Vitamin C (Ascorbic Acid)
Indications
Vitamin C (Ascorbic Acid) is used for:
Treatment or prevention of, Vitamin C Deficiency, Scurvy, Infection, Trauma, Burns, Cold exposure, Following Surgery, common cold, Fever, scurvy, Stress, Cancer, Methaemoglobinaemia and Children receiving unfortified formulas. Also indicated in, Hematuria, Dental Caries, Gum Diseases, Pyorrhea, Acne, Infertility, Atherosclerosis, Fractures, Leg ulcers, Hay fever, Vascular thrombosis prevention, Levodopa toxicity, Arsenic toxicity.
Adult Dose
Oral
Scurvy
Adult: Prevention: 25-75 mg daily. 4 tablets 2 to 3 times daily. Treatment: >250 mg daily, given in divided doses.
May also be given via IM/IV/SC admin.
250-500mg IV qDay/BID for at least 2 weeks.
Thalassaemia
Adult: 100-200 mg daily, to be given with desferrioxamine.
Common cold: 1 gm or more daily in divided doses, i.e. 4 tablets daily.
In wound healing: 2-4 tablets 2 to 3 times daily
In other conditions: 1-2 tablets daily
For the reduction of risk of stroke in the elderly: 1-2 tablets daily.
1 effervescent tablet daily with a meal or as directed by physician. Dissolve one tablet in half glass (100 ml) of water and drink instantly.
Child Dose
Children:
Child: 1 mth-4 yr: 125-250 mg daily;
4-12 yr: 250-500 mg daily;
12-18 yr: 500 mg-1 g daily.
Doses to be given in 1-2 divided doses.
Thalassaemia
Child: 100-200 mg daily, to be given with desferrioxamine.
Metabolic disorders
Child: Neonate: 50-200 mg daily, adjust if needed;
1 mth-18 yr: 200-400 mg daily in 1-2 divided doses, up to 1 g daily may be needed.
Renal Dose
Administration
May be taken with or without food.
IV Preparation
Dilute with large volume of compatible fluid to minimize adverse reactions
Compatible w/ most common diluents (dextrose solns, NS, LR, Ringer's, ½NS, dextrose-saline, dextrose-LR etc)
IV Administration
Avoid rapid infusion
Contra Indications
Precautions
Should be given with caution to patient with hyperoxaluria.
Pregnancy-Lactation
Pregnancy
No adverse developmental outcomes are reported in the published literature
There are no available data on use of Ascor in pregnant women to inform a drug-associated risk of adverse developmental outcomes
Lactation
There are no data on the presence of ascorbic acid in human milk following IV dosing in lactating women
Ascorbic acid is present in human milk after maternal oral intake
Interactions
Vit C: Deferroxamine, hormonal contraceptives, flufenazine, warfarin, elemental iron, salicylates, warfarin, fluphenazine, disulfiram, mexiletine, vitamin B12.
Adverse Effects
Side effects of Vitamin C (Ascorbic Acid) :
Flushing, Flank pain, Faintness, headache, Diarrhea, dyspepsia, nausea, vomiting, Hyperoxaluria (large doses)
Mechanism of Action
Vitamin C: Necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in conversion of folic acid to folinic acid.