Ferrous%252525252525252525252525252525252525252525252520ascorbate

# Ferrous Ascorbate ## Overview Ferrous ascorbate is a combination of iron (ferrous form) and ascorbic acid. Ascorbic acid enhances the absorption of elemental iron. ## Primary Indications Treatment and prevention of iron deficiency anemia. ## Adult Dosing * **Treatment of iron deficiency anemia:** Dosing is based on elemental iron. Typical dose is 100-200 mg of elemental iron per day, divided into 1-2 doses. This often equates to 300-600 mg of ferrous ascorbate per day. * **Prevention of iron deficiency anemia:** Typical dose is 60-100 mg of elemental iron per day. This often equates to 200-400 mg of ferrous ascorbate per day. * *Exact dosing is dependent on institutional protocols and individual patient response.* ## Pediatric Dosing * **Treatment of iron deficiency anemia:** 3-6 mg of elemental iron per kg per day, divided into 2-3 doses. Maximum dose is typically 100 mg of elemental iron per day. Ascorbic acid dose is typically 100-250 mg per day. * *Consult pediatric guidelines for specific age and weight-based dosing.* * **Prevention of iron deficiency anemia:** 1-2 mg of elemental iron per kg per day. Maximum dose is typically 30 mg of elemental iron per day. ## Dose Adjustments No dose adjustment is typically required for renal or hepatic impairment, but caution is advised and monitoring is essential due to potential for iron overload. ## Contraindications * Hemochromatosis and other causes of iron overload. * Hypersensitivity to ferrous ascorbate or any component of the formulation. * Concurrent treatment with oral iron therapy is generally contraindicated. ## Adverse Effects * **Gastrointestinal:** Constipation, diarrhea, nausea, vomiting, abdominal pain, dark stools (expected and harmless). * **Other:** Metallic taste, staining of teeth (with liquid formulations). ## Key Drug Interactions * **Tetracyclines and Doxycycline:** Iron significantly reduces absorption; separate administration by at least 2 hours. * **Levothyroxine:** Iron can decrease absorption; separate administration by at least 4 hours. * **Proton Pump Inhibitors (PPIs) and H2 Blockers:** May decrease gastric acidity, potentially reducing iron absorption, although ascorbic acid largely mitigates this. * **Antacids:** Can interfere with iron absorption; separate administration. * **Antiepileptic Drugs (e.g., Phenytoin):** Iron may decrease serum concentrations of some AEDs. ## Monitoring * **Hemoglobin and Hematocrit:** Monitor response to therapy. * **Ferritin and Iron Studies:** Assess iron stores and identify iron overload. * **Signs and symptoms of anemia:** Monitor for improvement. * **Signs and symptoms of GI distress:** Assess tolerance. ## Clinical Pearls * Administer on an empty stomach for optimal absorption, but can be taken with food if GI upset occurs. * Ascorbic acid in the formulation enhances iron absorption, particularly in individuals with achlorhydria or on acid-suppressive therapy. * Iron therapy should ideally continue for 3-6 months after normalization of hemoglobin to replete iron stores. * Accidental overdose in children is a leading cause of poisoning deaths; keep out of reach of children. *** **Disclaimer:** This information is intended for healthcare professionals and should not be used as a substitute for professional medical advice. Always consult current prescribing information and relevant guidelines before making any treatment decisions. Dosing and recommendations may vary.