Aurifer (Ferric Citrate)

Therapeutic Class: Oral Iron preparations

Indications

Control of serum phosphorus levels in adult patients with chronic kidney disease on dialysis.
Treatment of iron deficiency anemia in adult patients with chronic kidney disease not on dialysis.

Pharmacology

Ferric iron binds dietary phosphate in the GI tract and precipitates as ferric phosphate, which is insoluble and excreted in stool. This reduces phosphate absorption and lowers serum phosphate concentration. Ferric iron is reduced to ferrous form by ferric reductase, absorbed via enterocytes, and circulates bound to transferrin for incorporation into hemoglobin.

Dosage & Administration

Hyperphosphatemia (CKD on dialysis): Start with 2 tablets orally, 3 times daily with meals. Adjust as needed, up to 12 tablets/day.
Iron Deficiency Anemia (CKD not on dialysis): Start with 1 tablet orally, 3 times daily with meals. Adjust as needed, up to 12 tablets/day.
Children & Adolescents: Safety and efficacy not established.

Interactions

Separate administration from oral drugs such as Doxycycline & Ciprofloxacin.

Contraindications

Contraindicated in patients with iron overload syndrome (Hemochromatosis).

Side Effects

Discolored feces, diarrhea, constipation, nausea, vomiting, cough, abdominal pain, hyperkalemia.

Pregnancy & Lactation

No available data in pregnant or lactating women.

Precautions & Warnings

May cause excessive elevations in iron stores (↑ serum ferritin, ↑ TSAT).
Risk of accidental overdose in children under 6 years — keep out of reach.

Overdose Effects

No data available. Maximum studied dose in CKD patients: 2,520 mg ferric iron/day.