Ferrous%25252525252525252525252525252525252525252525252525252520ascorbate

# Ferrous Ascorbate ## Overview Ferrous ascorbate is an oral iron supplement used to treat and prevent iron deficiency anemia. It combines ferrous ions (iron) with ascorbic acid (Vitamin C), which enhances iron absorption. ## Primary Indications * Treatment of iron deficiency anemia. * Prevention of iron deficiency anemia, particularly in populations at risk (e.g., pregnant women, infants, vegetarians). ## Adult Dosing * **Treatment of Iron Deficiency Anemia:** * Typical dose: 100 mg elemental iron (from ferrous ascorbate) orally once daily. * May be increased to 200 mg elemental iron (from ferrous ascorbate) in divided doses (e.g., BID) if tolerated and needed, based on patient response and local protocols. * Duration of therapy: Typically continued for 3-6 months after normalization of hemoglobin to replete iron stores. * **Prevention:** * Typical dose: 30-60 mg elemental iron (from ferrous ascorbate) orally once daily, as per local guidelines and patient risk factors. ## Pediatric Dosing * Dosing varies significantly by age and iron status. Consult pediatric hematology guidelines or specific product information. * **Prophylaxis in infants:** Typically 7-15 mg elemental iron orally daily, starting at 4 months of age. * **Treatment of iron deficiency anemia in children:** Dosing is usually calculated based on body weight, typically 3-6 mg elemental iron/kg/day in divided doses, not to exceed adult doses. ## Dose Adjustments * No specific dose adjustments are routinely recommended for hepatic or renal impairment. However, caution is advised, and lower starting doses may be considered in patients with severe impairment. ## Contraindications * Iron overload states (e.g., hemochromatosis, hemosiderosis). * Hypersensitivity to iron or ascorbic acid. * Untreated megaloblastic anemia due to vitamin B12 deficiency (may mask the hematologic findings). * Certain conditions where oral iron is poorly absorbed or tolerated (e.g., inflammatory bowel disease). ## Adverse Effects * **Common:** Gastrointestinal upset (nausea, vomiting, constipation, diarrhea, abdominal pain, dark stools). * **Less Common:** Allergic reactions, metallic taste. * **Overdose:** Can be serious, especially in children. Symptoms include nausea, vomiting, abdominal pain, diarrhea, lethargy, hypotension, shock, and coma. ## Key Drug Interactions * **Absorption Decreased By:** Antacids, calcium supplements, tetracyclines, doxycycline, cimetidine, proton pump inhibitors, bisphosphonates, levothyroxine, penicillamine, cholestyramine. Separate administration by at least 2 hours (or 4 hours for antacids). * **Absorption Increased By:** Vitamin C (inherent in ferrous ascorbate formulation). * **Other:** Iron can interfere with the absorption of certain antibiotics (e.g., fluoroquinolones) and mycophenolate mofetil. ## Monitoring * Hemoglobin and hematocrit levels. * Reticulocyte count. * Serum ferritin levels (to assess iron stores). * Signs and symptoms of iron deficiency anemia. * Tolerance to the medication (GI side effects). ## Clinical Pearls * Taking ferrous ascorbate with ascorbic acid (inherent in the product) enhances absorption, especially when taken on an empty stomach. However, taking it with food may improve GI tolerance. * Darkening of stools is a common and expected side effect and does not indicate bleeding. * Accidental overdose is a significant risk in children; store securely and out of reach. * Parenteral iron therapy may be considered for patients who cannot tolerate oral iron, have malabsorption issues, or require rapid correction of severe anemia. *** **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 local protocols before making any clinical decisions.