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# Ferrous Ascorbate
## Overview
Ferrous ascorbate is a combination of ferrous iron and ascorbic acid. Ascorbic acid enhances the absorption of ferric iron.
## Primary Indications
Treatment and prevention of iron deficiency anemia.
## Adult Dosing
* **Treatment of iron deficiency anemia:** 100-200 mg elemental iron daily, divided into 1-2 doses.
* Maximum: 200 mg elemental iron per day.
* **Prevention of iron deficiency anemia:** 60-100 mg elemental iron daily.
## Pediatric Dosing
Dosing varies by age and iron status. Specific recommendations should follow local guidelines and pediatric hematology consultation. Generally, doses range from 3-6 mg/kg/day of elemental iron, divided into 1-3 doses, up to a maximum of 200 mg elemental iron per day.
## Dose Adjustments
No dose adjustment is typically required based on renal or hepatic impairment, but iron overload should be considered in patients with severe liver disease.
## Contraindications
* Hemochromatosis and other iron overload conditions.
* Hypersensitivity to ferrous ascorbate or any component of the formulation.
* Anemia not due to iron deficiency (e.g., vitamin B12 deficiency, folate deficiency, hemolytic anemia).
## Adverse Effects
* **Common:** Gastrointestinal upset (nausea, vomiting, constipation, diarrhea, abdominal pain, metallic taste). Stool discoloration (black or dark green).
* **Serious:** Iron overload (hemochromatosis), anaphylaxis (rare).
## Key Drug Interactions
* **Antibiotics (Tetracyclines, Fluoroquinolones):** Iron can decrease absorption. Separate administration by at least 2 hours before or 4 hours after.
* **Levothyroxine:** Iron can decrease absorption. Separate administration by at least 4 hours.
* **Antacids:** May decrease iron absorption. Separate administration.
* **Bisphosphonates:** Iron can decrease absorption. Separate administration by at least 2 hours.
* **Vitamin E:** May interfere with iron absorption.
## Monitoring
* Hemoglobin, hematocrit, and reticulocyte count to assess response.
* Serum ferritin levels for iron stores.
* Monitor for signs and symptoms of gastrointestinal intolerance.
## Clinical Pearls
* Administer on an empty stomach for optimal absorption, but if gastrointestinal upset occurs, take with a small amount of food. Avoid taking with milk, tea, coffee, or eggs.
* Ascorbic acid in the formulation enhances absorption.
* Stool may turn black or dark green; this is expected and not a cause for concern.
* Iron overdose is a medical emergency, especially in children.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and literature for complete details and to verify dosage and safety before use.*
