Ferrous%25252525252525252525252525252525252525252520ascorbate

# Ferrous Ascorbate ## Overview Ferrous ascorbate is a combination of iron (ferrous iron) and ascorbic acid. Ascorbic acid enhances the absorption of non-heme iron. ## Primary Indications Treatment of iron deficiency anemia. ## Adult Dosing * **Iron Deficiency Anemia:** Typically Dosed as Elemental Iron. * **Elemental Iron Dose:** 60-100 mg elemental iron orally once daily or divided into two doses. * **Ferrous Ascorbate Equivalent:** This corresponds to approximately 300-600 mg of ferrous ascorbate (assuming ferrous ascorbate contains roughly 20% elemental iron). Dosing should be guided by the specific product's elemental iron content. * **Duration:** Treatment duration is typically 3-6 months after hemoglobin levels normalize to replenish iron stores. ## Pediatric Dosing * **Iron Deficiency Anemia:** Dosing depends on age and weight. * **Dose:** 3-6 mg/kg/day of elemental iron, divided into two or three doses. * **Maximum Elemental Iron:** Generally not to exceed 200 mg elemental iron per day. * **Ferrous Ascorbate Equivalent:** Calculate based on the elemental iron content of the specific ferrous ascorbate product. For example, if a product contains 20% elemental iron, a dose of 3 mg/kg/day elemental iron would require 15 mg/kg/day of the ferrous ascorbate product. ## Dose Adjustments * **Renal Impairment:** No specific dose adjustment is typically required for mild to moderate renal impairment, but caution is advised. Patients with severe renal impairment may require closer monitoring. * **Hepatic Impairment:** No specific dose adjustment is typically required, but caution is advised. ## Contraindications * Iron overload states (e.g., hemochromatosis, aplastic anemia). * Known hypersensitivity to iron or ascorbic acid. * Patients receiving repeated blood transfusions. ## Adverse Effects * **Common:** Gastrointestinal upset (nausea, vomiting, constipation, diarrhea, abdominal pain, metallic taste). Stool may appear dark or black. * **Serious:** Acute iron poisoning (especially in children), hypersensitivity reactions. ## Key Drug Interactions * **Antacids, Calcium Supplements, Tetracyclines, Quinolones:** Can decrease iron absorption. Separate administration by at least 2 hours. * **Levothyroxine:** Iron can decrease the absorption of levothyroxine. Separate administration by at least 4 hours. * **Proton Pump Inhibitors (PPIs) and H2 Receptor Antagonists:** May decrease iron absorption by increasing gastric pH. * **Certain Antibiotics:** May chelate iron, reducing absorption. ## Monitoring * **Hemoglobin and Hematocrit:** Monitor periodically to assess response to therapy. * **Iron Studies (Ferritin, Transferrin Saturation):** May be monitored to assess iron stores and confirm resolution of deficiency. * **Signs and Symptoms of GI Upset:** Assess for tolerance. ## Clinical Pearls * Administer ferrous ascorbate on an empty stomach to maximize absorption, but if GI upset occurs, it can be taken with food. * Taking with vitamin C-rich foods or drinks (like orange juice) can enhance iron absorption. * Avoid taking with milk, eggs, or high-fiber foods, which can impair absorption. * Accidental overdose, especially in children, can be life-threatening. Keep out of reach of children. * Dosing is typically based on the elemental iron content of the specific product. Always verify the elemental iron percentage on the product label. *** *Disclaimer: This information is intended for healthcare professionals. Always verify current prescribing information and consult with a qualified healthcare provider before making any treatment decisions. Drug information can change, and individual patient factors must be considered.*