Composition
Active ingredient: Â ascorbic acid 100 mg
Pharmacological action
Ascorbic acid has pronounced restorative properties, participates in the regulation of carbohydrate metabolism, redox processes, blood clotting, normalization of capillary permeability, tissue regeneration, synthesis of steroid hormones, collagen, procollagen.
Pharmacokinetics
Binding to plasma proteins is 25%. The normal concentration of ascorbic acid in plasma is approximately 10-20 mcg / ml. Easily penetrates into white blood cells, platelets, and then – into all tissues; the highest concentration is achieved in glandular organs, white blood cells, liver and lens of the eye; penetrates through the placenta.
 The concentration of ascorbic acid in white blood cells and platelets is higher than in red blood cells and in plasma. In deficient states, the concentration in white blood cells decreases later and more slowly and is considered as a better criterion for assessing the deficit than the concentration in plasma.
It is mainly metabolized in the liver to deoxyascorbic acid and then to 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. When high doses are administered, the rate of elimination increases dramatically. Smoking and drinking ethanol accelerate the breakdown of ascorbic acid (conversion to inactive metabolites), dramatically reducing the body’s reserves. It is excreted during hemodialysis.
Indications
- As an auxiliary agent: hemorrhagic diathesis, nasal, uterine, pulmonary and other bleeding, against the background of radiation sickness; overdose of anticoagulants, infectious diseases and intoxications, liver diseases, nephropathy of pregnant women, Addison’s disease, sluggish healing wounds and bone fractures. dystrophy and other pathological processes.
- Prevention and treatment of hypo-and vitamin C deficiency;
- The drug is prescribed for increased physical and mental stress, during pregnancy and lactation, during recovery from severe long-term illnesses.
Contraindications
Hypersensitivity.
With prolonged use in large doses (more than 500 mg):
- diabetes mellitus,
- hyperoxaluria,
- nephroliteasis,
- hemochromatosis,
- thalassemia,
- glucose-6-phosphate dehydrogenase deficiency.
With caution: sideroblastic anemia, urolithiasis.
Side effects
From the central nervous system: with rapid intravenous use – dizziness, fatigue, with prolonged use of large doses (more than 1 g) – headache, increased excitability of the central nervous system, insomnia.
From the urinary system: moderate pollakiuria (with 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 cardiovascular system: with prolonged use of high doses-a decrease in capillary permeability (possible deterioration of tissue trophism, increased blood pressure, hypercoagulation, the development of microangiopathies).
Allergic reactions: allergic reactions up to the development of anaphylactic shock.
Laboratory parameters: thrombocytosis, hyperprothrombinemia, erythropenia, neutrophilic leukocytosis, hypokalemia, glucosuria.
Local reactions: soreness at the site of intramuscular injection.
Other: with prolonged use of large doses (more than 1 g) – inhibition of the function of the insular apparatus of the pancreas (hyperglycemia, glucosuria), with intravenous use-the threat of termination of pregnancy (due to estrogenemia), hemolysis of red blood cells.
Interaction
Pharmacologically incompatible with aminophylline, bleomycin, cefazolin, cefapirin, chlordiazepoxide, estrogens, dextrans, doxapram, erythromycin, methicillin, nafzillin, benzylpenicillin, warfarin.
Increases the concentration of benzylpenicillin and tetracyclines in the blood; at a dose of 1 g/day, it increases the bioavailability of ethinyl estradiol (including that included in oral contraceptives). Reduces the effectiveness of heparin and indirect anticoagulants.
When used concomitantly with acetylsalicylic acid, the urinary excretion of ascorbic acid increases and the excretion of acetylsalicylic acid decreases.
 Increases the risk of crystalluria during treatment with short-acting salicylates and sulfonamides, slows down the excretion of acids by the kidneys, increases the excretion of drugs with 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.
Quinoline-type drugs, calcium supplements, salicylates, and glucocorticosteroids deplete ascorbic acid reserves with prolonged use.
When used concomitantly, it reduces the chronotropic effect of isoprenaline.
 When used for a long time or in high doses, it may interfere with the interaction of disulfiram and ethanol. In high doses, it increases the excretion of mexiletine by the kidneys. Barbiturates and primidone increase the excretion of ascorbic acid in the urine.
Reduces the therapeutic effect of antipsychotic drugs (neuroleptics) – phenothiazine derivatives, tubular reabsorption of amphetamine and tricyclic antidepressants.
How to take, course of use and dosage
Apply as prescribed by a doctor.
Ascorbic acid is prescribed orally (after meals), intramuscularly or intravenously.
For preventive purposes, adults are prescribed 0.05 g-0.1 g per day; during pregnancy, in the postpartum period, and in the case of a low content of vitamin C in the milk of nursing women,0.3 g per day is prescribed for 10-15 days, after which 0.1 g per day is prophylactically administered during the entire lactation period.
Children are prescribed prophylactically 0.025 g 2-3 times a day.
Therapeutic doses for adults are taken orally-0.05-0.1 g 3-5 times a day; for children-0.05-0.1 g 2-3 times a day.
Therapeutic doses for adults with parenteral use is 1-3 ml of 5% solution (2-6 ml of 2.5% solution) per day.
Children are prescribed parenterally 1-2 ml of a 5% solution (2-4 ml of a 2.5% solution) per day.
The course of treatment depends on the nature and course of the disease.
Overdose
Symptoms: nephrolithiasis, insomnia, irritability, hypoglycemia.
Treatment: symptomatic, forced diuresis.
Special instructions
Due to the stimulating effect of ascorbic acid on the synthesis of corticosteroid hormones, it is necessary to monitor the function of the adrenal glands and blood pressure. High doses of ascorbic acid increase the excretion of oxalates, contributing to the formation of kidney stones.
Newborns whose mothers have taken high doses of ascorbic acid and adults who have taken high doses may experience rebound scurvy.
With prolonged use of large doses, the function of the pancreatic insular apparatus may be inhibited, so it should be regularly monitored during treatment. In patients with high iron content 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 (the content of glucose in the blood and urine, bilirubin, the activity of” liver ” transaminases and lactate dehydrogenase).
Influence on the ability to drive motor vehicles and manage mechanisms
During the treatment period, care should be taken when driving vehicles and engaging in potentially dangerous activities that require increased concentration of attention and speed of psychomotor reactions.
Form of production
Solution for injection.
Storage conditions
In a place protected from light at a temperature not exceeding 15°C.
Shelf
life is 1 year.
Active ingredient
Ascorbic acid
Conditions of release from pharmacies
By prescription
Dosage form
solution for injection and infusion
Indications
Stress, Colds, Intense Exercise, Flu and Cold Prevention, Malnutrition, Bleeding, Bone Fractures, Flu, Wounds, Hypovitaminosis, Varicose Veins, Infectious Diseases
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Side effects of Ascorbic acid, ampoules 10%, 2ml, 10pcs.
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