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Auryxia
Auryxia (ferric citrate) is a phosphate binder used to control serum phosphorus levels in patients with chronic kidney disease (CKD) who are on dialysis. It is also indicated for the treatment of iron deficiency anemia in adult patients with CKD who are not on dialysis. Auryxia helps reduce phosphorus absorption from food, which is crucial for preventing complications such as bone disease in patients with CKD. Additionally, it increases iron levels, which can help manage anemia.
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Frequently Asked Questions
How long does it take for Auryxia to start working?
Auryxia begins to lower serum phosphorus levels within days of starting treatment, but regular monitoring is needed to adjust the dose and ensure effective management of phosphorus levels.
Can I take Auryxia with other medications?
Auryxia may interfere with the absorption of certain medications, such as antibiotics and thyroid medications. To avoid interactions, take these medications at least 1 hour before or 2 hours after Auryxia.
Can Auryxia cause iron overload?
Yes, Auryxia can increase iron levels in the body, which may lead to iron overload in some patients, especially those with pre-existing iron storage disorders. Regular monitoring of iron levels is necessary.
What should I do if I miss a dose of Auryxia?
If you miss a dose, take it as soon as you remember, as long as it is with food. If it is close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for the missed one.
Does Auryxia affect stool color?
Yes, Auryxia may cause dark or black stools due to the iron content. This is a normal side effect and not a cause for concern unless accompanied by symptoms of gastrointestinal bleeding.
Comprehensive Drug Guide
How Does Auryxia Work?
Auryxia works by binding to phosphate in the gastrointestinal tract, reducing its absorption into the bloodstream. This helps maintain appropriate phosphorus levels in patients with CKD. Additionally, ferric citrate provides a source of iron, which is absorbed from the gastrointestinal tract and helps treat iron deficiency anemia by increasing hemoglobin levels.
Common Dosages
- Tablets: 210 mg of ferric iron (as ferric citrate), equivalent to 1 g of ferric citrate
Typical Dosing
- For the management of serum phosphorus in CKD patients on dialysis, the typical starting dose is 2 tablets (420 mg ferric iron) taken 3 times daily with meals. The dose may be adjusted based on serum phosphorus levels.
- For iron deficiency anemia in CKD patients not on dialysis, the typical starting dose is 1 tablet 3 times daily with meals, and the dose may be adjusted based on iron levels.
Typical Dosing
FDA Approved Indications
- Control of serum phosphorus levels in adult patients with CKD on dialysis
- Treatment of iron deficiency anemia in adult patients with CKD who are not on dialysis
Who Shouldn't Take Auryxia?
- Hemochromatosis or other conditions associated with iron overload
- Known hypersensitivity to ferric citrate or any component of the formulation
Advice From The Pharmacist
- Take Auryxia with meals to maximize its effectiveness in binding dietary phosphorus.
- Be aware that Auryxia can cause black or dark stools, which is a normal side effect due to the iron content and is not a cause for concern unless accompanied by symptoms of gastrointestinal bleeding.
- Regular monitoring of serum phosphorus, iron levels, and ferritin is required to ensure the medication is working effectively and to avoid iron overload.
- If you are taking other medications, such as antibiotics or thyroid medications, take them at least 1 hour before or 2 hours after Auryxia to prevent absorption issues.
Side Effects of Auryxia
Common Side Effects
- Diarrhea
- Nausea
- Constipation
- Abdominal pain
- Dark stools (due to iron content)
Uncommon/Severe Side Effects
- Iron overload, particularly in patients with pre-existing iron storage disorders
- Hypersensitivity reactions, such as rash, itching, or swelling
Risks and Warnings of Auryxia
- Iron overload: Auryxia can increase iron levels, which can lead to iron overload if not monitored properly, especially in patients with conditions like hemochromatosis or those on multiple iron therapies.
- Gastrointestinal effects: Auryxia may cause gastrointestinal discomfort, such as diarrhea, nausea, or constipation. These side effects are usually mild, but if they become severe, notify your healthcare provider.
- Medication interactions: Auryxia may interfere with the absorption of certain medications, such as antibiotics, thyroid medications, and bisphosphonates. Take these medications at least 1 hour before or 2 hours after Auryxia.
Interactions with Auryxia
Common Drug Interactions
- Antibiotics (e.g., doxycycline, ciprofloxacin): Auryxia can reduce the absorption of these medications. To avoid interactions, take antibiotics at least 1 hour before or 2 hours after Auryxia.
- Thyroid medications (e.g., levothyroxine): Auryxia may interfere with the absorption of thyroid medications. Take thyroid medications at least 1 hour before or 2 hours after Auryxia.
- Calcium supplements: Calcium supplements may decrease the effectiveness of Auryxia as a phosphate binder. Consult your healthcare provider about timing the intake of calcium supplements.
Alternatives to Auryxia
- Sevelamer (Renvela, Renagel): Another phosphate binder used in patients with CKD to reduce phosphorus levels.
- Lanthanum carbonate (Fosrenol): A phosphate binder that helps control phosphorus levels in patients with CKD.
- Ferric pyrophosphate citrate (Triferic): An iron replacement product used in dialysis patients to manage anemia and maintain hemoglobin levels.
- Calcium acetate (PhosLo): A phosphate binder that is used to control high phosphorus levels in patients with CKD.
