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Ferric Citrate: Brands, Price & Uses in Bangladesh
Established / FDA-Approved Uses Control of serum phosphorus levels in adult patients with chronic kidney disease (CKD) who are on dialysis (hemodialysis or peritoneal dialysis).
About Ferric Citrate
Indications of Ferric Citrate
Established / FDA-Approved Uses
- Control of serum phosphorus levels in adult patients with chronic kidney disease (CKD) who are on dialysis (hemodialysis or peritoneal dialysis). Ferric Citrate is used as a phosphate binder to reduce hyperphosphatemia in this population.
- Treatment of iron deficiency anemia in adult patients with chronic kidney disease who are not on dialysis. Ferric Citrate is used as an oral iron replacement product in this setting.
Ferric Citrate has two distinct, FDA-approved indications depending on the clinical context (phosphate control on dialysis vs. anemia treatment off dialysis), and the dosing target differs accordingly (serum phosphorus vs. hemoglobin).
Dosage & Administration of Ferric Citrate
Dosing by Indication
| Indication | Starting Dose | Titration | Maximum |
|---|---|---|---|
| Hyperphosphatemia in CKD on dialysis | 2 tablets orally three times daily with meals | Adjust in increments of 1-2 tablets/day at intervals of ≥1 week, based on serum phosphorus levels | 12 tablets/day |
| Iron deficiency anemia in CKD not on dialysis | 1 tablet orally three times daily with meals | Adjust in increments of 1-2 tablets/day at intervals of ≥1 week, based on hemoglobin response | 12 tablets/day |
Administration Instructions
- Take Ferric Citrate with meals for optimal phosphate-binding effect.
- Swallow tablets whole; do not crush, chew, or divide, as this may cause discoloration of the mouth and teeth.
- If a dose is missed, take it with the next meal; do not double the dose.
Dose adjustments and monitoring (serum phosphorus for the dialysis indication; hemoglobin, ferritin, and transferrin saturation for the anemia indication) should be guided by a physician.
Side Effects of Ferric Citrate
The most common side effects of Ferric Citrate are gastrointestinal and generally dose-related, often improving with continued use:
- Discolored (dark or black) stool - an expected effect of the iron content, not necessarily a sign of gastrointestinal bleeding; however, persistent or severe gastrointestinal symptoms should be evaluated by a physician.
- Diarrhea (most common, reported in roughly one-fifth of patients)
- Nausea
- Constipation
- Vomiting
- Abdominal pain, cough
- Hyperkalemia (elevated blood potassium) has also been reported
Iron overload (elevated ferritin/transferrin saturation) can occur with excessive intake - see Contraindications and Precautions.
Contraindications of Ferric Citrate
Ferric Citrate is contraindicated in:
- Patients with iron overload syndromes (e.g., hemochromatosis).
- Patients with known hypersensitivity to ferric citrate or any component of the formulation.
Frequently Asked Questions about Ferric Citrate
What is Ferric Citrate used for?
Ferric Citrate is used to control high serum phosphorus levels in adults with chronic kidney disease who are on dialysis, and to treat iron deficiency anemia in adults with chronic kidney disease who are not on dialysis.
How should I take Ferric Citrate?
Ferric Citrate should be taken by mouth with meals, swallowing the tablet whole. Do not crush or chew it, as this can discolor the teeth and mouth. Your physician will determine the correct number of tablets based on your condition and lab results.
Will Ferric Citrate change the color of my stool?
Yes, dark or black stools are a common and expected effect of Ferric Citrate due to its iron content, and this is not usually a cause for concern. However, if you have persistent abdominal pain or other concerning symptoms, contact your physician.
Can I take iron supplements while using Ferric Citrate?
Taking additional oral or intravenous iron together with Ferric Citrate increases the risk of iron overload. Your physician will monitor your iron levels (ferritin and transferrin saturation) and adjust treatment as needed; do not add other iron products without medical advice.
Who should not take Ferric Citrate?
Ferric Citrate should not be used by patients with iron overload conditions such as hemochromatosis, or by anyone with a known hypersensitivity to ferric citrate.
Is Ferric Citrate safe during pregnancy or breastfeeding?
Data on Ferric Citrate use during pregnancy and breastfeeding are limited. It should be used during pregnancy only if clearly needed, when the potential benefit justifies the potential risk to the fetus, and only under medical supervision; the same caution applies while breastfeeding. Always consult your physician.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.