ferric citrate

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ferric citrate

(fe-rik si-trate)


Therapeutic: electrolyte modifiers
Pharmacologic: phosphate binders
Pregnancy Category: B


Control of serum phosphorous in chronic renal failure patients on dialysis.


Binds phosphorous and precipitates it as ferric phosphate.

Therapeutic effects

Maintenance of normal phosphorous levels.


Absorption: Some absorption follows oral administration and may lead to iron overload.
Distribution: Unknown.
Metabolism and Excretion: Following binding, precipitated ferric phosphate is excreted in stool.
Half-life: Unknown.

Time/action profile (lowering of serum phosphorous)

POwithin 1 wkunknownunknown


Contraindicated in: Iron overload syndromes including hemochromatosis).
Use Cautiously in: GI bleeding/inflammation; Obstetric: Use cautiously during pregnancy (consider effects on vitamins/nutrient and potential iron overload); Lactation: Consider possible iron transport into milk; Pediatric: Safe and effective use in children has not been established.

Adverse Reactions/Side Effects


  • diarrhea (most frequent)
  • discolored feces (most frequent)
  • nausea (most frequent)
  • constipation
  • vomiting


  • iron overload


Drug-Drug interaction

Will bind and ↓ absorption of doxycycline (should be given one hr prior to ferric citrate).


Oral (Adults) 2 tablets (2 g ferric citrate) three times daily. Adjust by 1–2 tablets/day at weekly (or longer) intervals to attain target phosphorous levels.


Tablets: 1 g (contains 210 mg ferric iron)

Nursing implications

Nursing assessment

  • Monitor clinical responses or blood levels of concurrent medications; may decrease bioavailability of medications administered concurrently.
  • Lab Test Considerations: Monitor serum phosphorous prior to starting and periodically during therapy to keep serum phosphorous at target levels.
    • Assess iron parameters (serum ferritin and transferritin saturation TSAT) prior to starting and periodically during therapy. May cause ↑ serum ferritin and TSAT requiring reduced dose or discontinuation of IV iron therapy.

Potential Nursing Diagnoses

Deficient knowledge, related to medication regimen (Patient/Family Teaching)


  • Oral: Administer 3 times daily with meals.

Patient/Family Teaching

  • Instruct patient to take ferric citrate as directed and to continue with prescribed diet.
  • Advise patient that ferric citrate may cause dark stools; this is normal for medications containing iron.
  • Inform patient that ferric citrate may cause diarrhea, nausea, constipation, and vomiting. Notify health care professional if GI symptoms become severe or persistent.
  • Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications. Medications may need to be taken separately from ferric citrate.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Normal serum phosphorous levels.
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References in periodicals archive ?
to manufacture ferric citrate, the active pharmaceutical ingredient (API) in Auryxia tablets, a medicine approved for the treatment of two common complications of chronic kidney disease, the company said.
Ferric citrate has been used in Japan for the treatment of anemia in ESRD patients, and has recently been approved by the U.
100, 200, and 300[micro]L aliquots of standard 50 mM ferric citrate (Merck, Germany) solution were added to each sample and differential pulse polarography experiment was done for them exactly with the conditions mentioned above.
Renal therapy company Keryx Biopharmaceuticals (NasdaqCM:KERX) disclosed on Friday the receipt of approval from the US Food and Drug Administration (FDA) for Ferric Citrate (formerly known as Zerenex) for the control of serum phosphorus levels in patients with chronic kidney disease (CKD) on dialysis.
Ferric citrate coordination complex (FCCC), an investigational oral product also known as Zerenex, effectively lowered patients elevated serum phosphate into normal range while repleting iron stores, boosting hemoglobin, and reducing levels of the cardiotoxic protein fibroblast growth factor 23 (FGF23), Dr.
The media having 0% FBS/DMEM/F12+ITES were supplemented with ferric citrate solution containing ascorbic acid andL-glutamine.
Again, addition of ferric citrate to the IDA serum before immunoprecipitation restored the size of the complex to ~330 kDa.
Five abstracts related to ferric citrate have been accepted for poster presentation at the upcoming American Society of Nephrologys (ASN) 2016 Kidney Week taking place November 15 20, 2016.
a biopharmaceutical company focused on bringing innovative medicines to people with renal disease, today announced that researchers will present new data from a pivotal Phase 3 study of ferric citrate for the treatment of iron deficiency anemia (IDA) in adults with non-dialysis dependent chronic kidney disease (CKD).
M2 EQUITYBITES-January 21, 2014-Japan Tobacco receives marketing approval for ferric citrate
M2 PHARMA-January 21, 2014-Japan Tobacco receives marketing approval for ferric citrate