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# Ferrous Ascorbate
## Overview
Ferrous ascorbate is an oral iron supplement that combines ferrous iron with ascorbic acid. Ascorbic acid enhances iron absorption.
## Primary Indications
* Treatment and prevention of iron deficiency anemia.
## Adult Dosing
* **Iron Deficiency Anemia Treatment:** Typically 100-200 mg elemental iron daily, divided into 1-3 doses.
* Ferrous ascorbate 650 mg tablet generally contains 100 mg elemental iron.
* *Example:* Ferrous ascorbate 650 mg (100 mg elemental iron) two to three times daily.
* **Iron Deficiency Anemia Prevention:** Typically 60-100 mg elemental iron daily.
* *Example:* Ferrous ascorbate 650 mg (100 mg elemental iron) once daily.
## Pediatric Dosing
Dosing is typically based on elemental iron per kilogram of body weight and varies by age and indication. Consult specific pediatric guidelines or product labeling.
* **Iron Deficiency Anemia Treatment (6 months to 5 years):** 3 mg/kg/day elemental iron in 3 divided doses. Maximum 65 mg elemental iron daily.
* **Iron Deficiency Anemia Treatment (5 years and older):** 60 mg elemental iron two to three times daily.
* **Iron Deficiency Anemia Prevention (6 months to 12 years):** 1 mg/kg/day elemental iron once daily. Maximum 30 mg elemental iron daily.
* **Iron Deficiency Anemia Prevention (12 years and older):** 30-60 mg elemental iron daily.
## Dose Adjustments
* No specific dose adjustments are typically required for hepatic or renal impairment, but caution is advised in severe cases. Monitor closely for signs of iron overload.
## Contraindications
* Hypersensitivity to ferrous ascorbate or its components.
* Hemochromatosis.
* Hemosiderosis.
* Hemolytic anemia.
* Gastrointestinal conditions that interfere with iron absorption (e.g., inflammatory bowel disease, achlorhydria - although ascorbic acid may mitigate this).
## Adverse Effects
* **Common:** Gastrointestinal upset (nausea, vomiting, constipation, diarrhea, abdominal pain, metallic taste), dark stools.
* **Serious (rare):** Iron overload, hypersensitivity reactions.
## Key Drug Interactions
* **Antibiotics (Tetracyclines, Quinolones):** Reduced absorption of both iron and the antibiotic. Separate administration by at least 2 hours.
* **Levothyroxine:** Reduced absorption of levothyroxine. Separate administration by at least 4 hours.
* **Antacids, Calcium Supplements, Proton Pump Inhibitors:** May decrease iron absorption. Separate administration by at least 2 hours.
* **Iron Overload Risk:** Concomitant use with other iron-containing products.
## Monitoring
* **Hemoglobin and Hematocrit:** To assess response to therapy.
* **Iron Studies (Ferritin, Transferrin Saturation):** To assess iron stores and guide duration of therapy.
* **Signs and symptoms of GI distress.**
## Clinical Pearls
* Administer ferrous ascorbate on an empty stomach for optimal absorption, but with food if GI upset occurs.
* Ascorbic acid enhances iron absorption; taking with vitamin C-rich foods or juices (e.g., orange juice) may improve efficacy.
* Dark stools are a normal expected finding and indicate that iron is being absorbed.
* Accidental overdose of iron-containing products is a leading cause of poisoning deaths in children. Keep out of reach of children. Consult a poison control center immediately in case of overdose.
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*Disclaimer: This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and relevant clinical guidelines before making any treatment decisions. Dosing and recommendations may vary based on individual patient factors and local protocols.*
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