vadadustat + ferric citrate

Vadadustat + ferric citrate is a combination of two oral drugs: vadadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), and ferric citrate, an oral iron-based phosphate binder and iron supplement. - Vadadustat works by inhibiting HIF-prolyl-4-hydroxylases, leading to the stabilization of HIF-1α and HIF-2α transcription factors and increasing endogenous erythropoietin (EPO) production, thereby stimulating erythropoiesis (red blood cell production) for the treatment of anemia, especially in chronic kidney disease (CKD)[1][3][4]. - Ferric citrate functions as both a phosphate binder (to reduce serum phosphorus levels in CKD) and as an iron supplement, increasing iron stores for erythropoiesis[2]. The combination is anticipated for use in treating anemia and hyperphosphatemia in CKD, particularly in dialysis patients, though co-administration potentially impacts vadadustat pharmacokinetics: ferric citrate can decrease vadadustat exposure when given together, so careful dosing interval management is required[1][3].