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

Ascorbic acid actively participates in many oxidation-reduction reactions, it has a nonspecific general stimulating effect on the body. Increases the adaptive abilities of the body and its resistance to infections; promotes regeneration processes.

Pharmacokinetics:

It is adsorbed in the gastrointestinal tract (mainly in the small intestine). Connection with plasma proteins - 25%.

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 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; deposited in the posterior lobe of the pituitary gland, adrenal cortex, ocular epithelium, ovaries, 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 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.

Indications:

Prevention and treatment of hypo- and avitaminosis C;

As an aid:

- hemorrhagic diathesis;

- nasal, uterine, pulmonary and other hemorrhages;

- an overdose of anticoagulants;

- flaccid wounds and fractures of bones.

The drug is prescribed: with increased physical and mental stress, during pregnancy and breastfeeding, during recovery from severe long-term illnesses.

Contraindications:

- Hypersensitivity to the components of the drug;

- thrombophlebitis;

- propensity to thrombosis;

- diabetes;

- children under 5 years.

Carefully:

- Hyperoxalaturia;

- oxalose;

- kidney stone disease; kidney failure;

- hemochromatosis;

- thalassemia;

- polycythemia;

- leukemia;

- sideroblastic anemia;

- deficiency of glucose-6-phosphate dehydrogenase;

- sickle-cell anemia;

- progressive malignant diseases.

Pregnancy and lactation:

The minimum daily requirement for ascorbic acid in the II - III trimesters of pregnancy is 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 the deficiency of vitamin C in an infant (it is recommended not to exceed the maximum daily requirement for ascorbic acid by the nursing mother).

Dosing and Administration:

The drug is taken orally after a meal.

For prophylaxis: adults 0.05-0.1 g (1-2 tablets) per day, children from 5 years to 0.05 g (1 tablet) per day.

For treatment: adults 0.05-0.1 g (1-2 tablets) 3-5 times a day, children from 5 years of 0.05-0.1 g (1-2 tablets) 2-3 times a day day.

During pregnancy and breastfeeding, 0.3 g (6 tablets) per day for 10-15 days; further to 0.1 g (2 tablets) per day.

Side effects:

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

From the digestive system: irritation of the gastrointestinal mucosa, nausea, vomiting, diarrhea, stomach cramps.

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

From the urinary system: when used in high doses - hyperoxalaturia and the formation of urinary stones from calcium oxalate.

From the cardiovascular system: thrombosis, when used in high doses - increased blood pressure, the development of microangiopathies, myocardial dystrophy.

Allergic reactions: skin rash, rarely anaphylactic shock.

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

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

Overdose:

When taking more than 1 g per day, heartburn, diarrhea, difficulty urinating or staining the urine red, hemolysis (in patients with a deficiency of glucose-6-phosphate dehydrogenase) are possible.

If any side effects occur, stop taking the medication and consult a doctor.

Interaction:

With simultaneous application ascorbic acid increases the concentration in the blood of benzylpenicillin and tetracyclines; in a dose of 1 g / day increases the bioavailability of ethinyl estradiol (including those included in oral contraceptives).

With simultaneous application ascorbic acid improves absorption in the intestine of iron preparations (converts trivalent iron into bivalent).

With simultaneous application of absorption and absorption of ascorbic acid reduce:

- acetylsalicylic acid (ASA);

- oral contraceptives;

- fresh juices and alkaline drink.

With the simultaneous use of ascorbic acid with ASA, urinary excretion of ascorbic acid increases and the excretion of ASA decreases. ASA reduces the absorption of ascorbic acid by about 30%.

Simultaneous use of ascorbic acid increases the risk of developing crystalluria in the treatment of short-acting salicylates and sulfonamides; slows the excretion of kidney acids, reduces the concentration of oral contraceptives in the blood. With the simultaneous use of ascorbic acid, the overall clearance, 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 application ascorbic acid reduces:

- chronotropic action of isoprenaline;

- the therapeutic effect of antipsychotics (phenothiazine derivatives);

- tubular reabsorption of amphetamine and tricyclic antidepressants;

- efficacy of heparin and indirect anticoagulants.

With prolonged use or use in high doses ascorbic acid can disrupt the interaction of disulfiram-ethanol.

With simultaneous application ascorbic acid increases excretion:

- mexiletine (with ascorbic acid in high doses);

- drugs that have an alkaline reaction (including alkaloids);

- iron with simultaneous application with deferoxamine.

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

Special instructions:

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

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, activity of "liver" transaminases and lactate dehydrogenase).

Form release / dosage:

Tablets of 50 mg.

Packaging:

For 10 tablets in a planar cell package.

For 10 tablets in contour non-jammed packaging.

By 20 or 50, or 100 tablets in cans of polymer.

By 1, 2, 3,4, 5 contour packs or each jar along with the instructions for use are put in a cardboard box.

Contoured packages with an equal number of instructions for use should be placed in a group package.

Storage conditions:

In a dry, dark place at a temperature of 12 - 15 ° C.

In a place inaccessible to children.

Shelf life:

3 years.

Do not use the product after the expiry date printed on the package.

Terms of leave from pharmacies:Without recipe

Registration number:P N003344 / 01

Date of registration:02.04.2009

Expiration Date:Unlimited

The owner of the registration certificate:MEDISORB, CJSC MEDISORB, CJSC Russia

Manufacturer: & nbsp

MEDISORB, CJSC Russia

Information update date: & nbsp26.09.2017

Illustrated instructions

Instructions

Ascorbic acid (Ascorbic acid)