Ferric Citrate Hydrate

Ferric Citrate Hydrate Uses, Dosage, Side Effects, Food Interaction and all others data.

Ferric Citrate Hydrate is an iron containing phosphate binder used to treat hyperphosphatemia and iron deficiency anemia in adults with chronic kidney disease.

Ferric Citrate Hydrate was granted FDA approval on 5 September 2014.

Ferric Citrate Hydrate is an iron containing product indicated to treat iron deficiency anemia and hyperphosphatemia. It has a wide therapeutic index, as doses can be varied significantly between patients. Ferric Citrate Hydrate has a long duration of action in the treatment of iron deficiency anemia, due to the slow loss of iron from the body, and a moderate duration of action in the treatment of hyperphosphatemia, due to its action being dependant on residence time in the gastrointestinal tract. Patients should be counselled regarding the risk of iron overload.

Ferric Citrate Hydrate
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Ferric Citrate Hydrate
Generic	Tetraferric tricitrate decahydrate
Tetraferric tricitrate decahydrate Other Names	Ferric citrate, Ferric citrate hydrate
Type
Formula	C₁₈H₃₂Fe₄O₃₁
Weight	Average: 967.803 Monoisotopic: 967.832498
Protein binding	Ferric iron is reduced to ferrous iron, which is carried by transferrin in serum.
Groups	Approved
Therapeutic Class
Manufacturer
Available Country
Last Updated:	September 19, 2023 at 7:00 am

Uses

Ferric citrate is a phosphate binder used to control serum phosphorus levels or as an iron supplement.

Ferric Citrate Hydrate is indicated to control serum phosphorous in adults with chronic kidney disease who require dialysis. Ferric Citrate Hydrate is also indicated to treat iron deficiency anemia in adults with chronic kidney disease who are not on dialysis.

Ferric Citrate Hydrate is also used to associated treatment for these conditions: Hyperphosphataemia, Iron Deficiency Anemia (IDA)

How Ferric Citrate Hydrate works

Ferric (Fe³⁺) iron is absorbed from the gastrointestinal tract by divalent metal transporter-1, and reduced to ferrous (Fe²⁺) iron by ferrireductase and cytochrome b reductase 1. Ferrous iron is stored intracellularly in ferritin and transported into the blood by ferroportin 1. Transport by ferroportin 1 is coupled with oxidation to ferric iron by hephaestin or ceruloplasmin. Ferric iron in plasma is bound to transferrin, which carries iron to other cells. Iron is transported to mitochondria for the synthesis of heme or iron-sulfur clusters, which are integral parts of several metalloproteins like hemoglobin.

Ferric iron can also bind to phosphate in the gastrointestinal tract, which precipitates as the insoluble ferric phosphate. Ferric phosphate remains unabsorbed and is eliminated in the feces. Decreased phosphate absorption gradually lowers phosphate levels in the blood.

Toxicity

Patients experiencing an overdose of iron may present with nausea, vomiting, abdominal pain, diarrhea, fluid and blood loss, hypovolemia, hematemesis, perforation, and peritonitis. Mild overdoses can be treated with symptomatic and supportive measures. More severe overdoses may require more intense treatment including chelating agents, and intravenous fluids. Activated charcoal is not expected to be beneficial in the case of iron overdose.

The acute oral LD₅₀ in rats is 1487mg/kg and in mice is 1520mg/kg. The acute dermal LD₅₀ in rabbits is 2000mg/kg.

Food Interaction

Take with food.

Elimination Route

Ferric iron has been shown to have inferior bioavailability to ferrous iron preparations. Ferric Citrate Hydrate has 19% the bioavailability of ferrous ascorbate.

Clearance

Data regarding the clearance of iron is not readily available. However, iron loss due to exfoliation of epithelial cells is approximately 1mg/day.

Elimination Route

Unabsorbed oral Ferric Citrate Hydrate is eliminated in the feces. The absorbed iron from Ferric Citrate Hydrate is generally not eliminated from the body by any route other than blood loss and exfoliation of epithelial cells.