Auryxia (ferric citrate) is a phosphate binder used to treat high phosphorus levels (hyperphosphatemia) in adults with chronic kidney disease (CKD) on dialysis. It's also used as an iron supplement to treat iron-deficiency anemia (IDA) in adults with CKD who aren't on dialysis. Auryxia (ferric citrate) comes as a 210 mg tablet and is taken by mouth three times per day with meals. It's not available as a generic. Common side effects include dark stools, diarrhea, and constipation.
High phosphorus levels (hyperphosphatemia) in adults with chronic kidney disease (CKD) on dialysis
Iron-deficiency anemia (IDA) in adults with CKD not on dialysis
Auryxia (ferric citrate) is a phosphate binder. It works by attaching to phosphorus from the food you eat in your stomach. This prevents phosphorus from being absorbed into the blood, allowing it to leave the body through waste. By lowering phosphorus levels, Auryxia (ferric citrate) helps protect your kidneys and bones.
Auryxia (ferric citrate) also acts as an iron supplement. It provides your body with iron, an important mineral needed to make hemoglobin. Hemoglobin is a protein in red blood cells that carries and delivers oxygen through your body.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Good option for lowering phosphorus levels and raising iron stores
Dose can be adjusted based on your blood test results
Specifically approved for people with CKD
Needs to be taken up to three times per day with meals
Commonly causes dark stools, constipation, and diarrhea
Can interact with some medications by changing how they are absorbed
Take Auryxia (ferric citrate) three times per day with each meal. If you're taking it to lower phosphorus levels, ask your prescriber if you should also take it with snacks. Swallow the tablet whole to avoid staining your teeth and mouth.
Mark your calendar with your appointments to see your prescriber and get blood tests during treatment with Auryxia (ferric citrate). Your prescriber will monitor your phosphorus and iron levels to check how the medication is working for you.
Stomach-related side effects, like diarrhea, constipation, nausea, and stomach pain, are common with Auryxia (ferric citrate). Contact your care team if these side effects don't go away or become severe.
Auryxia (ferric citrate) can cause a change in stool color, which is common with iron-containing medications. Don't be alarmed if you see your stool turn a tarry-black color.
If you're prescribed doxycycline or ciprofloxacin antibiotics, let your care team know you're taking Auryxia (ferric citrate). You’ll need to space out when you take your medications. Take doxycycline at least 1 hour before Auryxia (ferric citrate), and for ciprofloxacin, wait at least 2 hours before or after taking Auryxia (ferric citrate).
Check the labels of any vitamins or supplements to see if they contain iron while taking Auryxia (ferric citrate). Too much iron can cause side effects like upset stomach, nausea, and constipation.
Keep Auryxia (ferric citrate) out of reach of children to avoid accidental ingestion. If your child takes Auryxia (ferric citrate) and experiences vomiting blood, diarrhea, or stomach pain, call the Poison Control Center at 1-800-222-1222 right away.
Auryxia (ferric citrate) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Taking too much iron
If you take multiple medications or supplements with iron or take more Auryxia (ferric citrate) than recommended, there's a chance that your iron levels might become too high. This is dangerous because it can lead to problems such as tears in the gut, seizures, and liver damage. Your prescriber will regularly check your iron levels with blood tests while you're taking Auryxia (ferric citrate). Let your care team know right away if you experience symptoms of too much iron, such as nausea, vomiting, stomach pain, and diarrhea.
Risk factors: Children under age 6
Accidental overdose of iron-containing products like Auryxia (ferric citrate) can be very dangerous for children under age 6. Keep Auryxia (ferric citrate) out of their reach to prevent accidental ingestion. If your child takes Auryxia (ferric citrate) and shows signs like vomiting blood, diarrhea, or stomach pain, call the Poison Control Center immediately at 1-800-222-1222.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
200 tablets of 210mg | 1 bottle | $1461.96 | $1461.96 |
Each tablet of Auryxia contains 210 mg of ferric citrate.
High phosphorus levels: The typical starting dose is 2 tablets by mouth three times a day with meals. Your prescriber will adjust the dose based on your phosphorus levels. The maximum dose is 12 tablets a day.
Iron-deficiency anemia: The typical starting dose is 1 tablet by mouth three times a day with meals. Your prescriber will adjust the dose based on your hemoglobin levels. The maximum dose is 12 tablets a day.
Conditions that cause high iron levels (e.g., hemochromatosis)
High phosphorus levels (hyperphosphatemia) in adults with chronic kidney disease (CKD) on dialysis
Iron-deficiency anemia (IDA) in adults with CKD not on dialysis
High blood phosphate levels in advanced kidney disease
High phosphate levels (hyperphosphatemia) in adults with chronic kidney disease (CKD) who are receiving dialysis
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Akebia Therapeutics, Inc. (2024). Auryxia- ferric citrate tablet, film coated [package insert]. DailyMed.
Billett, H. H., et al. (1990). Chapter 151 Hemoglobin and hematocrit. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.
National Institutes of Health Office of Dietary Supplements. (2021). Phosphorus: Fact sheet for consumers.
National Kidney Foundation. (2023). Dialysis.
Rout, P., et al. (2023). Hyperphosphatemia. StatPearls.
Yuen, H. W., et al. (2023). Iron toxicity. StatPearls.
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