💊 Feup (Ferric Citrate)

Feup serves a dual purpose for patients with Chronic Kidney Disease (CKD). It acts as a phosphate binder by trapping phosphorus from your food in the digestive tract so it can be excreted, and it also provides iron to help treat anemia.

📋 Indications

• Phosphorus Control: For adults with CKD who are on dialysis, to keep serum phosphorus at healthy levels.

• Iron Deficiency Anemia: For adults with CKD who are not on dialysis, to help increase hemoglobin levels.

🥄 Dosage & Administration

This medication must be taken with meals to effectively bind phosphate from food.

• For Patients on Dialysis (Hyperphosphatemia):

  • Starting Dose: 2 tablets, 3 times per day (with meals).

  • Adjustment: Your doctor may increase or decrease this by 1–2 tablets until the target phosphorus level is reached (Maximum 12 tablets/day).

• For Patients NOT on Dialysis (Iron Deficiency):

  • Starting Dose: 1 tablet, 3 times per day (with meals).

  • Adjustment: Adjusted based on your hemoglobin goals (Maximum 12 tablets/day).

• Pediatric Use: Safety has not been established for children or adolescents.

⚠️ Important Drug Interactions

Iron can prevent other medicines from being absorbed properly. You must separate the timing of Feup from:

• Antibiotics: Specifically Doxycycline and Ciprofloxacin.

• Consult your doctor if you are receiving IV Iron, as Feup may require a dose reduction of the injectable form to avoid iron overload.

⚠️ Side Effects & Precautions

• Common: Darkened or discolored stools (very common with iron), diarrhea, constipation, nausea, or abdominal pain.

• Potassium Alert: It may lead to hyperkalemia (high potassium levels), which is particularly important for kidney patients to monitor.

• Iron Overload: Do not use if you have a history of iron overload syndromes like Hemochromatosis.

🤰 Pregnancy & Lactation

There is currently limited data on the use of Ferric Citrate in pregnant women or nursing mothers. It should only be used if clearly directed by your specialist.

📦 Storage & Safety

• Store below 30°C in a dry, dark place.

• 🚨 CRITICAL SAFETY: Accidental overdose of iron products is a leading cause of fatal poisoning in children under 6. Keep this medication strictly out of reach of children.