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# Ferrous ascorbate
## Overview
Ferrous ascorbate is a combination of ferrous iron and ascorbic acid, used to treat iron deficiency anemia. Ascorbic acid enhances the absorption of non-heme iron.
## Primary Indications
* Treatment of iron deficiency anemia.
## Adult Dosing
* **Iron Deficiency Anemia:** Generally dosed as 100 mg elemental iron per day, divided into 1-2 doses.
* *Elemental Iron:* The amount of elemental iron varies by product. For example, a 60 mg elemental iron tablet taken twice daily would provide 120 mg elemental iron daily. A common formulation is 100 mg elemental iron in a once-daily tablet.
* *Specific product dosing:* Consult the specific product labeling for precise elemental iron content and recommended dosage. Maximum daily elemental iron dosage is typically not to exceed 200 mg.
## Pediatric Dosing
* Dosing for pediatric patients is not well-established for ferrous ascorbate. Iron therapy in children should be guided by elemental iron requirements based on age and weight, and often uses ferrous sulfate or ferrous gluconate preparations. Consult pediatric hematology resources for established iron dosing guidelines.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised, and monitoring is important.
## Contraindications
* Hemochromatosis or other causes of iron overload.
* Hypersensitivity to ferrous ascorbate or its components.
* Patients receiving frequent blood transfusions.
## Adverse Effects
* **Common:** Gastrointestinal upset (nausea, vomiting, constipation, diarrhea, abdominal pain, metallic taste), dark stools.
* **Serious (rare):** Iron toxicity, especially in overdose.
## Key Drug Interactions
* **Antacids:** May decrease iron absorption. Separate administration by at least 2 hours.
* **Tetracyclines and Doxycycline:** May decrease absorption of both iron and the antibiotic. Separate administration by at least 2 hours.
* **Levothyroxine:** May decrease absorption of levothyroxine. Separate administration by at least 4 hours.
* **Proton Pump Inhibitors (PPIs):** May decrease iron absorption.
* **Vitamin E:** High doses of vitamin E may interfere with iron absorption.
## Monitoring
* Hemoglobin and hematocrit.
* Ferritin levels.
* Resolution of anemia symptoms.
* Signs of iron toxicity (especially in pediatric patients or with overdose).
## Clinical Pearls
* Administer on an empty stomach for optimal absorption, but if gastrointestinal upset occurs, take with food.
* Avoid co-administration with milk, dairy products, tea, coffee, eggs, and whole grains, as these can impair absorption.
* Ascorbic acid is present to enhance iron absorption.
* Overdose can be serious, especially in children, and requires immediate medical attention.
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**Disclaimer:** This information is intended for educational purposes and is not a substitute for professional medical advice. Always consult the most current prescribing information and a qualified healthcare provider for any health concerns or before making any decisions related to your health or treatment.
