Ferrous%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520ascorbate

# Ferrous Ascorbate ## Overview Ferrous ascorbate is an iron salt combined with ascorbic acid (Vitamin C). Ascorbic acid enhances the absorption of non-heme iron from the gastrointestinal tract. ## Primary Indications * Treatment and prevention of iron deficiency anemia. * Treatment and prevention of iron deficiency. ## Adult Dosing * **Treatment of iron deficiency anemia:** Typically 100-200 mg of elemental iron per day, divided into 1-2 doses. Dosage may vary based on the severity of iron deficiency and patient tolerance. A common starting dose is 100 mg elemental iron daily. * **Prevention of iron deficiency:** Typically 30-60 mg of elemental iron per day. **Note:** Ferrous ascorbate formulations vary in elemental iron content. Always calculate the dose based on the percentage of elemental iron in the specific product. For example, if a tablet contains 100 mg of ferrous ascorbate and is 33% elemental iron, it provides 33 mg of elemental iron. ## Pediatric Dosing * **Treatment of iron deficiency anemia:** 3-6 mg of elemental iron per kg of body weight per day, divided into 1-3 doses. Maximum dose: 200 mg of elemental iron per day. * **Prevention of iron deficiency:** 1 mg of elemental iron per kg of body weight per day. Maximum dose: 30 mg of elemental iron per day. **Note:** Dosing in neonates and infants should be carefully supervised and may differ based on specific guidelines. ## Dose Adjustments * **Renal Impairment:** No specific dose adjustments are routinely recommended, but caution is advised as iron overload can occur. * **Hepatic Impairment:** No specific dose adjustments are routinely recommended, but caution is advised as iron overload can occur. ## Contraindications * Hypersensitivity to ferrous ascorbate or any component of the formulation. * Hemochromatosis, hemosiderosis, or other conditions of iron overload. * Anemia not due to iron deficiency (e.g., hemolytic anemia, megaloblastic anemia due to vitamin B12 or folate deficiency). * Concurrent use with parenteral iron (generally contraindicated due to risk of iron overload). ## Adverse Effects * **Common:** Gastrointestinal disturbances including nausea, vomiting, constipation, diarrhea, abdominal pain, dark stools. * **Less Common:** Metallic taste, epigastric distress, anorexia. * **Rare:** Allergic reactions. ## Key Drug Interactions * **Antacids, Calcium Supplements, Carbonate, Bicarbonate, Cholestyramine, Phosphate Binders, Tetracyclines, Quinolone Antibiotics, Levothyroxine, Penicillamine, Mycophenolate Mofetil:** Decreased absorption of ferrous ascorbate. Separate administration by at least 2 hours. * **Iron Absorption Enhancers (e.g., Vitamin C):** Ascorbic acid in ferrous ascorbate enhances iron absorption; avoid concurrent administration of additional high-dose Vitamin C. * **Iron Absorption Inhibitors (e.g., Phytates, Tannates found in coffee, tea, eggs, dairy products, whole grains):** Decreased absorption of ferrous ascorbate. Separate administration by at least 2 hours from these substances. ## Monitoring * **Hemoglobin and Hematocrit:** Monitor response to therapy. * **Ferritin Levels:** Assess iron stores and response. * **Signs and Symptoms of Iron Deficiency/Anemia:** Clinical assessment. * **Signs and Symptoms of Iron Overload:** Especially in patients with underlying conditions or prolonged therapy. ## Clinical Pearls * Administer ferrous ascorbate on an empty stomach to maximize absorption, if tolerated. If gastrointestinal upset occurs, administer with food or milk, but be aware this may decrease absorption. * Taking ferrous ascorbate with citrus fruits or juices can enhance absorption. * Advise patients that stools may turn black or dark green, which is an expected and harmless side effect. * Keep out of reach of children, as accidental overdose can be serious and potentially fatal. * The efficacy of ferrous ascorbate is highly dependent on accurate elemental iron dosing. *** *Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines before making any therapeutic decisions.*