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

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, utilization of carbohydrates, synthesis of lipids, proteins, carnitine, immune reactions, hydroxylation of serotonin, enhances the absorption of non-iron gland.

It has antiplatelet and pronounced antioxidant properties.

Regulates the transport of hydrogen ions 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.

Supports the colloidal state of the intercellular substance and normal permeability of capillaries (inhibits hyaluronidase).

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

Improves bile secretion, restores exocrine function pancreas and endocrine - thyroid.

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

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

In low doses (150-250 mg / day inwards) improves the complexing function of deferoxamine with chronic intoxication with iron preparations, which leads to increased excretion of the latter.

Pharmacokinetics:

Absorbed in the gastrointestinal tract (GIT) (mainly in the jejunum).

With an increase in the dose to 200 mgabsorbed up to 140 mg (70%); 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 the stomach and duodenum, constipation or diarrhea, helminthic invasion, giardiasis), the use of fresh fruit and vegetable juices, alkaline drink reduce absorption of ascorbate in the intestine.

The concentration of ascorbic acid in plasma is approximately 10-20 mcg / ml, reserves in the body - about 1.5 g with daily recommended doses and 2.5 g when taken 200 mg / day. The time to reach the maximum concentration after ingestion is -4 hours.

Easily penetrates into leukocytes, platelets, and then into all tissues; 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 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 and prevention of hypo- and avitaminosis C.

Contraindications:

- Hypersensitivity,

- long-term use in large doses (more than 500 mg) in diabetes mellitus,hyperoxaluria, nephrolithiasis, hemochromatosis, thalassemia, deficiency of glucose-6-phosphate dehydrogenase.

Carefully:

With care appoint to patients with diseases: diabetes mellitus, glucose-6-phosphate dehydrogenase deficiency, hemochromatosis, sideroblastic anemia, thalassemia, Hyperoxaluria, renal stone disease.

Pregnancy and lactation:

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 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).

Dosing and Administration:

Inside, after eating.

Powder is used to prepare a solution - 1 g or 2.5 grams per liter or 2.5 liters of water, respectively (0.1% solution). Shelf life of the solution is no more than 5 days in a dark place at a temperature of 2 to 8 ° C (in the refrigerator). The solution is taken freshly prepared, according to the dosages listed below.

For the prevention of hypo-and avitaminosis C: adults - 50-100 mg / day. (50-100 ml of a 0.1% solution); children 3-6 years - 25 mg / day. (25 ml of a 0.1% solution), 6-14 years - 50 mg / day. (50 ml of a 0.1% solution), 14-18 years - 75 mg / day. (75 ml of a 0.1% solution); during pregnancy and lactation - 300 mg / day. (300 ml of 0.1% solution) for 10-15 days; further on 100 mg / sut. (100 ml of a 0.1% solution).

With a therapeutic purpose: adults - 50-100 mg (50-100 ml 0.1% solution) 3-5 times a day; children - 50-100 mg (50-100 ml 0.1% solution) 2-3 times a day for 2 weeks.

In the treatment of scurvy: adults - up to 1000 mg / day. (1000 ml of a 0.1% solution); children - up to 500 mg / day. (500 ml of a 0.1% solution).

The maximum daily dose for adults is -1 g (1000 ml 0.1% solution).

For dosing, it is recommended to use a medical measuring cup (not included).

Side effects:

From the central nervous system (CNS): with prolonged use of large doses (more than 1000 mg) - headache, 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, nephrolithiasis (from calcium oxalate), damage to the glomerular apparatus of the kidneys.

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

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

Allergic reactions: skin rash, skin hyperemia.

Other: oppression of the insular pancreas function (hyperglycemia, glucosuria).

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:

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

Improves absorption in the intestine of iron preparations (converts trivalent iron into bivalent); can increase the excretion of iron when used simultaneously with deferoxamine.

Reduces efficacy of heparin and indirect anticoagulants.

Acetylsalicylic acid (ASA), oral contraceptives, fresh juices and alkaline drink reduce absorption and absorption of the drug.

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

Increases risk of developing crystalluria in the treatment of salicylates and sulfonamides of short action, slows down excretion of acids by the kidneys, increases the elimination of drugs that have an alkaline reaction (including alkaloids), reduces concentration in the blood of oral contraceptives.

Raises the the total clearance of ethanol, which in turn reduces concentration ascorbic acid in the body.

Medicinal products of quinoline series, calcium chloride, salicylates, glucocorticoid agents with prolonged use exhaust stocks of ascorbic acid.

With simultaneous application ascorbic acid reduces the chronotropic action of isoprenaline.

With prolonged use or use in high doses, it can interfere with the interaction of disulfiram and ethanol.

In high doses enhances excretion of mexiletine by the kidneys.

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

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

Special instructions:

Foods rich in ascorbic acid: citrus fruits, greens, vegetables (peppers, broccoli, cabbage, tomatoes, potatoes). When storing products (including prolonged freezing, drying, pickling, pickling), cooking (especially in copper vessels), chopping vegetables and fruits in salads,preparation of puree is a partial destruction of ascorbic acid (with a temperature treatment - up to 30-50%).

In connection with the stimulating effect of ascorbic acid on the synthesiscorticosteroid 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 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 glucose, bilirubin, activity of "liver" transaminases and lactate dehydrogenase).

Form release / dosage:

Powder for solution for oral administration 1.0 g and 2.5 g.

Packaging:

Packages heat-sealing.

For 5, 10, 20, 50 or 100 packages with instructions for use are placed in a pack of cardboard box.

Packages with an equal number of instructions for use are placed in a group packing.

Storage conditions:

In a dry, protected from light place at a temperature of no higher than 25 ° C.

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:LP-000952

Date of registration:18.10.2011

Expiration Date:18.10.2016

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

Manufacturer: & nbsp

MEDISORB, CJSC Russia

Information update date: & nbsp25.09.2017

Illustrated instructions

Instructions

Ascorbic acid (Ascorbic acid)