Ascorbic acid


Concise Prescribing Info
Indications/Uses
Scurvy.
Dosage/Direction for Use
Adult : PO ≥240 mg/day in divided doses. IM/IV/SC 0.5-1 g/day.
Dosage Details
Oral
Scurvy
Adult: ≥240 mg daily in divided doses. For preventive therapy, 25-75 mg daily.
Child: 100-300 mg daily. For preventive therapy: Same as adult dose.

Parenteral
Scurvy
Adult: 0.5-1 g daily. For preventive therapy, 200-500 mg daily. Doses are given via IM, IV or SC inj.
Child: For curative therapy: 100-300 mg daily. For protective therapy: 30 mg daily. Doses are given via IM, IV or SC inj.
Renal Impairment
ESRD: 60-100 mg once daily.
Administration
May be taken with or without food.
Reconstitution
IV inj: Dilute w/ large volume of glucose or normal saline.
Incompatibility
Incompatible w/ ferric salts, oxidising agents, salts of heavy metals, particularly copper. Y-site admin: Incompatible w/ etomidate, propofol, thiopental. Syringe: Incompatible w/ cefazolin, doxapram, aminophylline, bleomycin sulfate, erythromycin, nitrufurantoin, sodium bicarbonate, nafcillin Na, sulfafurazole diethanolamine.
Special Precautions
Patient w/ hyperoxaluria, G6PD deficiency, DM, haemochromatosis. Renal impairment (e.g. renal failure, renal calculi). Pregnancy and lactation.
Adverse Reactions
GI disturbances (e.g. diarrhoea, nausea, vomiting, abdominal cramps, transient colic, flatulent distention), heartburn, fatigue, flushing, headache, insomnia, sleepiness; hyperoxaluria, renal Ca oxalate calculi formation; temporary faintness/dizziness (IV); transient mild soreness at the site of inj (IM/SC).
IM/IV/Parenteral/PO/SC: C
Overdosage
Symptoms: Diarrhoea, hyperoxaluria, renal Ca oxalate calculi formation. Management: Symptomatic treatment.
Drug Interactions
Induced tissue desaturation w/ aspirin, nicotine, Fe, phenytoin, tetracycline estrogen from OCs, and some appetite suppressants and anticonvulsant drugs. Reduced absorption and decreased urinary excretion w/ aspirin. Reduced serum levels w/ OCs. May cause unexpected renal tubular reabsorption of acidic drugs and decreased reabsorption of basic drugs. May reduce response to oral anticoagulants. May decrease plasma concentration of fluphenazine. May worsen Fe toxicity to the heart w/ desferrioxamine.
Food Interaction
Induced tissue desaturation w/ alcohol.
Lab Interference
False-negative results from plasma, stool occult blood (48-72 hr after ingestion), and urinary glucose test.
Action
Description: Ascorbic acid, a water-soluble vitamin, acts as a cofactor and antioxidant. It is essential for tissue repair and formation of collagen and intercellular materials. Additionally, it is involved in conversion of folic acid to folinic acid, synthesis of lipids and proteins, carbohydrate metabolism, iron absorption and storage, and cellular respiration.
Onset: Scurvy symptoms reversal: 2 days to 3 wk.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract.
Distribution: Widely distributed in the body tissues. Crosses the placenta and enters breast milk. Plasma protein binding: Approx 25%.
Metabolism: Reversibly oxidised to dehydroascorbic acid (DHA), some are metabolised to the inactive metabolites, ascorbate-2-sulfate and oxalic acid.
Excretion: Via urine (as unchanged drug and as inactive metabolites). Elimination half-life: 10 hr.
Chemical Structure

Chemical Structure Image
Ascorbic acid

Source: National Center for Biotechnology Information. PubChem Database. Ascorbic acid, CID=54670067, https://pubchem.ncbi.nlm.nih.gov/compound/Ascorbic-acid (accessed on Jan. 21, 2020)

Storage
Tab/cap/liq: Store at room temp. Soln for inj: Store below 25°C. Protect from light. Do not freeze.
MIMS Class
ATC Classification
A11GA01 - ascorbic acid (vit C) ; Belongs to the class of ascorbic acid (vitamin C). Used as dietary supplements.
References
Anon. Ascorbic Acid. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/10/2016.

Ascorbic Acid Injection, Solution (American Regent, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/10/2016.

Buckingham R (ed). Vitamin C Substances. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/10/2016.

Joint Formulary Committee. Ascorbic Acid (Vitamin C). British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/10/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Ascorbic Acid, Calcium Ascorbate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 06/10/2016.

Disclaimer: This information is independently developed by MIMS based on Ascorbic acid from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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