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

Pharmacological effects: in quantities significantly exceeding the daily requirement (90 mg), almost no effect, except for the rapid elimination of symptoms of hypo- and avitaminosis (scurvy). Physiological functions: is a cofactor of some hydroxylation and amidation reactions - transfers electrons to enzymes, providing them with a replacement equivalent. Participates in the reactions of hydroxylation of proline and lysine residues of procollagen with the formation of hydroxyproline and hydroxylizine (post-translational modification of collagen), the oxidation of the side chains of lysine in proteins with the formation of hydroxytrimethyllysine (during the synthesis of carnitine), the oxidation of folic acid to folinic, the metabolism of the drug 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 Fe3 + to Fe2 + in the intestines, 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 with chronic intoxication with iron preparations, which leads to increased excretion of the latter.

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:Absorbed in the gastrointestinal tract (GIT) (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 (stomach ulcer and duodenal ulcer, 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. The time to reach the maximum concentration (T_from_m_Oh) after ingestion for 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 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 vitamin deficiency of vitamin C and associated conditions.

Contraindications:

Hypersensitivity to the components of the drug, thrombophlebitis, propensity to thrombosis. With long-term use in high doses (more than 500 mg) - diabetes mellitus, hyperoxaluria, nephrolithiasis, hemochromatosis, thalassemia, glucose-6-phosphate dehydrogenase deficiency, sugarase / isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption.

Carefully:Sideroblastic anemia, sickle-cell anemia, urolithiasis, polycythemia, leukemia.

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 newborn can develop the "withdrawal" syndrome.

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) a day, children from 5 years of 0.05 g (1 tablet) per day.

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

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

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

From the central nervous system (CNS): with prolonged the 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 of the mucosa 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 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, hyperemia.

Other: at long application of the big doses (more than 1 g) - oppression of function of an insulin device of a pancreas (a hyperglycemia, a glucosuria).

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

Overdose:

Symptoms: diarrhea, nausea, irritation of the gastrointestinal mucosa, flatulence, abdominal pain of a spastic nature, frequent urination, 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 / day increases the bioavailability of ethinyl estradiol.

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

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

When used simultaneously with ASA, urinary excretion of ascorbic acid increases and ASA excretion 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 release of kidney acids, increases the excretion of 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.

Preparations of quinoline series (fluoroquinolones, etc.), 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 disrupt the interaction of disulfiram-ethanol.

In high doses increases the renal excretion of mexiletine.

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:

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 transaminases, lactate dehydrogenase).

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

The use of the drug in accordance with the instructions does not affect the psychomotor functions associated with driving a car or controlling cars and mechanisms.

With prolonged use of large doses of the drug, it is possible to manifest such side effects as headache, increased central nervous system irritability, increased blood pressure, therefore, during the treatment period, care must be taken when driving vehicles and mechanisms that require concentration and speed of psychomotor reactions.

Form release / dosage:Dragee.

Packaging:On 100, 200 dragees in banks of polymeric. Each bank is polymer with instructions for use in a pack of cardboard.

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 6 months.

Do not use after the date shown on the package.

Terms of leave from pharmacies:Without recipe

Registration number:LP-001641

Date of registration:09.04.2012 / 26.04.2017

Expiration Date:Unlimited

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

Manufacturer: & nbsp

ALTAYVITAMINS, CJSC Russia

Information update date: & nbsp11.10.2017

Illustrated instructions

Instructions

Ascorbic acid (Ascorbic acid)