Ferrous%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520ascorbate

# Ferrous Ascorbate ## Overview Ferrous ascorbate is an iron supplement used to treat and prevent iron deficiency anemia. Ascorbic acid enhances iron absorption. ## Primary Indications * Treatment of iron deficiency anemia. * Prevention of iron deficiency anemia in individuals with increased iron requirements or inadequate dietary intake. ## Adult Dosing * **Treatment:** Typically 60-100 mg of elemental iron daily, divided into 1-3 doses. For example, 100 mg elemental iron BID or TID. Maximum elemental iron dose is generally not to exceed 200 mg daily. * **Prevention:** Typically 30-60 mg of elemental iron daily. Dosing should be individualized based on the severity of iron deficiency and patient response. Prescribing information or local protocol should be consulted for specific dosing regimens. ## Pediatric Dosing * **Treatment:** 3-6 mg of elemental iron per kg of body weight per day, divided into 3 doses. Maximum daily dose is generally not to exceed 60 mg of elemental iron. * **Prevention:** 1-2 mg of elemental iron per kg of body weight per day. Maximum daily dose is generally not to exceed 30 mg of elemental iron. Consult product labeling or local pediatric hematology protocols for precise dosing and administration in children. ## Dose Adjustments No dose adjustments are typically required for renal or hepatic impairment, but caution is advised in patients with these conditions due to potential for iron overload and altered metabolism. ## Contraindications * Hypersensitivity to ferrous ascorbate or any component of the formulation. * Conditions of iron overload (e.g., hemochromatosis, hemosiderosis). * Anemias not caused by iron deficiency (e.g., megaloblastic anemia due to vitamin B12 deficiency, hemolytic anemia). ## Adverse Effects * **Common:** Gastrointestinal upset (nausea, vomiting, constipation, diarrhea, abdominal pain, dark stools). * **Less Common:** Staining of teeth (with liquid formulations), metallic taste. * **Rare/Serious:** Iron overload, allergic reactions. ## Key Drug Interactions * **Antibiotics:** Quinolones (e.g., ciprofloxacin, levofloxacin) and tetracyclines: Reduced absorption of both drugs. Separate administration by at least 2 hours before or 4-6 hours after. * **Bisphosphonates:** Reduced absorption of bisphosphonates. Separate administration by at least 30 minutes. * **Levothyroxine:** Reduced absorption of levothyroxine. Separate administration by at least 4 hours. * **Antacids and Calcium Supplements:** May reduce iron absorption. Separate administration by at least 2 hours. * **Proton Pump Inhibitors:** May reduce iron absorption. * **Vitamin E:** May interfere with iron absorption. ## Monitoring * Hemoglobin and hematocrit levels. * Reticulocyte count (to assess response). * Serum ferritin and transferrin saturation (in cases of prolonged therapy or suspected overload). * Symptoms of iron deficiency and toxicity. ## Clinical Pearls * Administer iron supplements on an empty stomach to maximize absorption; however, if GI upset occurs, take with food. Avoid taking with milk, antacids, or tea. * Concomitant administration of vitamin C (ascorbic acid) enhances iron absorption. * Stools may turn dark or black; this is a normal finding and not a cause for concern. * Iron poisoning is a medical emergency, especially in children. Keep iron-containing products out of reach of children. *** **Disclaimer:** This information is intended for healthcare professionals and does not substitute for professional medical advice. Always consult the most current prescribing information and relevant clinical guidelines before making any treatment decisions.