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# Ferrous Ascorbate
## Overview
Ferrous ascorbate is an oral iron supplement used to treat and prevent iron deficiency anemia. Ascorbic acid (Vitamin C) enhances the absorption of non-heme iron from the gastrointestinal tract.
## Primary Indications
* Treatment of iron deficiency anemia.
* Prevention of iron deficiency anemia, particularly in pregnant women and individuals with increased iron requirements.
## Adult Dosing
Dosing varies based on the severity of iron deficiency and patient tolerance.
* **Treatment of Iron Deficiency Anemia:** Typically 100-200 mg of elemental iron per day, divided into 2-3 doses. Ferrous ascorbate formulations vary in their elemental iron content. For example, a 60 mg elemental iron tablet of ferrous ascorbate would be dosed once or twice daily.
* **Prevention of Iron Deficiency:** Typically 30-60 mg of elemental iron per day.
## Pediatric Dosing
Dosing depends on age and weight.
* **Treatment of Iron Deficiency Anemia:** 3-6 mg/kg/day of elemental iron, divided into 2-3 doses, not to exceed 200 mg elemental iron per day.
* **Prevention of Iron Deficiency:** 1-2 mg/kg/day of elemental iron, not to exceed 30 mg elemental iron per day.
## Dose Adjustments
No specific dose adjustments for hepatic or renal impairment are typically required, but caution is advised in severe cases. Consultation with a specialist may be warranted.
## Contraindications
* Hemochromatosis or other conditions of iron overload.
* Hypersensitivity to ferrous ascorbate or any component of the formulation.
* Peptic ulceration, regional enteritis, or ulcerative colitis (may exacerbate).
## Adverse Effects
Common adverse effects include constipation, diarrhea, nausea, vomiting, abdominal pain, and dark stools. Less common include metallic taste and gastric irritation.
## Key Drug Interactions
* **Antibiotics:** Tetracyclines and quinolones (absorption may be reduced). Separate administration by at least 2 hours.
* **Antacids:** May decrease iron absorption. Separate administration by at least 2 hours.
* **Levothyroxine:** May decrease absorption of levothyroxine. Separate administration by at least 4 hours.
* **Penicillamine:** May decrease absorption of penicillamine. Separate administration by at least 2 hours.
## Monitoring
* **Hemoglobin and Hematocrit:** Monitor periodically to assess response to therapy.
* **Ferritin and serum iron levels:** May be monitored to assess iron stores and absorption. Clinical response is often the most practical indicator.
* **Gastrointestinal tolerance:** Assess for adverse effects.
## Clinical Pearls
* Administer ferrous ascorbate 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, as these can inhibit absorption.
* Ascorbic acid in the formulation aids absorption; however, patients taking high doses of vitamin C supplements concurrently should be monitored for potential toxicity.
* Iron overdose is a serious concern, especially in children. Keep out of reach of children.
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*This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always verify current prescribing information and consult with a qualified healthcare provider before making any decisions related to drug therapy.*
