Ascorbic acid - instructions for use, dose, side effects, contraindications

Increases the activity of amidating enzymes involved in the processing of oxytocin, ADH and holitsistokinina. Participates in steroidogenesis in the adrenal glands. Restores iron trivalent to ferrous iron in the intestines, contributing to its absorption.

The main role in the tissues is participation in the synthesis of collagen, proteoglycans and other organic components of the intercellular substance of the teeth, bones and endothelium of the capillaries.

Pharmacokinetics:

It is adsorbed in the gastrointestinal tract (GIT) (mainly in the jejunum). With an increase in the dose up to 200 mg, up to 140 mg (70%) is absorbed; with a further increase in the dose, the absorption decreases (50-20%). Connection with plasma proteins - 25%. Diseases of the gastrointestinal tract (stomach ulcer and duodenal ulcer, constipation or diarrhea, helminthic invasion, giardiasis), the use of fresh fruit and vegetable juices, alkaline drink reduce absorption of ascorbic acid in the intestine.

The concentration of ascorbic acid in the plasma is normally about 10-20 μg / ml, the reserves in the body are about 1.5 g when taking daily recommended doses and 2.5 g when taking 200 mg / day. Time to reach the maximum concentration in the blood after ingestion - 4 hours.

Easily penetrates into leukocytes, platelets, and then into all tissues; the greatest concentration is achieved in glandular organs, leukocytes, liver and lens of the eye; penetrates the placenta. The concentration of ascorbic acid in leukocytes and platelets is higher than in erythrocytes and in plasma. With deficient states, the concentration in leukocytes decreases later and more slowly and is considered as the best criterion for assessing the deficit than the concentration in the plasma.

Metabolised mainly in the liver in desoxyascorbic and then in oxaloacetic acid and ascorbate-2-sulfate.

It is excreted by the kidneys, through the intestines, with sweat, breast milk in the unchanged form and in the form of metabolites.

At the appointment of high doses, the rate of excretion increases sharply. Smoking and the use of ethanol accelerate the destruction of ascorbic acid (conversion into inactive metabolites), sharply reducing the reserves in the body.

It is in hemodialysis.

Indications:

Prevention and treatment of hypo- and vitamin deficiency vitamin C.

The states of increased need for ascorbic acid: unbalanced nutrition, increased mental and physical loads, recovery period after severe diseases,a feverish state against the background of ARI, ARVI; pregnancy (multiple, with nicotine or drug dependence).

Contraindications:

Hypersensitivity to the components of the drug; with prolonged use in large doses (more than 500 mg) - diabetes mellitus, hyperoxaluria, nephrolithiasis, hemochromatosis, thalassemia, deficiency of glucose-6-phosphate dehydrogenase; children under 5 years.

Carefully:Diabetes mellitus, deficiency of glucose-6-phosphate dehydrogenase, hemochromatosis, sideroblastic anemia, thalassemia, hyperoxaluria, renal stone disease, progressive malignant diseases.

Pregnancy and lactation:

During pregnancy, a doctor's consultation is necessary before using the drug. The minimum daily requirement for ascorbic acid in II-III trimesters of pregnancy - about 60 mg.

The minimum daily requirement for breastfeeding is 80 mg.

A mother's diet containing an adequate amount of ascorbic acid is sufficient to prevent vitamin C deficiency in an infant (it is recommended not to exceed the maximum monthly requirement for ascorbic acid in the nursing mother).

It should be borne in mind that the fetus can adapt to high doses of ascorbic acid, which is taken by a pregnant woman, and then a "cancellation" syndrome may develop in a newborn.

Dosing and Administration:

Inside, after eating. Powder is used for making beverages - 2.5 g of ascorbic acid powder (contents of one sachet bag) per 2.5 liters of water. The solution is taken freshly prepared, according to the dosages proposed below. For dosing, the use of a medical measuring cup is recommended.

For prevention: adults 50 mg - 100 mg (50 ml - 100 ml) per day, children from 5 years of 50 mg (50 ml) a day.

For treatment: adults 50 mg - 100 mg (50 ml - 100 ml) 3-5 times a day, children from 5 years 50 mg (50 ml) -100 mg (100 ml) 2-3 times a day.

During pregnancy and breastfeeding 300 mg (300 ml) per day for 10-15 days, then - 100 mg (100 ml) per day.

For adults: the maximum single dose is 200 mg, the daily dose is 1 g; for children: the maximum single dose is 100 mg, daily - 500 mg.

Note: the medical measuring cup is not included in the kit.

Side effects:

From the central nervous system (CNS): headache, fatigue, with prolonged use of large doses - increased excitability of the central nervous system, sleep disorders, insomnia.

From the digestive system: irritation of the gastrointestinal mucosa, with prolonged use of large doses - hyperacid gastritis, ulceration of the mucous membrane of the gastrointestinal tract, nausea, vomiting, diarrhea, stomach cramps.

From the endocrine system: oppression of the function of the insular apparatus pancreas (hyperglycemia, glucosuria).

Co the side of the urinary system: when used in high doses - hyperoxalaturia and the formation of urinary stones from calcium oxalate; moderate pollakiuria (when taking a dose of more than 600 mg / day), with prolonged use of large doses - damage to the glomerular apparatus of the kidneys.

From the side of the cardiovascular system: thrombosis, when used in high doses - increased blood pressure, development of microangiopathies, myocardial dystrophy. With prolonged use of large doses, a decrease in the permeability of capillaries (possibly a worsening of tissue trophism, hypercoagulability).

Allergic reactions: skin rash, skin hyperemia, rarely - anaphylactic shock.

Laboratory indicators: thrombocytosis, hyperprothrombinemia, erythropenia, neutrophilic leukocytosis, hypokalemia.

Other: sensation of heat, with prolonged use of large doses - sodium retention (Na⁺) and fluids, the disruption of zinc metabolism (Zn²⁺), copper (Cu²⁺).

Overdose:

Symptoms: diarrhea, nausea, irritation of the mucous membrane of the gastrointestinal tract, flatulence, abdominal pain of a spastic nature, frequent urination, nephrolithiasis, insomnia, irritability, hypoglycemia. If any side effects occur, stop taking the medication and consult a doctor.

Treatment: symptomatic, forced diuresis.

Interaction:

Increases the concentration in the blood of benzylpenicillin and tetracyclines; in a dose of 1 g / day increases the bioavailability of ethinyl estradiol. Improves absorption in the intestines of iron preparations (converts trivalent iron into bivalent); can increase the excretion of iron with simultaneous application with deferoxamine. Acetylsalicylic acid (ASA), oral contraceptives, fresh juices and alkaline drink reduce absorption and absorption. With simultaneous application with ASA, urinary excretion of ascorbic acid increases and ASA excretion decreases. ASA reduces the absorption of ascorbic acid by about 30%. Increases the risk of developing crystalluria in the treatment of salicylates and sulfonamides short-acting, slows the excretion of kidney acids, increases the excretion of drugs that have an alkaline reaction (including alkaloids), reduces the concentration of oral contraceptives in the blood.Increases the total clearance of ethanol, which, in turn, reduces the concentration of ascorbic acid in the body. Preparations of quinoline series (fluoroquinolones, etc.), calcium chloride, salicylates, glucocorticosteroids with long-term use deplete the stores of ascorbic acid. With simultaneous use reduces the chronotropic effect of isoprenaline. With prolonged use or use in high doses, it can disrupt the interaction of disulfiram-ethanol. In high doses increases the renal excretion of mexiletine. Barbiturates and primidon increase the excretion of ascorbic acid in the urine. Reduces the therapeutic effect of antipsychotic drugs (phenothiazine derivatives), tubular reabsorption of amphetamine and tricyclic antidepressants.

Reduces the effectiveness of heparin and indirect anticoagulants.

Special instructions:

In connection with the stimulating effect of ascorbic acid on the synthesis of glucocorticosteroid hormones, it is necessary to monitor the function of the adrenal glands and arterial pressure. With prolonged use of large doses, oppression of the insulin function of the pancreas is possible, so during the treatment of her must be regularly monitored. In patients with elevated iron levels in the body, ascorbic acid should be used in minimal doses. Assigning ascorbic acid to patients with. rapidly proliferating and intensely metastatic tumors can aggravate the course of the process. Ascorbic acid, as a reducing agent, can distort the results of various laboratory tests (blood glucose, bilirubin, transaminase activity, lactate dehydrogenase). High doses of ascorbic acid increase the excretion of oxalates, promoting the formation of kidney stones. In newborns, whose mothers took high doses of ascorbic acid, and in adults who took high doses, there may be a "ricochet" scurvy.

Form release / dosage:

Powder for solution for oral administration 2.5 g.

Packaging:

By 2.5 grams in heat-sealing bags of packaging material of films, papers and combined materials or material combined "Buflen".

1, 2, 5, 10, 20, 50, 100 heat-sealable packages together with the instruction for use are placed in a hermetically sealed packet of a film of polyethylene opaque or transparent,or from packaging material of films, papers and combined materials or the material of a combined "Buflen".

For hospitals with 200, 400, 600 heat-sealable packets together with an equal number of instructions are placed in a hermetically sealed packet of a film of polyethylene opaque or transparent.

1, 2, 5, 10, 20, 50, 100 heat-sealable Packages together with instructions for use are placed in a cardboard pack.

It is allowed to apply instructions for use on the pack and on the package of consumer packaging.

Packs, packages consumer packages and packages for hospitals stacked in a box of cardboard.

Storage conditions:

In a dry, the dark place at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Shelf life:

3 years.

Do not use after the expiration date.

Terms of leave from pharmacies:Without recipe

Registration number:LSR-006427/10

Date of registration:06.07.2010 / 29.02.2016

Expiration Date:Unlimited

The owner of the registration certificate:LYUMI, LLC LYUMI, LLC Russia

Manufacturer: & nbsp

LYUMI, LLC Russia

Information update date: & nbsp26.09.2017

Illustrated instructions

Instructions

Ascorbic acid (Ascorbic acid)