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

Ascorbic acid (vitamin C) is not formed in the human body, but comes only with food.Is a cofactor of some hydroxylation and amidation reactions - transfer electrons to enzymes, supplying them replacement equivalent. Participates in the reactions of hydroxylation of proline and lysine residues of procollagen with the formation of hydroxyproline and hydroxylisin (poststranslational modification of collagen), oxidation of the side chains of lysine in proteins with the formation of hydroxymethyllysine (during synthesis of the picture), the oxidation of folic acid to folinic, the metabolism of drugs in liver microsomes and hydroxylation dopamine with the formation of norepinephrine. Increases activity amidating enzymes involved in the processing of oxytocin, antidiuretic hormone and holitsistokinina. Participates in steroidogenesis in the adrenal glands. Restores trivalent iron ions to the divalent iron ions in the intestine, promoting 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. In low doses (150-250 mg / day inwards) improves the complexing function of deferoxamine in chronic intoxication with iron preparations, which leads to increased excretion of the latter.

Pharmacokinetics:

Absorbed in the gastrointestinal tract (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 (peptic ulcer of stomach and duodenum, constipation or diarrhea, helminthic invasion, giardiasis), the use of fresh fruit and vegetable juices, alkaline drink reduce the 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 (TCmah) 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:Treatment and prevention of hypo- and avitaminosis C and associated conditions.

Contraindications:

Hypersensitivity. With prolonged use in large doses (more than 500 mg) - diabetes mellitus, hypercoagulation, nephrourolythiasis, thrombophlebitis, a tendency to thrombosis, deficiency of glucose-6-phosphate dehydrogenase, hemochromatosis, thalassemia.

Carefully:

Hyperoxalaturia, renal failure, polycythemia, leukemia, sideroblastic anemia, sickle cell anemia, progressive malignant diseases, oxalosis, renal stone disease.

Pregnancy and lactation:

During pregnancy and during breastfeeding, do not exceed the recommended dose of ascorbic acid.

Pregnancy

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. During pregnancy, do not exceed the dose of ascorbic acid 300 mg per day.

Breastfeeding period

Ascorbic acid is excreted in breast milk.

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 a child.

Dosing and Administration:

Inside, after eating.

Powder is used for making drinks: the contents of one packet are dissolved in 2500 ml of water. The solution is used freshly prepared, according to the dosages provided below. For dosing, the use of a measuring cup * is recommended.

Treatment

Adults 50-100 mg (50-100 ml) 3-5 times a day.

Children from 5 years to 50-100 mg (50-100 ml of solution) 2-3 times a day.

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

Prevention

Adults 50-100 mg (50-100 ml of solution) per day.

Children from 3 to 6 years, 25 mg (25 ml solution) per day, from 6 to 14 years - 50 mg (50 ml solution) per day, from 14 to 18 years - 75 mg (75 ml solution) per day.

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

For adults: the maximum single dose is 200 mg, daily - 1000 mg; for children - the maximum single dose of 100 mg, daily - 500 mg.

* measuring cup is not included.

Side effects:

From the central nervous system (CNS): headache, fatigue, with prolonged use of large doses (more than 1000 mg) - increased excitability of the central nervous system, insomnia.

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

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

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

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

Allergic reactions: skin rash, skin hyperemia.

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

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.

Treatment: symptomatic, forced diuresis.

Interaction:

Absorption of ascorbic acid decreases with the simultaneous use of oral contraceptives, acetylsalicylic acid, the use of fresh fruit and vegetable juices, alkaline drinks.

Ascorbic acid when taken orally increases the absorption of penicillin and iron, reduces the effectiveness of heparin and indirect anticoagulants, increases the risk of developing crystalluria in the treatment of salicylates.

With simultaneous use reduces the chronotropic effect of isoprenaline.

With prolonged use or application in large doses, it can disrupt the interaction of disulfiram and ethanol.

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.

Special instructions:

When using ascorbic acid in high doses, it is necessary to monitor the function of the kidneys, the pancreas and the level of blood pressure.

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).

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

Effect on the ability to drive transp. cf. and fur:

Care must be taken when managing vehicles, mechanisms and engaging in potentially hazardous activities requiring attention and speed of psychomotor reactions, taking into account the possible development of side effects.

Form release / dosage:

Powder for solution for oral administration 2.5 g.

Packaging:

By 2.5 grams in heat-sealed bags of material combined on the basis of paper.

For 10, 20, 30, 40, 50 packets, together with instructions for use, are placed in a pack of cardboard.

For hospitals.

For 20, 50, 100, 200, 600 packages, together with an equal number of instructions for use, are placed in a polyethylene sealed bag of polyethylene film. One plastic bag is placed in a cardboard box.

Storage conditions:

In a dry, protected from light 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:LP-004207

Date of registration:21.03.2017

Expiration Date:21.03.2022

The owner of the registration certificate:MELIGEN FP, CJSC MELIGEN FP, CJSC Russia

Manufacturer: & nbsp

MELIGEN FP, CJSC Russia

Information update date: & nbsp17.04.2017

Illustrated instructions

Instructions

Ascorbic acid (Ascorbic acid)