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

Excipients: disodium edetate (Trilon B) 0.25 mg, sodium hydrogen carbonate₎ - 23.85 mg, - sodium sulfite anhydrous - 2.0 mg, water for injection - up to 1 ml.

Description:Transparent colorless or slightly yellowish or greenish-yellow liquid.

Pharmacotherapeutic group:Vitamin

ATX: & nbsp

A.11.G.A.01 Ascorbic acid

Pharmacodynamics:

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, reduces vascular permeability, reduces the need for vitamins B1, B2, A, E, folic acid, pantothenic acid.

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

Regulates hydrogen transport 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 enhances 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.

Regulates immunological reactions (activates the synthesis of antibodies, C3-component of complement, interferon), promotes phagocytosis.

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 blood plasma is normally about 10-20 μg / ml, the reserves in the body are about 1.5 g. It easily penetrates into leukocytes, platelets, and then into all tissues; the highest 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. In 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.

It is metabolized primarily in the liver, in the desoxyascorbic and further in oxaloacetic and diketogulonic acids.

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

When high doses are prescribed, when the plasma concentration reaches more than 1.4 mg / dL, the excretion increases sharply, with increased excretion remaining after discontinuation of the administration. 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 medical purposes in all clinical situations associated with the need for additional administration of ascorbic acid, including: parenteral nutrition, diseases of the gastrointestinal tract (persistent diarrhea, resection of the small intestine, peptic ulcer, gastrectomy), Addison's disease.

In laboratory practice: for marking red blood cells (together with sodium chromate CrSi).

Contraindications:Hypersensitivity. 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:

The use of the drug during pregnancy and during lactation is possible only according to the doctor's prescription in the event that the intended benefit to the mother exceeds the potential risk to the fetus or the child.

Dosing and Administration:

Ascorbic acid is administered intramuscularly, 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 (10 ml of 50 mg / ml solution) per day.

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

For the marking of erythrocytes (together with sodium chromate Cr51) - 100 mg of ascorbic acid is injected into a bottle of sodium chromate Cr51.

Side effects:

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

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

Allergic reactions: skin rash, skin hyperemia.

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

Local reactions: pain in the place of intramuscular injection.

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

Overdose:

Symptoms: nephrolithiasis, insomnia, irritability, hypoglycemia.

Treatment: symptomatic, forced diuresis.

Interaction:

Increases the concentration in the blood of benzylpenicillin and tetracyclines; in a dose of 1 g per day increases the bioavailability of ethinyl estradiol (including those included in oral contraceptives).

Improves absorption in the intestines of iron preparations (converts trivalent iron into bivalent); can increase the excretion of iron with simultaneous application with deferoxamine.

Reduces the effectiveness of heparin, indirect anticoagulants.

With simultaneous use with acetylsalicylic acid, urinary excretion of ascorbic acid increases and the excretion of acetylsalicylic acid decreases. 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.

The drugs of quinoline series, 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 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, dextrins, 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.

High doses of ascorbic acid increase the excretion of oxalates, promoting the formation of kidney stones.

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

The minimum daily requirement for ascorbic acid in II-III trimesters of pregnancy - 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 "cancellation" syndrome may develop in a newborn.

The minimum daily requirement for lactation is 80 mg. A mother's diet containing an adequate amount of ascorbic acid is sufficient to prevent her 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).

Effect on the ability to drive transp. cf. and fur:No data.

Form release / dosage:Solution for intravenous and intramuscular injection 50 mg / ml.

Packaging:

1 or 2 ml into ampoules. 10 ampoules are placed in a box of cardboard. In each box, an ampoule scaler and instructions for use are attached. Boxes are pasted with a label - parcel post.

5 ampoules are placed in a contour mesh package made of a polyvinyl chloride film.

2 contour packs together with the instructions for use and the ampoule scarifier are placed in a pack of cardboard.

When using ampoules with a notch, dot or ring fracture, 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:P N003312 / 01

Date of registration:29.05.2009 / 02.11.2011

Expiration Date:Unlimited

The owner of the registration certificate:MOSHIMFARM PREPARATES them. N.А.Semashko, OJSC MOSHIMFARM PREPARATES them. N.А.Semashko, OJSC Russia

Manufacturer: & nbsp

MOSHIMFARM PREPARATES them. NA Semashko OJSC Russia

Representation: & nbspMOSHIMFARM PREPARATES them. NA Semashko OJSC MOSHIMFARM PREPARATES them. NA Semashko OJSC Russia

Information update date: & nbsp26.09.2017

Illustrated instructions

Instructions

Ascorbic acid (Ascorbic acid)