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

Ascorbic acid (vitamin C) - a vitamin remedy, has a metabolic effect, is not formed in the human body, but comes only with food. Participates in the regulation of oxidation-reduction processes, carbohydrate metabolism, blood clotting, tissue regeneration; increases the body's resistance to infections.

Participates in the metabolism of phenylalanine, tyrosine, folic acid, norepinephrine, histamine, iron, glucose utilization, lipid synthesis, proteins, carnitine, immune reactions, hydroxylation of serotonin, enhances the absorption of non-iron gland. It has antiplatelet and antioxidant properties.

Regulates the transport of H + in many biochemical reactions, improves the use of glucose in the cycle of tricarboxylic acids, participates in the formation of tetrahydrofolic acid and tissue regeneration, the synthesis of steroid hormones, collagen, procollagen.

It supports the colloidal state of the intercellular substance and the normal permeability of capillaries (oppresses hyaluronidase).

Activates proteolytic enzymes, participates in the exchange of aromatic amino acids, pigments and cholesterol, promotes the accumulation of glycogen in the liver.Due to the activation of respiratory enzymes in the liver, it intensifies its detoxification and protein-forming functions, increases the synthesis of prothrombin.

It improves bile secretion, restores the exocrine function of the pancreas and the endocrine function of the pancreas.

It inhibits the release and accelerates the degradation of histamine, inhibits the formation of prostaglandins and other mediators of inflammation and allergic reactions.

Pharmacokinetics:

Connection with plasma proteins - 25%.

The concentration of ascorbic acid in the plasma is normally around 10-20 μg / ml. 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; deposited in the posterior lobe of the pituitary gland, adrenal cortex, ocular epithelium, interstitial cells of the seminal glands, ovaries, liver, spleen, pancreas, lungs, kidneys, intestinal wall, heart, muscles, thyroid gland; 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 and diketogulonovoy acid.

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

Treatment of hypo-and avitaminosis C (if necessary, rapid replenishment of vitamin C and the impossibility of oral administration).

Applied for therapeutic purposes in all clinical situations associated with the need for additional administration of ascorbic acid, including parenteral nutrition, gastrointestinal diseases (persistent diarrhea, small intestine resection, peptic ulcer, gastrectomy), Addison's disease.

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.

Carefully:

Diabetes mellitus, hyperoxaluria, deficiency of glucose-6-phosphate dehydrogenase, hemochromatosis, sideroblastic anemia, thalassemia, kidney stone disease.

Pregnancy and lactation:

In pregnancy and during lactation apply only if the intended benefit to the mother exceeds the potential risk to the fetus or child.

Dosing and Administration:

Apply to the doctor's prescription.

Ascorbic acid is prescribed intramuscularly and intravenously (slowly).

Therapeutic doses for adults - from 100 to 500 mg (2-10 ml of 50 mg / ml solution) per day, with scurvy therapy up to 1000 mg per day.

Therapeutic doses for children - from 100 to 300 mg (2-6 ml of 50 mg / ml solution) per day, with scurvy therapy up to 500 mg (up to 10 ml of 50 mg / ml solution) per day.

The duration of treatment depends on the nature and course of the disease.

Side effects:

From the central nervous system (CNS): with rapid intravenous injection - dizziness, fatigue, with prolonged use of large doses (more than 1 g) - headache, increased excitability of the central nervous system, insomnia.

From the urinary system: moderate pollakiuria (with a dose of more than 600 mg per day), with prolonged use of large doses - hyperoxaluria, nephrolithiasis (calcium oxalate), damage to the glomerular apparatus of the kidneys.

From the cardiovascular system: with prolonged use of large doses - a decrease in the permeability of capillaries (possibly worsening of tissue trophism, increased blood pressure, hypercoagulation, development of microangiopathies).

Allergic reactions: skin rash, skin hyperemia.

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

Other: with prolonged use of large doses (more than 1 g) - suppression of the function of the insulin apparatus of the pancreas (hyperglycemia, glucosuria), with intravenous administration of the threat of abortion (due to estrogenemia), hemolysis of erythrocytes.

Local reactions: pain in the place of intramuscular reference.

Interaction:

Ascorbic acid increases the concentration of benzylpenicillin and tetracyclines in the blood; in a dose of 1 g / day increases the bioavailability of ethinyl estradiol (including that of oral contraceptives).

Reduces the effectiveness of heparin and indirect anticoagulants.

With simultaneous use with acetylsalicylic acid (ASA), urinary excretion of ascorbic acid increases and the excretion of ASA 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 acid by the kidneys, increases the excretion of drugs (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.

LS quinoline, calcium chloride, salicylates, glucocorticosteroid hormones 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 interfere with the interaction of disulfiram and ethanol.

In high doses increases the excretion of mexiletine by the kidneys.

Barbiturates and primidon increase the excretion of ascorbic acid in the urine.

Reduces the therapeutic effect of antipsychotic drugs (neuroleptics) - phenothiazine derivatives, tubular reabsorption of amphetamine and tricyclic antidepressants.

Pharmaceutically incompatible with aminophylline, bleomycin, cefazolin, cefapyrin, chlordiazepoxide, estrogens, dextrans, doxapram, erythromycin, methicillin, nafcillin, benzylpenicillin, warfarin.

Special instructions:

In connection with the stimulating effect of ascorbic acid on the synthesis of corticosteroid hormones, it is necessary to monitor the function of the adrenals and arterial pressure.

With prolonged use of large doses, oppression of the insulin function of the pancreas is possible, so during treatment it must be regularly monitored.

In patients with elevated iron levels in the body, ascorbic acid should be used in minimal doses.

Ascorbic acid as a reducing agent can distort the results of various laboratory tests (blood and urine content of glucose, bilirubin, activity of "hepatic" transaminases and lactate dehydrogenase).

The minimum daily requirement for ascorbic acid in the II-III trimesters of pregnancy is about 60 mg. 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 newborn can develop the "withdrawal" syndrome.

The minimum daily requirement for lactation is 80 mg. A mother's diet containing an adequate amount of ascorbic acid is sufficient to prevent a deficiency in an infant. Theoretically, there is a danger to the child when the mother uses high doses of ascorbic acid (it is recommended not to exceed the daily need for ascorbic acid by the lactating mother).

Form release / dosage:

Solution for intravenous and intramuscular injection 50 mg / ml.

Packaging:

For 2 ml of the drug in the ampoules of neutral glass or light-protective neutral glass.

For 5, 10, 30, 50 or 100 ampoules, together with the instruction for medical use of the drug and the ampoule scarifier, is placed in a cardboard box.

For 5 or 10 ampoules, together with the instruction for medical use of the drug and the ampoule scarifier, is placed in a cardboard box with cardboard partitions, or 5 or 10 ampoules are placed in a contour mesh box made of cardboard or a polyvinylchloride film.

1, 2, 3, 4, 5, 6, 10, 15, 20 or 30 contour mesh packages together with instructions for the medical use of the preparation and the ampoule ampoule are placed in a pack of cardboard for consumer packaging brand chromium or chrome-ersatz.At 10, 15, 20, 30, 40, 50, 60 or 100 contour cell packs with 5-10 instructions for medical use of the drug and 5-10 ampoule scalers are placed in a box of corrugated cardboard [for hospitals].

When using ampoules with a notch or a fracture ring, the scarifier is not inserted.

Storage conditions:

In the dark place at a temperature of no higher than 25 ° C. Keep out of the reach of children.

Shelf life:

1 year. Do not use after the expiration date printed on the package.

Terms of leave from pharmacies:On prescription

Registration number:LSR-005603/09

Date of registration:13.07.2009 / 17.06.2014

Expiration Date:Unlimited

The owner of the registration certificate:ESKOM NPK, OAO ESKOM NPK, OAO Russia

Manufacturer: & nbsp

ESKOM NPK, OAO Russia

Information update date: & nbsp26.09.2017

Illustrated instructions

Instructions

Ascorbic acid (Ascorbic acid)