Ferric Citrate
Ferric citrate is an iron-based medication used to control high phosphorus levels in adults with chronic kidney disease on dialysis, and to treat iron deficiency anemia in adults with chronic kidney disease not on dialysis.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 3 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Ferric Citrate: Patient Information Guide
A plain-language walkthrough of Ferric Citrate — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Ferric citrate is approved for two distinct uses in adults with chronic kidney disease (CKD), depending on whether the patient is on dialysis.
- Auryxia (ferric citrate tablets) — controls high phosphorus levels (hyperphosphatemia) in adults with CKD who are on dialysis
- Auryxia (ferric citrate tablets) — treats iron deficiency anemia in adults with CKD who are not on dialysis
- Ferric Citrate tablets (generic) — controls high phosphorus levels in adults with CKD on dialysis
- Ferric Citrate tablets (generic) — treats iron deficiency anemia in adults with CKD not on dialysis
⚙️How it works▾
Ferric citrate works differently depending on which condition it is treating. For high phosphorus: the iron in ferric citrate binds to dietary phosphate in the digestive tract, forming an insoluble compound (ferric phosphate) that cannot be absorbed — it simply exits the body in the stool, which lowers phosphorus levels in the blood. For iron deficiency anemia: the ferric iron is converted by the gut into a form the body can absorb, then transported into the bloodstream where it binds to a carrier protein called transferrin and is ultimately used to produce hemoglobin in red blood cells.
💊How it's taken▾
Ferric citrate tablets are taken by mouth with meals. The number of tablets taken each day varies by condition and is adjusted by your doctor based on your lab results.
- Tablets must be swallowed whole — never chewed or crushed, as this can discolor your mouth and teeth
- For phosphorus control in dialysis patients, dosing is typically multiple tablets several times per day with meals; your doctor will fine-tune the amount over time
- For iron deficiency anemia in non-dialysis CKD patients, dosing generally starts lower and is adjusted to reach your hemoglobin goal
- Always follow your prescriber's specific instructions — do not adjust your dose without checking first
🤒Side effects — in detail▾
The most common side effects involve the digestive system and are often manageable.
- Discolored (dark or black) stools — very common; this is expected from the iron and is not a sign of bleeding
- Diarrhea
- Constipation
- Nausea
- Vomiting
- Abdominal pain
- Cough
- High potassium levels (hyperkalemia)
Gastrointestinal side effects are the most common reason people stop taking ferric citrate. If these symptoms are severe or persistent, contact your doctor. Also watch for signs of iron overload (see Warnings) and report them promptly.
⚠️Warnings & precautions▾
- Iron overload: Because ferric citrate delivers iron to your body, iron can accumulate to excessive levels — particularly if you are also receiving IV iron. Your doctor should check iron markers (ferritin and TSAT) before you start and regularly during treatment. If levels rise too high, your IV iron may need to be reduced or stopped.
- Child safety / accidental overdose: Iron-containing products are a leading cause of fatal poisoning in children under 6 years of age. Keep ferric citrate tablets stored securely out of children's reach at all times. If a child accidentally swallows any, call a doctor or poison control center immediately.
- Do not use if you have iron overload syndromes (such as hemochromatosis) — ferric citrate is contraindicated in these conditions.
🔀What it interacts with▾
Ferric citrate can reduce the absorption of certain oral medications when taken at the same time. Key interactions to be aware of:
- Doxycycline (antibiotic): Take doxycycline at least 1 hour before ferric citrate — ferric citrate can dramatically reduce doxycycline levels in the body
- Ciprofloxacin (antibiotic): Take ciprofloxacin at least 2 hours before or after ferric citrate — ferric citrate can reduce ciprofloxacin absorption by about 45%
- Other oral medications: For drugs where even a small drop in absorption could be harmful (especially those with a narrow therapeutic range), ask your doctor or pharmacist whether you need to space the timing of your doses
- Drugs tested and found not to interact significantly (when taken at the same time or 2 hours apart) include clopidogrel, digoxin, diltiazem, glimepiride, and losartan — but always confirm with your pharmacist for any new medication
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Iron overload conditions (e.g., hemochromatosis): Do not take ferric citrate — it is contraindicated
- Pregnancy: No safety data exist for ferric citrate tablets in pregnant women; iron overdose in pregnancy may carry risk of spontaneous abortion, gestational diabetes, and fetal malformation — discuss with your doctor
- Breastfeeding: It is unknown whether ferric citrate passes into human breast milk; weigh benefits and risks with your doctor
- Children: Safety and effectiveness have not been established in pediatric patients; children under 6 are at serious risk from accidental ingestion
- Older adults (65+): Clinical studies included patients 65 and older without identifying meaningful differences in safety or efficacy compared to younger adults
- Receiving IV iron: Tell your doctor — your IV iron dose may need to be adjusted to prevent iron overload
🚑If you take too much▾
No specific overdose cases in patients taking ferric citrate tablets have been fully reported, but taking too much can lead to excessive iron buildup in the body, which can damage organs. One clinical trial case documented iron accumulation in the liver in a dialysis patient also receiving IV iron. If you think you or someone else has taken too much, contact a doctor or poison control center right away — this is especially urgent if a child has accidentally swallowed any tablets.
📡Pharmacodynamics — effects in the body▾
In dialysis patients treated for high phosphorus, ferric citrate measurably lowers blood phosphorus levels. It also raises iron-related blood markers — including ferritin, transferrin saturation (TSAT), and serum iron — which can reduce the need for IV iron supplementation. In non-dialysis CKD patients treated for iron deficiency anemia, ferric citrate can increase hemoglobin levels and has also been shown to reduce blood phosphorus as a secondary effect.
🔬Pharmacokinetics — how your body processes it▾
Formal pharmacokinetic studies (measuring exactly how the body absorbs and clears the drug) have not been conducted for ferric citrate tablets. However, changes in blood iron markers confirm that iron from ferric citrate is absorbed into the body systemically. When taken at the same time as ciprofloxacin, ferric citrate reduces the antibiotic's absorption by about 45%; separating the doses by 2 hours eliminates this interaction.
📦How to store it▾
Store at 20° to 25°C (68° to 77°F), excursions permitted to 15° to 30°C (59° to 86°F). Protect from moisture.
📄 Written from Ferric Citrate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
Supplements & herbs that interact with Ferric Citrate
17 supplements and herbal products have documented interactions with Ferric Citrate in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 1
- Moderate · 7
- Minor · 9
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Ferric Citrate — the kind of thing our pharmacy team would talk through with you at the counter.
Why are my stools turning dark or black — is that dangerous? ▾
Do I have to take it with food, or can I take it on an empty stomach? ▾
Can I crush or chew the tablets if they're hard to swallow? ▾
I also take ciprofloxacin (Cipro). Is that a problem? ▾
Is there anything I should watch out for that would mean I need to call my doctor? ▾
I'm pregnant. Is it safe to keep taking ferric citrate? ▾
Is Ferric Citrate available over the counter? ▾
When was Ferric Citrate first available? ▾
Who makes Ferric Citrate? ▾
💬 Answers drafted from Ferric Citrate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Ferric Citrate comes
Ferric Citrate is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Tablet
How this form is used
- Auryxia is used to control high phosphorus levels (hyperphosphatemia) in adults with chronic kidney disease on dialysis
- Auryxia is used to treat iron deficiency anemia in adults with chronic kidney disease not on dialysis
- Ferric Citrate tablets are used to control high phosphorus levels in adults with chronic kidney disease on dialysis
- Ferric Citrate tablets are used to treat iron deficiency anemia in adults with chronic kidney disease not on dialysis
- Auryxia and Ferric Citrate tablets must be swallowed whole — do not chew or crush, as this can stain your mouth and teeth
- Take tablets with meals, as directed by your doctor — typically multiple times per day
- Your doctor will adjust your dose based on your phosphorus or hemoglobin lab results; do not change your dose on your own
- Store tablets out of reach of children at all times
📊 Ferric Citrate across the U.S. market
How Ferric Citrate appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
Also listed with the FDA, not a patient dose form: Powder (8) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Ferric Citrate is used
A general measure of how commonly Ferric Citrate is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Ferric Citrate is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Ferric Citrate prescribed? Of the 1,596 medications we measure, Ferric Citrate ranks #887 by Medicaid prescriptions — more than 44% of them.
Utilization by Ferric Citrate product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
ferric citrate 1000 MG Oral Tablet
Summed across the 2 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1594680
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Ferric Citrate, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 3 listed Ferric Citrate NDCs with Medicaid activity.
🔍 Compare Ferric Citrate products
A representative set of FDA-listed product records for Ferric Citrate — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Tablet | ||||
| 210 mg | Oral | Akebia Therapeutics, Inc. × 3 listings | NDA | View NDC → |
| 210 mg | Oral | Mylan Pharmaceuticals Inc. | NDA AUTHORIZED GENERIC | View NDC → |
| 210 mg | Oral | Teva Pharmaceuticals, Inc. | ANDA | View NDC → |
| 💊Bulk drug substance | ||||
| 1 kg/kg | — | Apicore Pharmaceuticals Private Limited | BULK INGREDIENT | View NDC → |
| 1 mg/mg | — | Cohance Lifesciences Limited | BULK INGREDIENT FOR HUMAN PRESCRIPTION COMPOUNDING | View NDC → |
| 1 kg/kg | — | Hetero Drugs Limited | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Lupin Manufacturing Solutions Limited | BULK INGREDIENT | View NDC → |
| 35 kg/35 kg | — | Nuray Chemicals Private Limited | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Siegfried St. Vulbas SAS | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Siegfried USA, LLC | BULK INGREDIENT | View NDC → |
| 60 kg/60 kg | — | Sionc Pharmaceuticals Pvt Ltd | BULK INGREDIENT | View NDC → |
Showing 13 of 13 products — FDA National Drug Code Directory. See every product, package size and price: browse all 13 Ferric Citrate NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Ferric Citrate — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Ferric Citrate in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Ferric Citrate went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 1594675 1 dose form · 1 strength
-
Dose form (SCDF) Oral Tablet RxCUI 1594679In current FDA listingsClinical drug / strength (SCD) 1000 MGRxCUI 1594680
Look up RxCUI 1594675 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Ferric Citrate is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Ferric Citrate belongs to the Drugs for treatment of hyperkalemia and hyperphosphatemia class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 3 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Mylan Pharmaceuticals Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.