Ascorbic Acid (Vitamin C)

( Vitamin C ) Pronunciation: (ASS-kor-bik acid)Class: Vitamin

Trade Names:Cecon- Solution 100 mg/mL

Trade Names:Cevi-Bid- Tablets 500 mg

Trade Names:Chewable Vitamin C- Tablets, chewable 250 mg vitamin C as sodium ascorbate and ascorbic acid- Tablets, chewable 500 mg vitamin C as sodium ascorbate and ascorbic acid

Trade Names:Dull C- Powder 1060 mg/tsp

Trade Names:Fruit C 500- Tablets, chewable 500 mg vitamin C as calcium ascorbate and ascorbic acid

Trade Names:Fruit C 100- Tablets, chewable 100 mg vitamin C as calcium ascorbate and ascorbic acid

Trade Names:Fruit C 200- Tablets, chewable 200 mg vitamin C as calcium ascorbate and ascorbic acid

Trade Names:N'ice Vitamin C Drops- Lozenges 60 mg

Trade Names:Sunkist Vitamin C- Tablets, chewable 60 mg vitamin C as sodium ascorbate and ascorbic acid- Tablets, chewable 250 mg vitamin C as sodium ascorbate and ascorbic acid- Tablets, chewable 500 mg vitamin C as sodium ascorbate and ascorbic acid

Trade Names:Vicks Vitamin C Drops- Lozenges 25 mg vitamin C as sodium ascorbate and ascorbic acid

Trade Names:Vita-C- Crystals 1,000 mg/tsp

Proflavanol (Canada)Revitalose-C-1000 (Canada)Timedose Vitamin C (Canada)

Pharmacology

Essential vitamin believed important for synthesis of cellular components, catecholamines, steroids, and carnitine.

Pharmacokinetics

Absorption

Absorbed almost completely from distal small intestine.

Distribution

Distributed throughout water-soluble compartments. Adrenal cortex, leukocytes, platelets, and pituitary gland contain high concentrations.

Elimination

Excreted in the urine.

Indications and Usage

Prevention and treatment of scurvy.

Unlabeled Uses

Treatment of idiopathic methemoglobinemia; combination therapy with methenamine to increase acidity of urine. Although not proven scientifically, prevention of common colds and treatment of cancer, asthma, atherosclerosis, burns, and other wounds. Topical vitamin C may photoprotect against UVR because of its antioxidant and anti-inflammatory properties.

Contraindications

Standard considerations.

Dosage and Administration

Adults

PO Recommended daily allowance 60 mg; average protective dose 70 to 150 mg/day.

Nicotine useAdults

The RDA for smokers is 100 mg/day because of an increased utilization of vitamin C.

High Dose TherapyAdults

Taper vitamin C prior to discontinuing supplementation.

ScurvyAdults

IV/IM/subcutaneous 75 to 150 mg/day; up to 6 g/day has been administered without toxicity.

Enhanced Wound HealingAdults

PO 300 to 500 mg/day for 7 to 10 days has been given.

ParenteralAdults

Used in acute deficiency or when oral absorption is uncertain. Avoid rapid IV administration.

Storage/Stability

Refrigerate when possible, although storage at room temperature is acceptable.

Drug Interactions

None well documented.

Laboratory Test Interactions

Amine-dependent tests for occult blood in stool

May cause false-negative results.

Urine glucose determinations

May cause false-negative determinations.

Adverse Reactions

CNS

Faintness or dizziness may occur with rapid IV administration.

GI

Diarrhea; nausea; vomiting.

Genitourinary

Excessive doses over long period of time may cause precipitation of cystine, oxalate or urate crystals in kidney.

Miscellaneous

Injection site irritation may occur with IM or subcutaneous administration.

Precautions

Pregnancy

Category A . ( Category C in doses above the RDA).

Lactation

Excreted in breast milk.

Tartrazine Sensitivity

Some products contain tartrazine, which can precipitate breathing difficulties in sensitive individuals.

Sulfite Sensitivity

Some products contain sulfites, which may precipitate a reaction in sensitive individuals.

Excessive doses

Diabetic patients, patients prone to renal calculi, patients on sodium restricted diets, and those taking anticoagulants should not take excessive doses (more than 5 g/day) over extended periods of time.

Patient Information

  • Explain that taking product with foods high in iron will enhance absorption of iron.
  • Explain to any patient scheduled for glucose studies that product should not be taken for at least 48 to 72 h before test.
  • Inform patient that abruptly stopping high-dose therapy may lead to loosening of teeth and bleeding gums.

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