Ferric citrate
Generic name: ferric citrate [ FER-ik-SIT-rate ]
Brand name: Auryxia
Dosage form: oral tablet (210 mg)
Drug class: Phosphate binders
What is ferric citrate?
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.
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.
Ferric citrate may cause serious side effects. Call your doctor at once if you have:
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severe stomach problems--stomach pain, vomiting, constipation, diarrhea, nausea; or
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high blood potassium--weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.
Common side effects of ferric citrate may include:
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diarrhea, constipation;
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dark colored stools;
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nausea, vomiting, stomach pain; or
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.
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Warnings
Keep ferric citrate out of the reach of children. An accidental overdose of ferric citrate can be fatal.
Before taking this medicine
You should not use ferric citrate if you have an iron overload disorder (hemochromatosis).
Tell your doctor if you have or have ever had:
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high levels of iron in your blood; or
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any other medical conditions.
Tell your doctor if you are pregnant or breastfeeding.
How should I take ferric citrate?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Take ferric citrate with meals. You will need to follow a special diet. Follow all instructions of your doctor or dietitian. Learn about the foods you should eat or avoid.
Swallow the tablet whole and do not crush, chew, or break it. The pill may discolor your teeth or mouth.
You will need frequent blood tests to check your iron levels.
Ferric citrate may cause discolored (dark) stools but this discoloration is considered normal.
Store at room temperature, away from moisture and heat.
Ferric citrate dosing information
Usual Adult Dose for Hyperphosphatemia of Renal Failure:
Each tablet contains ferric iron 210 mg equivalent to ferric citrate 1 g
Initial dose: 2 tablets orally 3 times a day with meals
-Adjust dose in increments/decrements of 1 to 2 tablets per day per week or longer intervals to maintain serum phosphorous at target levels
Average dose: 8 to 9 tablets per day
Maximum dose: 12 tablets per day
Comments:
-Monitor serum phosphorous and titrate dose accordingly.
-Tablets should not be chewed or crushed because it may cause discoloration of mouth and teeth.
Use: Control of serum phosphorous levels in patients with chronic kidney disease on dialysis.
Usual Adult Dose for Anemia Associated with Chronic Renal Failure:
Each tablet contains ferric iron 210 mg equivalent to ferric citrate 1 g
Initial dose: 1 tablet orally 3 times a day with meals
-Adjust dose as needed to achieve and maintain target hemoglobin levels
Average dose: 5 tablets per day
Maximum dose: 12 tablets per day
Comments:
-Tablets should not be chewed or crushed because it may cause discoloration of mouth and teeth.
Use: Treatment of iron deficiency anemia in patients with chronic kidney disease not on dialysis.
Usual Adult Dose for Iron Deficiency Anemia:
Each tablet contains ferric iron 210 mg equivalent to ferric citrate 1 g
Initial dose: 1 tablet orally 3 times a day with meals
-Adjust dose as needed to achieve and maintain target hemoglobin levels
Average dose: 5 tablets per day
Maximum dose: 12 tablets per day
Comments:
-Tablets should not be chewed or crushed because it may cause discoloration of mouth and teeth.
Use: Treatment of iron deficiency anemia in patients with chronic kidney disease not on dialysis.
What happens if I miss a dose?
Take the medicine (with food) as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
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 takes ferric citrate.
What should I avoid while taking ferric citrate?
Do not take a vitamin or mineral supplement that contains iron while you are taking ferric citrate, unless your doctor tells you to.
What other drugs will affect ferric citrate?
Ferric citrate can make it harder for your body to absorb other medicines you take by mouth. Avoid taking other medicines at the same time as ferric citrate.
If you take any of the following medicines, take them as follows:
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An antibiotic called doxycycline: take ferric citrate at least 1 hour before you take ferric citrate.
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An antibiotic called ciprofloxacin: take it at least 2 hours before or 2 hours after you take ferric citrate.
Tell your doctor about all your other medicines, especially:
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iron supplements or any other medications that contain iron.
This list is not complete. Other drugs may affect ferric citrate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
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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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