Auryxia (ferric citrate) for Kidney Disease: Drug Warnings


Generic drug: ferric citrate

Brand name: Auryxia

What is Auryxia (ferric citrate), and how does it work?

Auryxia (ferric citrate) is a phosphate binder used for the control of serum phosphorus levels in patients with chronic kidney disease on dialysis.

What are the side effects of Auryxia?

Common side effects of Auryxia include:

What is the dosage for Auryxia?

Dosage For Hyperphosphatemia In Chronic Kidney Disease On Dialysis

  • The recommended starting dose is 2 tablets, swallowed whole, 3 times per day with meals.
  • Auryxia tablets must not be chewed or crushed because it may cause discoloration of mouth and teeth.
  • Monitor serum phosphorus levels and titrate the Auryxia dose in decrements or increments of 1 to 2 tablets per day as needed to maintain serum phosphorus at target levels, up to a maximum dose of 12 tablets daily.
  • Dose can be titrated at 1-week or longer intervals.
  • In a clinical trial, patients required an average of 8 to 9 tablets a day to control serum phosphorus levels.

Dosage For Iron Deficiency Anemia In Chronic Kidney Disease Not On Dialysis

  • The recommended starting dose is 1 tablet, swallowed whole, 3 times per day with meals.
  • Auryxia tablets must not be chewed or crushed because it may cause discoloration of mouth and teeth.
  • Titrate the dose of Auryxia as needed to achieve and maintain hemoglobin at target levels, up to a maximum dose of 12 tablets daily.
  • In a clinical trial in patients with chronic kidney disease not on dialysis (CKD-NDD), patients required an average of 5 tablets per day to increase hemoglobin levels.

What drugs interact with Auryxia?

Table 2: Oral drugs that can be administered concomitantly with Auryxia

Amlodipine
Metoprolol

Aspirin
Pravastatin

Atorvastatin
Propranolol

Calcitriol
Sitagliptin

Clopidogrel
Warfarin

Digoxin

Diltiazem

Doxercalciferol

Enalapril

Fluvastatin

Glimepiride

Levofloxacin

Losartan

Oral drugs that have to be separated from Auryxia and meals

Dosing Recommendations

Doxycycline
Take at least 1 hour before Auryxia

Ciprofloxacin
Take at least 2 hours before or after Auryxia

Oral Medications Not Listed In Table 2

  • There are no empirical data on avoiding drug interactions between Auryxia and most concomitant oral drugs.
  • For oral medications where a reduction in the bioavailability of that medication would have a clinically significant effect on its safety or efficacy, consider separation of the timing of the administration of the two drugs.
  • The duration of separation depends upon the absorption characteristics of the medication concomitantly administered, such as the time to reach peak systemic levels and whether the drug is an immediate release or an extended release product.
  • Consider monitoring clinical responses or blood levels of concomitant medications that have a narrow therapeutic range.




QUESTION

The only purpose of the kidneys is to filter blood.
See Answer

Is Auryxia safe to use while pregnant or breastfeeding?

  • There are no available data on Auryxia use in pregnant women to inform a drug-associated risk of major birth defects and miscarriage.
  • There are no human data regarding the effect of Auryxia in human milk, the effects on the breastfed child, or the effects on milk production.

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