Ferrous%252525252525252525252525252525252525252525252525252525252520ascorbate

# Ferrous Ascorbate ## Overview Ferrous ascorbate is a combination of iron (ferrous) and ascorbic acid (vitamin C). Ascorbic acid enhances the absorption of non-heme iron. ## Primary Indications Treatment and prevention of iron deficiency anemia. ## Adult Dosing * **Treatment of iron deficiency anemia:** 100-200 mg of elemental iron daily, divided into 1-2 doses. This typically corresponds to 300-600 mg of ferrous ascorbate (containing 100-200 mg elemental iron) daily. * **Prevention of iron deficiency anemia:** 60-100 mg of elemental iron daily. Dosing depends on the severity of anemia and patient response. ## Pediatric Dosing * **Treatment of iron deficiency anemia (6 months to 5 years):** 3-5 mg/kg/day of elemental iron, divided into 1-3 doses. * **Treatment of iron deficiency anemia (5 years to 12 years):** 1-1.5 mg/kg/day of elemental iron, divided into 1-3 doses, not to exceed 200 mg elemental iron daily. * **Prevention of iron deficiency anemia (4 months to 12 years):** 1 mg/kg/day of elemental iron, not to exceed 30 mg elemental iron daily. Specific pediatric dosing may vary based on local guidelines or physician discretion. ## Dose Adjustments No dose adjustment is typically required for hepatic or renal impairment, but caution is advised and iron overload should be monitored, especially in severe renal impairment. ## Contraindications * Known hypersensitivity to ferrous ascorbate or its components. * Patients with hemochromatosis or other conditions of iron overload. * Pernicious anemia. ## Adverse Effects Common: Gastrointestinal upset (nausea, vomiting, diarrhea, constipation, abdominal pain), metallic taste, dark stools. Less Common: Allergic reactions, iron overload symptoms (fatigue, joint pain, abdominal pain) with chronic excessive use. ## Key Drug Interactions * **Antacids, calcium supplements, tetracyclines, levothyroxine, bisphosphonates:** May decrease iron absorption. Separate administration by at least 2 hours. * **Proton pump inhibitors (PPIs) and H2-receptor antagonists:** May decrease iron absorption by increasing gastric pH. * **Antibiotics (e.g., fluoroquinolones, tetracyclines):** May chelate with iron, reducing absorption of both. Separate administration by at least 2 hours. * **Vitamin E:** May reduce the absorption of iron. ## Monitoring * Hemoglobin and hematocrit levels. * Iron studies (serum ferritin, serum iron, total iron-binding capacity) to assess iron status and response. * Monitor for signs and symptoms of gastrointestinal intolerance. * Monitor for signs of iron overload in patients with chronic disease or prolonged therapy. ## Clinical Pearls * Administer on an empty stomach for optimal absorption, but if gastrointestinal upset occurs, take with food. * Ascorbic acid improves absorption; taking with orange juice may be beneficial. * Avoid co-administration with milk, antacids, or medications that interfere with iron absorption. * Dark stools are a expected and benign side effect. * Iron overload can be serious; adhere to prescribed doses and duration of therapy. *** **Disclaimer:** This information is intended for healthcare professionals. Always verify current prescribing information and consult appropriate resources before making clinical decisions.