ferric citrate


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ferric citrate

(fe-rik si-trate)

Classification

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

Indications

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

Action

Binds phosphorous and precipitates it as ferric phosphate.

Therapeutic effects

Maintenance of normal phosphorous levels.

Pharmacokinetics

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)

ROUTEONSETPEAKDURATION
POwithin 1 wkunknownunknown

Contraindications/Precautions

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

Gastrointestinal

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

Miscellaneous

  • iron overload

Interactions

Drug-Drug interaction

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

Route/Dosage

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.

Availability

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)

Implementation

  • 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.
References in periodicals archive ?
and its subsidiary Torii Pharmaceutical Co., Ltd., reported positive top-line results from their pivotal Phase 3 comparative study evaluating Riona Tablets (generic name in Japan: ferric citrate hydrate) for the treatment of iron deficiency anemia (IDA) in adult patients in Japan.
While ferrous sulphate had no effect, both ferric citrate and ferric EDTA caused an increase in cellular levels of amphiregulin, a biomarker for cancer.
Ferric citrate has been used in Japan for the treatment of anemia in ESRD patients, and has recently been approved by the U.S.
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.
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.
As a-hydroxycarboxylate, citric acid can act as an iron chelator; in fact, YfmCDEF is the ferric citrate receptor in B.
The FDA list of iron compounds generally recognized as safe (GRAS) includes elemental iron, ferrous ascorbate, ferrous carbonate, ferrous citrate, ferrous fumarate, ferrous gluconate, ferrous lactate, ferrous sulfate, ferric ammonium citrate, ferric chloride, ferric citrate, ferric pyrophosphate and ferric sulfate.
We incubated IDA serum with 40 mg/L ferric citrate before immunoprecipitation to determine whether an increase in iron concentration changes the composition of the Tf-TfR complex.
This settlement resolves patent litigation brought by Keryx and Panion in response to Par's Abbreviated New Drug Application (ANDA) seeking approval to market a generic version of Auryxia (ferric citrate) tablets prior to the expiration of the applicable patents.
The article, entitled "Hemoglobin Response to Ferric Citrate in Patients with Non-dialysis-dependent Chronic Kidney Disease and Iron Deficiency Anemia," describes associations of baseline demographic, clinical and laboratory variables with change in hemoglobin in ferric citrate-treated patients.
M2 PHARMA-December 15, 2017-BioVectra to Continue Ferric Citrate Production for Keryx Biopharmaceuticals