tablets per day

Comments:

Use(s): Iron deficiency anemia in patients with chronic kidney disease not on dialysis

Usual Adult Dose for Iron Deficiency Anemia:

Initial dose: 1 tablet (1 gram ferric citrate) orally 3 times a day with meals
-Adjust dose as needed to maintain target hemoglobin levels.
Average dose: 5 tablets per day
Maximum dose: 12 tablets per day

Comments:

Use(s): Iron deficiency anemia in patients with chronic kidney disease not on dialysis

What other drugs will affect ferric citrate?

Other drugs may interact with ferric citrate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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