Usage
- Sodium feredetate is prescribed for the treatment and prevention of iron deficiency anemia. It is particularly useful in cases where other oral iron preparations are not well-tolerated.
- Pharmacological classification: Iron supplement, hematinic.
- Mechanism of action: Sodium feredetate provides a source of iron, which is essential for hemoglobin synthesis. Hemoglobin is the protein in red blood cells responsible for carrying oxygen throughout the body. By replenishing iron stores, sodium feredetate helps the body produce more red blood cells and hemoglobin, thereby correcting the anemia.
Alternate Names
- Sodium iron edetate
- Brand names: Sytron®, SodiFer®, Feredet®
How It Works
- Pharmacodynamics: Sodium feredetate increases hemoglobin levels and red blood cell count in individuals with iron deficiency anemia. This improves oxygen delivery to tissues.
- Pharmacokinetics:
- Absorption: Primarily absorbed in the duodenum and jejunum (small intestine). Absorption is enhanced in an acidic environment and by the presence of vitamin C. Milk, dairy products, antacids, and certain antibiotics can interfere with absorption.
- Metabolism: The iron in sodium feredetate is incorporated into hemoglobin within red blood cells.
- Elimination: Primarily excreted in feces; small amounts are eliminated in urine and bile.
Dosage
Standard Dosage
Adults:
- Treatment: 5-10 mL three times daily. The dose may be gradually increased based on the individual’s response and tolerance.
- Prophylaxis: Dosage varies depending on individual needs and risk factors for iron deficiency.
Children:
- Treatment: 3-6 mg of elemental iron per kg of body weight daily, divided into 2-3 doses. (Note: 5 mL of sodium feredetate solution typically contains 27.5 mg of elemental iron).
- Prophylaxis: Dosage varies depending on age, feeding method, and risk factors. For example, preterm, exclusively breastfed infants may receive 0.9 mL (approximately 5 mg of elemental iron) daily, starting around 4-6 weeks after birth.
- Pediatric safety considerations: Carefully measure and administer the correct dose to avoid accidental overdose. Liquid preparations should be administered with an oral syringe or medicine spoon to ensure accurate dosing. Keep out of reach of children.
Special Cases:
- Elderly Patients: Similar dosing to adults, but start with a lower dose and titrate up as tolerated. Monitor for gastrointestinal side effects.
- Patients with Renal Impairment: Dose adjustment may be necessary based on the degree of impairment.
- Patients with Hepatic Dysfunction: Use with caution; monitor liver function tests.
- Patients with Comorbid Conditions: Dosage adjustments may be needed in patients with certain gastrointestinal disorders (e.g., inflammatory bowel disease, peptic ulcer disease).
Clinical Use Cases
Dosing in specific clinical settings generally follows the standard adult and pediatric guidelines outlined above.
Dosage Adjustments
- Dose adjustments are based on individual patient factors, including response to therapy, tolerance of side effects, and the presence of comorbid conditions. Serum ferritin and hemoglobin levels should be monitored to assess the effectiveness of treatment.
Side Effects
Common Side Effects
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Dark stools (harmless)
- Abdominal discomfort
Rare but Serious Side Effects
- Allergic reactions (rash, itching, swelling, difficulty breathing)
Long-Term Effects
- Iron overload (with prolonged or excessive use)
Adverse Drug Reactions (ADR)
- Allergic reactions requiring immediate medical attention.
Contraindications
- Hypersensitivity to sodium feredetate or any of its components.
- Iron overload disorders (e.g., hemochromatosis, hemosiderosis).
- Anemias not caused by iron deficiency.
Drug Interactions
- Antacids
- Proton pump inhibitors
- Calcium supplements
- Certain antibiotics (e.g., tetracyclines, quinolones, chloramphenicol)
- Levodopa
- Methyldopa
- Penicillamine
- Thyroid medications (e.g., levothyroxine)
- Bisphosphonates (e.g., alendronate)
- Tea, coffee, and dairy products can decrease iron absorption.
- Vitamin C increases iron absorption.
Pregnancy and Breastfeeding
- Generally considered safe to use during pregnancy and breastfeeding when used as directed. Consult a physician before use.
Drug Profile Summary
- Mechanism of Action: Replenishes iron stores, facilitating hemoglobin synthesis and red blood cell production.
- Side Effects: Nausea, constipation, diarrhea, dark stools. Rarely, allergic reactions.
- Contraindications: Iron overload, hypersensitivity to components.
- Drug Interactions: Antacids, antibiotics, calcium, and certain other medications.
- Pregnancy & Breastfeeding: Generally safe when used as directed.
- Dosage: Varies by age and indication. See detailed dosage guidelines.
- Monitoring Parameters: Hemoglobin, ferritin, red blood cell count.
Popular Combinations
- Often combined with folic acid and vitamin B12, especially during pregnancy or in cases of combined deficiencies.
Precautions
- General Precautions: Assess iron status before starting therapy. Monitor for gastrointestinal side effects.
- Specific Populations:
- Pregnant Women: Monitor iron levels regularly.
- Breastfeeding Mothers: Ensure adequate maternal iron intake.
- Children & Elderly: Careful dosing and monitoring are crucial.
- Lifestyle Considerations: Avoid co-administration with tea, coffee, and dairy products. Taking with vitamin C-rich foods can enhance absorption.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Sodium Feredetate?
A: The dosage varies depending on the patient’s age, the reason for taking the medication (treatment or prevention), and individual factors. Refer to the detailed dosage section above for specific recommendations.
Q2: Can Sodium Feredetate be taken during pregnancy?
A: Yes, sodium feredetate is generally considered safe during pregnancy but should be used under the supervision of a doctor.
Q3: What are the common side effects of Sodium Feredetate?
A: The most common side effects are gastrointestinal, including nausea, vomiting, constipation, diarrhea, and abdominal discomfort. Stools may appear darker, which is a harmless side effect.
Q4: How does Sodium Feredetate interact with other medications?
A: Sodium feredetate can interact with antacids, calcium supplements, certain antibiotics (e.g., tetracyclines, quinolones), and some other medications. It’s important to inform your doctor about all other medications you are taking.
Q5: Are there any contraindications to using Sodium Feredetate?
A: Yes, contraindications include hypersensitivity to the drug, iron overload disorders (e.g., hemochromatosis), and anemias not caused by iron deficiency.
Q6: How is Sodium Feredetate different from other iron supplements?
A: Sodium feredetate contains iron in a chelated form, which is generally better tolerated and less likely to cause gastrointestinal side effects compared to some other iron salts. It also does not stain teeth.
Q7: How should Sodium Feredetate liquid be administered to children?
A: Use an oral syringe or medicine spoon to accurately measure the prescribed dose. Do not use a kitchen teaspoon. The liquid can be given before or between feeds.
Q8: What should be done in case of an overdose?
A: Seek immediate medical attention. Symptoms of overdose can include nausea, vomiting, abdominal pain, and diarrhea.
Q9: Can sodium feredetate be taken with food?
A: While it’s generally recommended to take sodium feredetate between meals for optimal absorption, it can be taken with food if gastrointestinal upset occurs. Avoid taking it with milk, dairy products, antacids, or eggs, as these can interfere with absorption.
