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Tetraferric Tricitrate Decahydrate

Tetraferric tricitrate decahydrate

Synopsis, Chemistry

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Also known as: Tetraferric tricitrate decahydrate, Ferric citrate hydrate, Ferric citrate [usan], Krx-0502, Db14520, Iron (as ferric citrate) [vandf]

Molecular Formula

C₁₈H₃₂Fe₄O₃₁

Molecular Weight

967.8 g/mol

InChI Key

UISKQNNAQKPSDO-UHFFFAOYSA-E

FDA UNII

Q91187K011

Tetraferric tricitrate decahydrate is an iron containing phosphate binder used to treat hyperphosphatemia and iron deficiency anemia in adults with chronic kidney disease. Tetraferric tricitrate decahydrate was granted FDA approval on 5 September 2014.

1 2D Structure

Tetraferric tricitrate decahydrate

2 Identification

2.1 Computed Descriptors

2.1.1 IUPAC Name

iron(3+);2-oxidopropane-1,2,3-tricarboxylate;decahydrate

2.1.2 InChI

InChI=1S/3C6H7O7.4Fe.10H2O/c3*7-3(8)1-6(13,5(11)12)2-4(9)10;;;;;;;;;;;;;;/h3*1-2H2,(H,7,8)(H,9,10)(H,11,12);;;;;10*1H2/q3*-1;4*+3;;;;;;;;;;/p-9

2.1.3 InChI Key

UISKQNNAQKPSDO-UHFFFAOYSA-E

2.1.4 Canonical SMILES

C(C(=O)[O-])C(CC(=O)[O-])(C(=O)[O-])[O-].C(C(=O)[O-])C(CC(=O)[O-])(C(=O)[O-])[O-].C(C(=O)[O-])C(CC(=O)[O-])(C(=O)[O-])[O-].O.O.O.O.O.O.O.O.O.O.[Fe+3].[Fe+3].[Fe+3].[Fe+3]

2.2 Other Identifiers

2.2.1 UNII

Q91187K011

2.3 Synonyms

2.3.1 MeSH Synonyms

1. Ferric Citrate

2. Ferric Citrate Anhydrous

3. Ferric Citrate Dihydrate

4. Ferric Citrate Hydrate

5. Ferric Citrate Iron(+3) Salt

6. Ferric Citrate Trihydrate

7. Ferric Citrate, 59fe-labeled Cpd

8. Ferric Citrate, Iron Salt, 59fe-labeled Cpd

9. Ferric-citric Acid

10. Iron(iii) Citrate

11. Jtt-751

12. Zerenex

2.3.2 Depositor-Supplied Synonyms

1. Tetraferric Tricitrate Decahydrate

2. Ferric Citrate Hydrate

3. Ferric Citrate [usan]

4. Krx-0502

5. Db14520

6. Iron (as Ferric Citrate) [vandf]

7. Q91187k011

8. Q22075864

9. 1,2,3-propanetricarboxylic Acid, 2-hydroxy-, Iron(3+) Salt, Hydrate (4:3:10)

2.4 Create Date

2015-02-20

3 Chemical and Physical Properties

Molecular Formula	C₁₈H₃₂Fe₄O₃₁
Molecular Weight	967.8 g/mol
Hydrogen Bond Donor Count	10
Hydrogen Bond Acceptor Count	31
Rotatable Bond Count	6
Exact Mass	967.83250 g/mol
Monoisotopic Mass	967.83250 g/mol
Topological Polar Surface Area	440 Å²
Heavy Atom Count	53
Formal Charge	0
Complexity	211
Isotope Atom Count	0
Defined Atom Stereocenter Count	0
Undefined Atom Stereocenter Count	0
Defined Bond Stereocenter Count	0
Undefined Bond Stereocenter Count	0
Covalently Bonded Unit Count	17

4 Drug and Medication Information

4.1 Drug Indication

Tetraferric tricitrate decahydrate is indicated to control serum phosphorous in adults with chronic kidney disease who require dialysis. Tetraferric tricitrate decahydrate is also indicated to treat iron deficiency anemia in adults with chronic kidney disease who are not on dialysis.

5 Pharmacology and Biochemistry

5.1 Pharmacology

Tetraferric tricitrate decahydrate is an iron containing product indicated to treat iron deficiency anemia and hyperphosphatemia. It has a wide therapeutic index, as doses can be varied significantly between patients. Tetraferric tricitrate decahydrate has a long duration of action in the treatment of iron deficiency anemia, due to the slow loss of iron from the body, and a moderate duration of action in the treatment of hyperphosphatemia, due to its action being dependant on residence time in the gastrointestinal tract. Patients should be counselled regarding the risk of iron overload.

5.2 Absorption, Distribution and Excretion

Absorption

Ferric iron has been shown to have inferior bioavailability to ferrous iron preparations. Tetraferric tricitrate decahydrate has 19% the bioavailability of ferrous ascorbate.

Route of Elimination

Unabsorbed oral Tetraferric tricitrate decahydrate is eliminated in the feces. The absorbed iron from Tetraferric tricitrate decahydrate is generally not eliminated from the body by any route other than blood loss and exfoliation of epithelial cells.

Clearance

Data regarding the clearance of iron is not readily available. However, iron loss due to exfoliation of epithelial cells is approximately 1mg/day.

5.3 Metabolism/Metabolites

Ferric cation is converted to ferrous iron by duodenal cytochrome B reductase. The heavy chain ferritin may also convert ferric iron to ferrous iron

5.4 Mechanism of Action

Ferric (Fe³⁺) iron is absorbed from the gastrointestinal tract by divalent metal transporter-1, and reduced to ferrous (Fe²⁺) iron by ferrireductase and cytochrome b reductase 1. Ferrous iron is stored intracellularly in ferritin and transported into the blood by ferroportin 1. Transport by ferroportin 1 is coupled with oxidation to ferric iron by hephaestin or ceruloplasmin. Ferric iron in plasma is bound to transferrin, which carries iron to other cells. Iron is transported to mitochondria for the synthesis of heme or iron-sulfur clusters, which are integral parts of several metalloproteins like hemoglobin. Ferric iron can also bind to phosphate in the gastrointestinal tract, which precipitates as the insoluble ferric phosphate. Ferric phosphate remains unabsorbed and is eliminated in the feces. Decreased phosphate absorption gradually lowers phosphate levels in the blood.