Gross formula

C6H8O6

Pharmacological group of the substance Ascorbic acid

Nosological classification (ICD-10)

CAS Code

50-81-7

Characteristics of the substance Ascorbic acid

Vitamin remedy (vitamin C). Ascorbic acid is a white crystalline powder with a sour taste. Easily soluble in water (1: 3.5), slowly soluble in ethanol (1:30), absolute alcohol (1:50), glycerin (1:100), propylene glycol (1:20). Solubility in water: 80.0% at 100 °C; 40.0% at 45 °C. Practically insoluble in ether, benzene, chloroform, petroleum ether, oils, fats. Under the influence of air and light it gradually darkens. When dry, it is stable in air. aqueous solutions oxidize quickly in air. Molecular weight 176.13.

Sodium ascorbate - small crystals, freely soluble in water: 62 g/100 ml at 25 °C, 78 g/100 ml at 75 °C.

Most primates (including humans) Guinea pigs, some birds and fish cannot synthesize vitamin C. In the human body, the necessary supply is replenished through food intake.

For medical purposes ascorbic acid obtained synthetically.

Pharmacology

pharmachologic effect- antioxidant, regulating redox processes, metabolic, replenishing vitamin C deficiency.

Has pronounced antioxidant properties. Regulates H+ transport in many bio chemical reactions, improves the use of glucose in the tricarboxylic acid cycle, participates in the formation of tetrahydro folic acid and tissue regeneration, synthesis steroid hormones, collagen, procollagen, carnitine, serotonin hydroxylation. Maintains colloidal state intercellular substance and normal capillary permeability (inhibits hyaluronidase). Activates proteolytic enzymes, participates in the metabolism of aromatic amino acids, pigments and cholesterol, promotes the accumulation of glycogen in the liver. Due to the activation of respiratory enzymes in the liver, it enhances its detoxification and protein-forming functions, increases the synthesis of prothrombin. Improves bile secretion, restores exocrine function pancreas and endocrine - thyroid. Regulates immunological reactions (activates the synthesis of antibodies, C3 component of complement, interferon), promotes phagocytosis, increases the body's resistance to infections. Has anti-inflammatory and anti-allergic effects. Inhibits the release and accelerates the degradation of histamine, inhibits the formation of PG and other mediators of inflammation and anaphylaxis. Reduces the need for vitamins B1, B2, A, E, folic acid, pantothenic acid. Ascorbic acid deficiency leads to the development of hypovitaminosis, in severe cases— vitamin deficiency (scorbutus, scurvy).

Absorbed into small intestine(duodenum, partially in the ileum). With an increase in dose to 200 mg, up to 70% is absorbed; with a further increase in dose, absorption decreases (50-20%). Gastrointestinal pathology (ulcers, constipation, diarrhea), helminthic infestation, giardiasis, consumption of fresh fruit and vegetable juices, alkaline drinking - reduce the utilization of ascorbate in the intestines. Cmax after oral administration is achieved within 4 hours. The degree of binding to plasma proteins is low (about 25%). Easily penetrates into leukocytes, platelets, and then into all tissues; the highest concentrations are found in glandular tissue. Deposited in the posterior lobe of the pituitary gland, adrenal cortex, ocular epithelium, interstitial cells of the seminal glands, ovaries, liver, brain, spleen, pancreas, lungs, kidneys, intestinal wall, heart, muscles, thyroid gland. Passes through the placenta. Metabolized, mainly in the liver, into deoxyascorbic acid and further into oxaloacetic and diketogulonic acids. Unchanged ascorbate and metabolites are excreted in urine, feces, sweat, breast milk. Excreted during hemodialysis.

At high doses Ah, when plasma concentrations reach more than 1.4 mg/dl, excretion increases sharply, and increased excretion may persist after discontinuation of dosage. Smoking and consumption ethyl alcohol accelerate destruction (conversion into inactive metabolites), sharply reducing reserves in the body.

When used as vaginal tablets ascorbic acid lowers vaginal pH, inhibiting bacterial growth, and helps restore and maintain normal indicators pH and vaginal microflora (Lactobacillus acidophilus, Lactobacillus gasseri). Thus, when the vaginal pH decreases over several days, there is a pronounced suppression of growth anaerobic bacteria, as well as restoration of normal flora.

Application of the substance Ascorbic acid

Hypovitaminosis C, hemorrhagic diathesis, capillary toxicosis, hemorrhagic stroke, bleeding (including nasal, pulmonary, uterine), infectious diseases, idiopathic methemoglobinemia, intoxication, incl. chronic intoxication with iron preparations, alcoholic and infectious delirium, acute radiation sickness, post-transfusion complications, liver diseases (Botkin's disease, chronic hepatitis and cirrhosis), gastrointestinal diseases (achylia, peptic ulcer, especially after bleeding, enteritis, colitis), helminthiasis, cholecystitis, adrenal insufficiency (Addison's disease), sluggishly healing wounds, ulcers, burns, bone fractures, dystrophy, physical and mental overload, the period of convalescence after past diseases, pregnancy (especially multiple pregnancy, against the background of nicotine or drug addiction), lactation, hemosiderosis, melasma, erythroderma, psoriasis, chronic common dermatoses. In laboratory practice - for marking red blood cells (together with sodium chromate 51 Cr).

Vaginal tablets - chronic or recurrent vaginitis caused by anaerobic flora (due to altered vaginal pH); normalization of disturbed vaginal microflora.

Contraindications

Hypersensitivity, thrombophlebitis, tendency to thrombosis, vulvovaginal candidiasis (for vaginal tablets).

Restrictions on use

Diabetes mellitus, glucose-6-phosphate dehydrogenase deficiency, hemochromatosis, sideroblastic anemia, thalassemia, hyperoxaluria, oxalosis, urolithiasis.

Use during pregnancy and breastfeeding

The minimum daily requirement for ascorbic acid in the II-III trimesters of pregnancy is about 60 mg. It should be borne in mind that the fetus can adapt to high doses of ascorbic acid taken by a pregnant woman, and then the newborn may develop withdrawal symptoms. It has been reported that treatment with high doses of vitamin C taken during pregnancy is associated with a risk of developing scurvy in newborns, and when administered intravenously in high doses, there is a risk of miscarriage due to estrogenemia ( non-teratogenic effects).

The minimum daily requirement during lactation is 80 mg. A maternal diet containing adequate amounts of ascorbic acid is sufficient to prevent deficiency in infant. Theoretically, there is a danger to the child when the mother uses high doses of ascorbic acid (it is recommended for a nursing mother not to exceed daily requirement in ascorbic acid).

For injection forms. Animal reproduction studies using ascorbic acid injections have not been conducted. It is not known whether vitamin C, when injected into pregnant women, can have embryotoxic effects or impair reproductive ability. Injectable forms can be prescribed during pregnancy only if absolutely necessary.

Side effects of the substance Ascorbic acid

From the outside of cardio-vascular system and blood (hematopoiesis, hemostasis): thrombocytosis, hyperprothrombinemia, erythropenia, neutrophilic leukocytosis.

From the outside nervous system and sense organs: with too rapid intravenous administration - dizziness, weakness.

From the gastrointestinal tract: when taken orally - irritation of the gastrointestinal mucosa (nausea, vomiting, diarrhea), diarrhea (when taking doses of more than 1 g / day), damage to tooth enamel (with intensive use chewable tablets or resorption of oral forms).

From the side of metabolism: metabolic disorders, inhibition of glycogen synthesis, excessive formation of corticosteroids, sodium and water retention, hypokalemia.

From the outside genitourinary system: increased diuresis, damage to the glomerular apparatus of the kidneys, formation of oxalate urinary stones(especially with long-term use in doses of more than 1 g / day).

Allergic reactions: skin rash, skin hyperemia.

Others: pain at the injection site (with intramuscular injection). For vaginal tablets: local reactions- burning or itching in the vagina, increased mucous discharge, hyperemia, swelling of the vulva.

Interaction

Increases the blood concentration of salicylates (increases the risk of developing crystalluria), ethinyl estradiol, benzylpenicillin and tetracyclines, reduces the concentration of oral contraceptives. Acetylsalicylic acid, oral contraceptives, fresh juices and alkaline drinking reduce absorption and absorption. Increases the activity of norepinephrine. Reduces the anticoagulant effect of coumarin and heparin derivatives. Improves the absorption of iron preparations in the intestines (by converting ferric iron to divalent iron). When used simultaneously with deferoxamine, increased tissue toxicity of iron is possible, incl. cardiotoxicity and development of heart failure. Increases the total clearance of ethyl alcohol. May affect the effectiveness of disulfiram in treatment chronic alcoholism. Quinoline drugs, calcium chloride, salicylates, corticosteroids for long-term use deplete vitamin C reserves. A solution of ascorbic acid, when mixed in one syringe, enters into a chemical interaction with many drugs.

Overdose

Symptoms: with long-term use large doses(more than 1 g) — headache, increased excitability of the central nervous system, insomnia, nausea, vomiting, diarrhea, hyperacid gastritis, ulceration of the gastrointestinal mucosa, inhibition of the function of the insular apparatus of the pancreas (hyperglycemia, glucosuria), hyperoxaluria, nephrolithiasis (calcium oxalate), damage to the glomerular apparatus of the kidneys, moderate pollakiuria (with taking a dose of more than 600 mg/day).

Reduced capillary permeability (possible deterioration of tissue trophism, increased blood pressure, hypercoagulation, development of microangiopathies).

When administered intravenously in high doses, there is a threat of miscarriage (due to estrogenemia), hemolysis of red blood cells.

Routes of administration

Inside, i/m, IV, intravaginal.

Precautions for the substance Ascorbic acid

When prescribing IV solutions, you should avoid administering them too quickly. During long-term treatment Monitoring of renal function, blood pressure and glucose levels is necessary (especially when prescribing high doses). Use extreme caution when prescribing high doses to patients with urolithiasis, diabetes mellitus, a tendency to thrombosis, receiving anticoagulant therapy, and being on a salt-free diet.

Ascorbic acid, as a reducing agent, can distort the results of various laboratory tests (blood glucose, bilirubin, transaminase activity, LDH, glucose in urine, including causing false-negative results of stool tests for occult blood).

When used in the form of vaginal tablets, ascorbic acid does not inhibit the growth of fungal flora of the vagina. Manifestations such as burning and itching may be due to the presence of a concomitant asymptomatic fungal infection, so if these symptoms occur, an analysis should be performed to exclude a fungal infection. Interruptions in the use of vaginal tablets due to intercyclic or menstrual bleeding are not necessary.

Interactions with other active ingredients

Trade names

Name	The value of the Vyshkowski Index ®

One dragee contains

active substance- ascorbic acid (vitamin C) 50 mg,

excipients – sucrose (sugar), starch syrup, wheat flour, talc, food flavoring “Lemon”, sunflower oil, beeswax.

Description

Ball-shaped dragee from white to light cream color

Pharmacotherapeutic group

Vitamins. Ascorbic acid in pure form. Ascorbic acid.

ATX code A11GA01

Pharmacological properties"type="checkbox">

Pharmacological properties

Pharmacokinetics

Absorbed in the small intestine. With an increase in dose to 200 mg, up to 140 mg (70%) is absorbed; with a further increase in dose, absorption decreases (50-20%). Connection with blood plasma proteins -25%. Diseases gastrointestinal tract(peptic ulcer of the stomach and duodenum, constipation or diarrhea, helminthic infestation, giardiasis), consumption of fresh fruit and vegetable juices, alkaline drinks reduce the absorption of ascorbonate in the intestine.

The normal concentration of ascorbic acid in blood plasma is approximately 10-20 mcg/ml; body reserves are about 1.5 g when taking daily recommended doses and 2.5 g when taking 200 mg/day. Maximum concentration(Tmax) after oral administration - 4 hours. Easily penetrates into leukocytes, platelets, and then into all tissues; the highest concentration is achieved in the glandular organs, leukocytes, liver and lens of the eye; deposited in the posterior lobe of the pituitary gland, adrenal cortex, ocular epithelium, cells of the seminal glands of the ovaries, liver, spleen, pancreas, lungs, kidneys, intestinal wall, heart, muscles, thyroid gland; penetrates the placenta. The concentration of ascorbic acid in leukocytes and platelets is higher than in erythrocytes and blood plasma. At deficiency states the concentration of ascorbic acid in leukocytes decreases later and more slowly and is therefore considered as a more reliable criterion for assessing deficiency than the concentration of ascorbic acid in the blood plasma. Metabolized mainly in the liver, into deoxyascorbic acid and further into oxaloacetic and diketogulonic acids. It is excreted by the kidneys, through the intestines, with sweat, and breast milk in the form of unchanged ascorbate and metabolites. When high doses are prescribed, the rate of elimination increases sharply. Smoking and drinking ethanol accelerates the destruction of ascorbic acid (conversion into inactive metabolites), sharply reducing its reserves in the body.

Excreted during hemodialysis.

Pharmacodynamics

Ascorbic acid is a vitamin that is not formed in the human body, but comes only with food. Participates in the regulation of redox processes, carbohydrate metabolism, blood clotting, tissue regeneration, in the synthesis of steroid hormones; increases the body's resistance to infections, reduces vascular permeability, reduces the need for vitamins B1, B2, A, E, folic acid, pantothenic acid. Participates in the metabolism of phenylalanine, tyrosine, folic acid, norepinephrine, histamine, iron, utilization of carbohydrates, synthesis of lipids, proteins, carnitine, immune reactions, hydroxylation of serotonin, enhances the absorption of non-heme iron. It has antiplatelet and pronounced antioxidant properties.

Maintains the colloidal state of the intercellular substance and normal capillary permeability. Regulates immunological reactions (activates the synthesis of antibodies, C3 component of complement, interferon), promotes phagocytosis, increases the body's resistance to infections. Inhibits the release and accelerates the degradation of histamine, inhibits the formation of prostaglandins and other inflammatory mediators.

Indications for use

Prevention, treatment of hypo- and avitaminosis of vitamin C

With an increased need for vitamin C in the body during

active growth in children, pregnancy, breastfeeding

With increased physical and mental stress, fatigue, stressful conditions

During the recovery period after long and serious illnesses

Directions for use and doses

Orally, for preventive purposes, 50 mg - 100 mg (1 - 2 tablets) per day; during pregnancy and lactation - 300 mg for 10-15 days (3 tablets), then - 100 mg (2 tablets) per day, children aged 6 years and older - 50 mg - 100 mg (1 - 2 tablets) per day day.

WITH therapeutic purpose: adults 50 mg-100 mg (1-2 tablets) 3-5 times a day, children over 6 years old 50 mg-100 mg (1-2 tablets) 2-3 times a day.

The duration of treatment depends on the nature and course of the disease and is prescribed by a doctor.

Side effects"type="checkbox">

Side effects

Headache, feeling tired

With long-term use of large doses - increased excitability

CNS, sleep disorder

Irritation of the gastrointestinal mucosa, nausea, vomiting,

diarrhea, stomach cramps

Promotion blood pressure, development of microangiopathies

Inhibition of the function of the pancreatic insular apparatus

(hyperglycemia, glycosuria)

Reduced capillary permeability and deterioration of tissue trophism, thrombosis when taking high doses

Allergic reactions: skin rash, rarely - anaphylactic shock

Contraindications

Hypersensitivity to the components of the drug

Thrombophlebitis

Tendency to thrombosis

Diabetes

Children under 6 years old

Increased blood clotting

Progressive malignant diseases

Hyperoxalaturia

Kidney failure

Hemochromatosis

Thalassemia

Glucose-6-phosphate dehydrogenase deficiency

Hyperoxaluria and formation of urinary stones from calcium oxalate, damage to the glomerular apparatus of the kidneys

Thrombocytosis, hyperprothrombinemia, erythropenia

Drug interactions"type="checkbox">

Drug interactions

Increases the blood concentration of salicylates (increases the risk of crystalluria), ethinyl estradiol, benzylpenicillin and tetracyclines, reduces the concentration of oral cotraceptives. Reduces the anticoagulant effect of coumarin derivatives. Improves the absorption of iron preparations in the intestines. Quinoline drugs, calcium chloride, salicylates, and corticosteroids deplete vitamin C reserves when used for a long time.

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

Increases the overall clearance of ethanol, which, in turn, reduces the concentration of ascorbic acid in the body.

Barbiturates and primidone increase the excretion of ascorbic acid in the urine.

Reduces therapeutic effect antipsychotropic drugs (phenothiazine derivatives), tubular reabsorption of amphetamine and tricyclic antidepressants.

special instructions"type="checkbox">

special instructions

When treating with large doses of ascorbic acid, it is necessary to monitor renal function, blood pressure (BP) and pancreatic function. Ascorbic acid, as a reducing agent, can distort the results of various laboratory tests (blood glucose, bilirubin, transaminase activity).

In patients with increased content iron in the body, ascorbic acid should be used in minimal doses.

Self-medication can be harmful to your health.
You should consult your doctor and read the instructions before use.

Ascorbic acid tablets: instructions for use

Compound

Active ingredient: ascorbic acid;

1 dragee contains ascorbic acid - 50 mg;

excipients: starch syrup, white sugar, yellow wax, mineral oil, talc, orange flavor (contains propylene glycol).

Description

international generic name: ascorbic acid;

basic physicochemical characteristics: dragee white or white with a yellowish tint. By appearance must have a spherical shape.

pharmachologic effect

Ascorbic acid (vitamin C) has pronounced restorative properties. Belongs to the group of water-soluble vitamins. Participates in redox reactions, regulation of carbohydrate metabolism, affects the metabolism of aromatic amino acids, the metabolism of thyroxine, the biosynthesis of catecholamines, steroid hormones and insulin, is necessary for blood clotting, the synthesis of collagen and procollagen, the regeneration of connective and bone tissue. Improves capillary penetration. Promotes the absorption of iron in the intestines and takes part in the synthesis of hemoglobin. Increases nonspecific resistance body, has antidote properties. A deficiency of vitamin C in food leads to the development of hypo- and avitaminosis C, since this vitamin is not synthesized in the body.

Absorption of ascorbic acid occurs predominantly in small intestine. The absorption process may be disrupted by intestinal dyskinesias, enteritis, achylia, helminthic infestation, giardiasis, as well as when consumed alkaline drinks, fresh fruits and vegetable juices. The maximum concentration of the drug in plasma after oral administration is achieved after 4 hours. Easily penetrates into leukocytes, platelets, and then into all tissues; deposited in the posterior part of the pituitary gland, adrenal cortex, ocular epithelium, intermediate cells of the seminal glands, ovaries, liver, brain, spleen, pancreas, lungs, kidneys, intestinal wall, heart, muscles, thyroid gland. Metabolized primarily in the liver into deoxyascorbic acid and further into oxaloacetic and diketogulonic acids. Unchanged ascorbate and metabolites are excreted in urine, feces and excreted in breast milk. When high doses are used, when plasma concentrations reach above 1.4 mg/dL, excretion increases sharply, and increased excretion may persist after discontinuation of use.

Indications for use

Prevention and treatment of vitamin C deficiency in the body.

Prevention and treatment of scurvy, stimulation of tissue regeneration, in complex therapy bleeding (uterine, pulmonary, nasal), with the syndrome radiation sickness, bone fractures, hemorrhagic diathesis, intoxications and infections, Addison's disease with an overdose of anticoagulants, during pregnancy and lactation, with increased mental stress and physical overload.

Contraindications

Hypersensitivity to ascorbic acid or excipient drug. Thrombosis, tendency to thrombosis, thrombophlebitis, diabetes, serious illnesses kidney Urolithiasis - when using doses above 1 g per day. Fructose intolerance, glucose-galactose malabsorption syndrome.

Children's age up to 4 years.

Pregnancy and lactation

A lack of vitamin C in the diet of pregnant women can be dangerous for the fetus, however, its use in high doses can also negatively affect the development of the fetus, therefore, during pregnancy, ascorbic acid is used exclusively as directed and under the supervision of a doctor, strictly adhering to the recommended doses (see section " Directions for use and dosage").

Ascorbic acid passes into breast milk, so during breastfeeding, vitamin C should be taken under the supervision of a doctor, adhering to the recommended doses (see section “Method of administration and dosage”).

Directions for use and doses

Prescribed to adults and children over 4 years of age. Dragees are taken orally after meals. Therapeutic dose for adults and children over 14 years old is 50-100 mg (1-2 tablets) 3-5 times a day.

children aged 4-7 years - 50-100 mg (1-2 tablets), children aged 7-10 years - 100 mg (2 tablets),

children aged 11-14 years - 100-150 mg (2-3 tablets) 2-3 times a day.

WITH for preventive purposes ascorbic acid is prescribed to adults and children over the age of 14 years in a daily dose of 50-100 mg (1-2 tablets).

For the purpose of preventing hypovitaminosis, children aged 4-14 years are prescribed 50 mg (1 tablet) 1 time per day.

Pregnant women, women after childbirth, as well as with low levels of vitamin C in breast milk are prescribed a daily dose of 300 mg (6 tablets) for 10-15 days, after which (for preventive purposes throughout the entire period of breastfeeding) - in a daily dose 100 mg (2 tablets).

The duration of use is determined by the doctor depending on the nature pathological condition and effectiveness of therapy.

Side effect

Ascorbic acid is generally well tolerated, but some problems may occur. adverse reactions:

from the outside digestive tract: when used in a dose of more than 1 g per day - irritation of the mucous membrane of the digestive tract, heartburn, nausea, vomiting, diarrhea; from the urinary system: damage to the glomerular apparatus of the kidneys, crystalluria, formation of urate, cystine and/or oxalate stones in the kidneys and urinary tract;

allergic reactions: skin rash, Quincke's edema, urticaria; sometimes - anaphylactic shock in the presence of sensitization;

from the outside endocrine system: damage to the insular apparatus of the pancreas (hyperglycemia, glucosuria) and disruption of glycogen synthesis, leading to the appearance of diabetes mellitus;

from the cardiovascular system: arterial hypertension, myocardial dystrophy; from the side)1s hematopoietic system: thrombocytosis, hyperprothrombinemia, erythrocytopenia, neutrophilic leukemia; in patients with deficiency of glucose-6-phosphate dehydrogenase of blood cells, hemolysis of red blood cells may result;

from the nervous system: increased excitability, sleep disturbance, headache; on the metabolic side: metabolic disorders of zinc and copper.

If any undesirable reactions occur, consult your doctor regarding further use of the drug!

Overdose

Symptoms: with one-time use excessive doses drug possible

the occurrence of nausea, vomiting, bloating and abdominal pain, itching, skin rash, increased excitability.

With long-term use in high doses, it is possible to suppress the insular apparatus of the pancreas (its function must be monitored), develop cystitis, and accelerate the formation of stones (urates, oxalates).

Treatment: discontinuation of the drug, gastric lavage, alkaline drinking, taking activated carbon or other sorbents, symptomatic therapy.

Interaction with other drugs

If you are taking any other medications, be sure to tell your doctor!

Absorption of ascorbic acid is reduced with simultaneous use of oral contraceptives, consumption of fruit or vegetable juices, and alkaline drinking. Ascorbic acid at oral administration increases the absorption of penicillin, tetracycline, iron, reduces the effectiveness of heparin and indirect anticoagulants, increases the risk of developing crystalluria during treatment with salicylates. Simultaneous use Vitamin C and deferoxamine increases tissue toxicity of iron, especially in the heart muscle, which can lead to decompensation of the circulatory system. Vitamin C can only be taken 2 hours after the deferoxamine injection.

Long-term use Large doses in persons treated with disulfiramine inhibit the disulfiram-alcohol reaction. Large doses of the drug reduce the effectiveness of tricyclic antidepressants, neuroleptics - phenothiazine derivatives, tubular reabsorption of amphetamine, and interfere with the excretion of mexiletine by the kidneys.

Ascorbic acid increases the total clearance of ethyl alcohol. Quinoline drugs, calcium chloride, salicylates, and corticosteroids, when used for a long time, reduce the reserves of ascorbic acid in the body.

Features of application

The ability to influence the reaction rate when driving a vehicle or working with other mechanisms. Does not affect.

Children. The drug is prescribed to children over 4 years of age.

Precautionary measures

Before starting treatment, consult your doctor!

When using the drug, you must adhere to the doses recommended by your doctor!

When taking high doses and long-term use of the drug, it is necessary to monitor kidney function and blood pressure levels, as well as pancreatic function. It should be used with caution in patients with a history of kidney disease.

For urolithiasis daily dose ascorbic acid should not exceed 1 g.

You should not prescribe large doses of the drug to patients with increased blood clotting.

Since ascorbic acid increases the absorption of iron, its use in high doses may be dangerous for patients with hemochromatosis, thalassemia, polycythemia, leukemia and sideroblastic anemia. Patients with high iron content in the body should use the drug in minimal doses.

Simultaneous use with an alkaline drink reduces the absorption of ascorbic acid, so you should not drink alkaline tablets mineral water. Also, the absorption of ascorbic acid may be impaired by intestinal dyskinesia, enteritis and achylia. Use with caution to treat patients with glucose-6-deficiency

phosphate dehydrogenase.

Ascorbic acid as a reducing agent can affect the results laboratory research, for example, when determining blood glucose, bilirubin, transaminase activity, lactate dehydrogenase, etc.

Since Ascorbic acid has a slight stimulating effect, it is not recommended to take the medicine at the end of the day.

Release form

50 tablets with a dosage of 50 mg in containers. 1 container in a cardboard pack.

Storage conditions

Store in original packaging at temperatures above 25 °C.

First obtained from lemon juice. In our body, this substance performs many essential functions, therefore, with its deficiency, serious disruptions in work develop internal organs. A person receives ascorbic acid along with those rich in vitamin C, but in some cases a prescription is required vitamin preparations. No matter how much useful functions performs ascorbic acid, the instructions for use state that you should not take it uncontrollably. What is the procedure for taking vitamin C for adults and children? Let's find out together.

Why is ascorbic acid needed?

Vitamin C acts powerful antioxidant, regulates many redox reactions occurring in the body of an adult and a child.

Without his participation, other important processes are impossible:

• collagen synthesis ;
• regulation of the blood coagulation system ;
• production of adrenal hormones and steroids ;
• iron metabolism and;
• normalization of permeability vascular wall ;
• hematopoiesis;
• anti-inflammatory effect ;
• reducing the effects of stress on the body ;
• strengthening the immune system ;
• wound healing;
• reducing the likelihood of developing allergic reactions ;
• absorption of calcium, iron, removal of lead, mercury and copper .

Some studies have shown that vitamin C has some activity against cancer cells. Moreover, in patients with oncological diseases Ascorbic acid reserves are sharply depleted, so its use during the treatment period is necessary to prevent vitamin deficiency.

Vitamin C is able to prevent the oxidation of cholesterol, thereby reducing the likelihood of deposition of atherosclerotic plaques in the lumen of blood vessels. Ascorbic acid helps cope with stress during periods of great emotional and psychological stress, which is especially important for children school age.

The human body practically does not accumulate this useful element Therefore, it is important to ensure a regular supply of the vitamin through food. And since it dissolves in water and is destroyed during heat treatment, preference should be given fresh vegetables and fruits - this is especially useful for children.

Release form and indications for use

Ascorbic acid is available in several dosage forms- , and containing solution for injection.

According to the instructions for use, ascorbic acid is prescribed in the following cases:

• vitamin C deficiency , or vitamin deficiency C;
• frequent bleeding (from the nose, lungs, uterus);
• hemorrhagic stroke ;
• radiation sickness in the acute stage;
• hemorrhagic diathesis ;
• psoriasis;
• various helminthiases ;
• pathologies after transfusion therapy ;
• infectious diseases ;
• poorly healing ulcers, wounds, cracks, burn surfaces ;
• bone fractures;
• intoxication with toxic substances , including iron supplements;
• dystrophy;
• dermatoses chronic;
• (multiple, as well as occurring against the background of nicotine or drug addiction);
• cholecystitis;
• adrenal insufficiency ;
• mental and physical overload in children ;
• convalescence period after illness;
• delirium alcoholic or infectious;
• liver pathology (Botkin's disease, cirrhosis, hepatitis);
• pathologies of the gastrointestinal tract (colitis, enteritis, peptic ulcer).

Children are often prescribed vitamin preparations in the autumn-winter period, when the risk of viral epidemics in kindergartens and schools increases.

How to take the vitamin

For prevention purposes, adults should take ascorbic acid tablets 1 day (100 mg). For medicinal purposes, 1 tablet is prescribed 3-5 times a day. Children are given 0.5-1 tablet 2-3 times a day.

Ascorbic acid in tablets is taken 1-2 pieces per day for adults and 1 tablet for children over 5 years old. For medicinal purposes, the dose is increased 2-3 times.

The injection solution is used only for medicinal purposes in a dosage of 0.05-0.15 g. The maximum single dose is 4 ml, the daily dose is 20 ml.

The injection solution is administered intravenously or intramuscularly for therapeutic purposes, 0.05-0.15 g (1-3 ml of solution), the maximum single dose is 0.20 g (4 ml), the daily dose is 1 g (20 ml); children - 0.05-0.10 g/day (1-2 ml). The duration of treatment depends on the nature and course of the disease.

Contraindications and restrictions

According to the instructions, it is not advisable to take ascorbic acid in patients with individual high sensitivity to vitamin C, as well as those suffering from thrombophlebitis and with a high risk of developing thromboembolism. The vitamin preparation should be used with caution in patients with diabetes mellitus, sideroblastic anemia, urolithiasis, and hemochromatosis.

Ascorbic acid during pregnancy and lactation

The daily requirement of a pregnant woman for vitamin C is 60-100 mg. It is important to consider that the fetus may become addicted to a large dose of the element, so after birth the child may experience withdrawal syndrome and develop scurvy. At intravenous administration A high dose of a vitamin preparation for a pregnant woman increases the risk of miscarriage or premature birth.

During breastfeeding, the need for vitamin is higher - about 80-100 mg. At good nutrition mothers infants a sufficient amount of the element passes along with mother's milk Therefore, the use of vitamin preparations during this period should take place in the appropriate dosage. If a woman takes high doses, there is a danger to the child.

Side effects of the element

Like any other medicinal substance, ascorbic acid in various ways application may cause some side effects, among which:

• thrombocytosis.
• dizziness, weakness (especially with rapid intravenous administration of the solution);
• when taken orally, symptoms from the gastrointestinal tract may occur - nausea, vomiting, flatulence, diarrhea, thinning of tooth enamel (when resorbing tablet forms);
• fluid retention in organism;
• metabolic disease ;
• hypokalemia;
• excessive synthesis of glucocorticosteroids ;
• frequent urination ;
• damage to kidney glomeruli ;
• the appearance of kidney stones (with long-term use of more than 1 g per day);
• allergic reactions - rash on skin, redness, urticaria;
• with intramuscular and intravenous administration possible pain at the injection site .

Interaction with other drugs

Ascorbic acid can increase the blood levels of tetracyclines, salicylates and benzylpenicillin, and reduces the effect of anticoagulants - heparin and coumarin. Joint reception vitamin C and oral contraceptives reduces the concentration of the latter. The element is able to enhance the rate and volume of absorption of iron-containing drugs.

Long-term use of quinolone drugs, salicylates, steroids and calcium chloride provokes depletion of ascorbic acid reserves. It is not advisable to mix vitamin C solution with other medicines in one syringe - chemical reactions are possible.

Overdose symptoms

Long-term intake of more than 1 gram of vitamin C per day can provoke the appearance of unwanted symptoms:

• headache;
• insomnia;
• excessive excitability central nervous system;
• nausea, vomiting;
• damage to the gastric mucosa ;
• gastritis with high acidity ;
• depression of pancreatic function ;
• glucosuria;
• urolithiasis disease ;
• hemolysis of red blood cells ;
• hyperglycemia;
• kidney damage ;
• increased urge to urinate ;
• low permeability of the vascular wall of capillaries (as a result - a violation of tissue trophism);
• increased blood pressure ;
• excessive blood clotting ;
• microangiopathies ;
• risk of miscarriage .

Precautionary measures

Before use medicinal substance You should consult a specialist and carefully read the instructions. When intravenous use It is recommended to administer the solution slowly. Long-term use of a vitamin preparation requires monitoring of kidney function, blood glucose levels and blood pressure. For patients suffering from diabetes mellitus, urolithiasis, prone to the formation of blood clots, and also receiving anticoagulants, vitamin C is prescribed in minimal doses and only under the supervision of a specialist.

Ascorbic acid acts as a reducing agent in chemical reactions, so it can distort the results of some laboratory tests (for example, biochemical research blood, determination of blood glucose levels).

The role of ascorbic acid for children

Vitamin C is an essential substance for a growing body. It can have a beneficial effect on the functioning of the nervous system and internal organs. Without ascorbic acid, it is impossible to fully absorb iron and eliminate harmful and toxic substances from the child's body. Children need ascorbic acid during the period of active growth, as it promotes bone growth and strengthening.

Children of preschool and school age are prone to frequent viral and colds due to imperfect functioning of the immune system. The biologically active substance has the ability to strengthen the immune system and support the body in the fight against pathogens. A child's daily diet should include fresh fruits and vegetables that have not passed heat treatment. Parents should give fruit and vegetable purees to a child under 2 years of age daily.

Additional intake of vitamin preparations is indicated for children if there are symptoms of vitamin C deficiency.

It manifests itself with the following symptoms:

• The child gets tired quickly, begins to lag behind in his studies, and his concentration decreases.
• Bleeding gums appeared even with weak mechanical impact.
• Frequent colds and infectious diseases of a bacterial and viral nature, which indicates a weakened immune system.
• Blueness of the nasolabial triangle, lips, nails, fingertips, ears.
• The skin is pale.

Parents should not decide on their own whether supplemental vitamin C is necessary. Daily dosage, the frequency of administration and duration of the course can only be determined by a specialist after examination and studying the results of additional studies.

Ascorbic acid

International nonproprietary name

Ascorbic acid

Dosage form

Solution for intravenous and intramuscular injection 5 %

Compound

1 ml of solution contains

active substance: ascorbic acid - 50.00 mg,

Excipients: sodium bicarbonate, sodium sulfite, water for injection, saturated with carbon dioxide.

Description

Transparent, slightly colored liquid.

Pharmacotherapeutic group

Vitamins.

Ascorbic acid.

ATX code A11GA01

Pharmacological properties

Pharmacokinetics

Communication with plasma proteins - 25%. The normal concentration of ascorbic acid in plasma is approximately 10-20 μg/ml. Easily penetrates into leukocytes, platelets, and then into all tissues; the highest concentration is achieved in the 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 plasma. In deficient conditions, the concentration in leukocytes decreases later and more slowly and is considered as best criterion deficiency estimates than plasma concentrations.

Metabolized primarily in the liver into deoxyascorbic acid and further into oxaloacetic acid and ascorbate-2-sulfate.

It is excreted by the kidneys, through the intestines, with sweat, breast milk unchanged and in the form of metabolites. When high doses are prescribed, the rate of elimination increases sharply. Smoking and drinking ethanol accelerate the destruction of ascorbic acid (conversion into inactive metabolites), sharply reducing reserves in the body. Excreted during hemodialysis.

Pharmacodynamics

Ascorbic acid (vitamin C) is not formed in the human body, but comes only from food. Pharmacological effects: in quantities significantly exceeding the daily requirement (90 mg), it has almost no effect, with the exception of quick fix symptoms of hypo- and vitamin deficiency (scurvy). Physiological functions: is a cofactor in some hydroxylation and amidation reactions - transfers electrons to enzymes, providing them with a reducing equivalent. Participates in the reactions of hydroxylation of proline and lysine residues of procollagen with the formation of hydroxyproline and hydroxylysine (post-translational modification of collagen), oxidation of lysine side chains in proteins with the formation of hydroxytrimethyllysine (in the process of kartinite synthesis), oxidation of folic acid to folinic acid, metabolism of drugs in liver microsomes and hydroxylation dopamine to form norepinephrine. Increases the activity of amidating enzymes involved in the processing of oxytocin, antidiuretic hormone and cholecystokinin. Participates in steroidogenesis in the adrenal glands. The main role in tissues is participation in the synthesis of collagen, proteoglycans and other organic components of the intercellular substance of teeth, bones and capillary endothelium.

Indications for use

Hypovitaminosis C (if you need to quickly replenish vitamin C

and the impossibility of oral administration)

Vitamin deficiency C (scurvy)

The period of convalescence after surgery infectious diseases And

intoxications

Post-transfusion complications

Liver diseases ( chronic hepatitis and cirrhosis) as part of complex therapy

Hypoacid gastritis, enteritis, colitis

Slow-healing wounds and ulcers, bone fractures

Small bowel resection

Peptic ulcer

Gastrectomy

Chronic adrenal insufficiency (Addison's disease), adrenal

Chechen crisis in Addison's disease

Laboratory practice: for marking red blood cells (together with sodium chromate Cr51).

Directions for use and doses

Intravenous, intramuscular (slow), adults from 100 to 500 mg (2 - 10 ml 5%) per day, for the treatment of scurvy - up to 1000 mg per day.

Children under the age of 6 months are prescribed 20-30 mg/day (0.4-0.6 ml of 5% solution), at the age of 6-12 months - 35 mg/day (0.7 ml of 5% solution), 1- 3 years - 40 mg/day (0.8 ml of 5% solution), 4-10 years - 45 mg/day (0.9 ml of 5% solution), 11-14 years - 50 mg/day (1 ml of 5% solution ), for children over 15 years old 60-100 mg (1.2-2 ml of 5% solution) 1 time per day. When treating scurvy in children - up to 500 mg (10 ml 5%) per day.

When treating adrenal crisis, 250-500 mg (5-10 ml of 5% solution) is administered intravenously slowly every 3-4 hours.

To mark red blood cells (together with sodium chromate Cr51), 100 mg of ascorbic acid is injected into a vial with sodium chromate Cr51.

Side effects

Increased blood pressure

Oppression endocrine function pancreas (hyperglycemia, glycosuria)

Thrombocytosis, anemia, neutrophilia

Hyperprothrombinemia, thrombophilia

Allergic reactions (including anaphylactic shock)

Renal dysfunction (glomerulopathy)

Disorders of zinc and copper metabolism with long-term use, leading to neurotoxic effects (increased excitability, sleep disturbance)

Myocardial dystrophy

Urolithiasis (formation of oxalate stones).

Contraindications

Hypersensitivity

With long-term use in large doses (more than 500 mg) - diabetes mellitus, hyperoxaluria, nephrolithiasis, hemochromatosis, thalassemia, glucose-6-phosphate dehydrogenase deficiency

Non-insulin dependent diabetes mellitus

Carefully

Sideroblastic anemia

Urolithiasis disease

Hyperoxaluria

Drug interactions

Pharmaceutically incompatible with aminophylline, bleomycin, cefazolin, cefapirin, chlordiazepoxide, estrogens, dextrans, doxapram, erythromycin, methicillin, nafcillin, benzylpenicillin, warfarin.

Increases the concentration of benzylpenicillin and tetracyclines in the blood; at a dose of 1 g/day increases the bioavailability of ethinyl estradiol (including that included in oral contraceptives).

Reduces the effectiveness of heparin and indirect anticoagulants.

When used simultaneously with acetylsalicylic acid The excretion of ascorbic acid in urine increases and the excretion of acetylsalicylic acid decreases.

Increases the risk of developing crystalluria when treated with salicylates and sulfonamides short acting, slows down the excretion of acids by the kidneys, increases the excretion of drugs that have alkaline reaction(including alkaloids), reduces the concentration of oral contraceptives in the blood.

Increases the overall clearance of ethanol, which in turn reduces the concentration of ascorbic acid in the body.

Quinoline drugs, calcium supplements, salicylates, and glucocorticosteroids deplete ascorbic acid reserves when used for a long time.

When used simultaneously, it reduces the chronotropic effect of isoprenaline.

With long-term use or use 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.

special instructions

Due to the stimulating effect of ascorbic acid on the synthesis of corticosteroid hormones, it is necessary to monitor adrenal function and blood pressure. High doses of ascorbic acid increase the excretion of oxalates, promoting the formation of kidney stones. Newborns whose mothers took high doses of ascorbic acid and adults who took high doses may experience rebound scurvy. With long-term use of large doses, inhibition of the function of the pancreatic insular apparatus is possible, so it must be regularly monitored during treatment. In patients with high iron levels 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, bilirubin in the blood and urine, the activity of liver transaminases and lactate dehydrogenase).

Use during pregnancy and lactation

During pregnancy and lactation, they are used only if the expected benefit to the mother outweighs the potential risk to the fetus and child. The minimum daily requirement for ascorbic acid in the II-III trimesters of pregnancy is about 60 mg. It should be borne in mind that the fetus can adapt to high doses of ascorbic acid taken by a pregnant woman, and then the newborn may develop a withdrawal syndrome. The minimum daily requirement during lactation is 80 mg. A mother's diet containing adequate amounts of ascorbic acid is sufficient to prevent its deficiency in the infant. Theoretically, there is a danger to the child when the mother uses high doses of ascorbic acid (it is recommended not to exceed by a nursing mother daily needs in ascorbic acid).

Features of influence medicine on the ability to manage vehicle or potentially dangerous mechanisms

During the treatment period, care must be taken when driving vehicles and engaging in potentially dangerous species activities that require increased concentration and speed of psychomotor reactions.

Overdose