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1. Ferric Citrate
2. Ferric Citrate Anhydrous
3. Ferric Citrate Dihydrate
4. Ferric Citrate Hydrate
5. Ferric Citrate Iron(+3) Salt
6. Ferric Citrate Trihydrate
7. Ferric Citrate, 59fe-labeled Cpd
8. Ferric Citrate, Iron Salt, 59fe-labeled Cpd
9. Ferric-citric Acid
10. Iron(iii) Citrate
11. Jtt-751
12. Zerenex
1. Tetraferric Tricitrate Decahydrate
2. Ferric Citrate Hydrate
3. Ferric Citrate [usan]
4. Krx-0502
5. Db14520
6. Iron (as Ferric Citrate) [vandf]
7. Q91187k011
8. Q22075864
9. 1,2,3-propanetricarboxylic Acid, 2-hydroxy-, Iron(3+) Salt, Hydrate (4:3:10)
Molecular Weight | 967.8 g/mol |
---|---|
Molecular Formula | C18H32Fe4O31 |
Hydrogen Bond Donor Count | 10 |
Hydrogen Bond Acceptor Count | 31 |
Rotatable Bond Count | 6 |
Exact Mass | 967.83250 g/mol |
Monoisotopic Mass | 967.83250 g/mol |
Topological Polar Surface Area | 440 Ų |
Heavy Atom Count | 53 |
Formal Charge | 0 |
Complexity | 211 |
Isotope Atom Count | 0 |
Defined Atom Stereocenter Count | 0 |
Undefined Atom Stereocenter Count | 0 |
Defined Bond Stereocenter Count | 0 |
Undefined Bond Stereocenter Count | 0 |
Covalently Bonded Unit Count | 17 |
Tetraferric tricitrate decahydrate is indicated to control serum phosphorous in adults with chronic kidney disease who require dialysis. Tetraferric tricitrate decahydrate is also indicated to treat iron deficiency anemia in adults with chronic kidney disease who are not on dialysis.
Tetraferric tricitrate decahydrate is an iron containing product indicated to treat iron deficiency anemia and hyperphosphatemia. It has a wide therapeutic index, as doses can be varied significantly between patients. Tetraferric tricitrate decahydrate has a long duration of action in the treatment of iron deficiency anemia, due to the slow loss of iron from the body, and a moderate duration of action in the treatment of hyperphosphatemia, due to its action being dependant on residence time in the gastrointestinal tract. Patients should be counselled regarding the risk of iron overload.
Absorption
Ferric iron has been shown to have inferior bioavailability to ferrous iron preparations. Tetraferric tricitrate decahydrate has 19% the bioavailability of ferrous ascorbate.
Route of Elimination
Unabsorbed oral Tetraferric tricitrate decahydrate is eliminated in the feces. The absorbed iron from Tetraferric tricitrate decahydrate is generally not eliminated from the body by any route other than blood loss and exfoliation of epithelial cells.
Clearance
Data regarding the clearance of iron is not readily available. However, iron loss due to exfoliation of epithelial cells is approximately 1mg/day.
Ferric cation is converted to ferrous iron by duodenal cytochrome B reductase. The heavy chain ferritin may also convert ferric iron to ferrous iron
Ferric (Fe3+) iron is absorbed from the gastrointestinal tract by divalent metal transporter-1, and reduced to ferrous (Fe2+) iron by ferrireductase and cytochrome b reductase 1. Ferrous iron is stored intracellularly in ferritin and transported into the blood by ferroportin 1. Transport by ferroportin 1 is coupled with oxidation to ferric iron by hephaestin or ceruloplasmin. Ferric iron in plasma is bound to transferrin, which carries iron to other cells. Iron is transported to mitochondria for the synthesis of heme or iron-sulfur clusters, which are integral parts of several metalloproteins like hemoglobin. Ferric iron can also bind to phosphate in the gastrointestinal tract, which precipitates as the insoluble ferric phosphate. Ferric phosphate remains unabsorbed and is eliminated in the feces. Decreased phosphate absorption gradually lowers phosphate levels in the blood.
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