Ascorbic acid dragee 50mg, No. 200

• prevention and treatment of hypo- and vitamin C deficiency;

• states of increased need for ascorbic acid;

• period of artificial feeding and intensive growth;

• unbalanced diet;

• increased mental and physical stress;

• the period of convalescence after serious illness;

• alcoholism;

• burn disease;

• febrile condition against the background of acute respiratory diseases, acute respiratory viral infections;

• long-term chronic infections;

• nicotine addiction;

• stressful condition;

• postoperative period, pregnancy (multiple fetuses, against the background of nicotine or drug addiction);

• chronic intoxication with iron preparations (as part of complex therapy with deferoxamine);

• idiopathic methemoglobinemia.

The drug is taken orally after meals.

For prophylaxis: adults 0.05-0.1 g (1-2 pills) / day, children from 5 years old - 0.05 g (1 pills) / day.

For treatment: adults 0.05-0.1 g (1-2 pills) 3-5 times / day, children from 5 years old - 0.05-0.1 g (1-2 pills) 2-3 times / day.

During pregnancy and lactation - 0.3 g (6 tablets) / day for 10-15 days, then 0.1 g (2 tablets) / day.

ascorbic acid 50 mg

• thrombophlebitis;

• tendency to thrombosis;

• diabetes;

• deficiency of sucrase / isomaltase, fructose intolerance,
  glucose-galactose malabsorption;

• hypersensitivity.

With care: hyperoxalaturia, renal failure, hemochromatosis, thalassemia, polycythemia, leukemia, sideroblastic anemia, glucose-6-phosphate dehydrogenase deficiency, sickle cell anemia, progressive malignant diseases.

pharmachologic effect

Ascorbic acid (vitamin C) is not formed in the human body, but comes only with food.

Pharmacological effects: in quantities significantly exceeding the daily requirement (90 mg), it has almost no effect, except for the rapid elimination of the symptoms of hypo- and avitaminosis (scurvy).

Physiological functions: is a cofactor of some hydroxylation and amidation reactions - transfers electrons to enzymes, supplying 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 kartytite synthesis), oxidation of folic acid to folinic acid, drug metabolism and hydroxylation in liver microsomes dopamine with the formation of norepinephrine.

Increases the activity of amidating enzymes involved in the processing of oxytocin, antidiuretic hormone and cholecystokinin. Participates in steroidogenesis in the adrenal glands;

Restores Fe3 + to Fe2 + in the intestine, promoting its absorption. 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.

In low doses (150-250 mg / day orally), it improves the complexing function of deferoxamine in chronic intoxication with iron preparations, which leads to an increase in the excretion of the latter.

Ascorbic acid is actively involved in many redox reactions, has a nonspecific general stimulating effect on the body. Increases the adaptive capacity of the body and its resistance to infections; promotes regeneration processes.

Pharmacokinetics

Absorbed in the gastrointestinal tract (mainly in the jejunum). With an increase in the dose to 200 mg, up to 140 mg (70%) is absorbed; with a further increase in the dose, absorption decreases (50-20%). Plasma protein binding - 25%. Diseases of the gastrointestinal tract (peptic ulcer and duodenal ulcer, constipation or diarrhea, helminthic invasion, giardiasis), the use of fresh fruit and vegetable juices, alkaline drinks reduce the absorption of ascorbic acid in the intestine.

The concentration of ascorbic acid in plasma is normally approximately 10-20 ?g / ml, the reserves in the body are about 1.5 g when taking the daily recommended doses and 2.5 g when taking 200 mg / day. The time to reach Cmax after oral administration is 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; crosses 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 a better criterion for assessing deficiency than plasma concentration.

It is metabolized mainly 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 prescribed, the rate of elimination increases dramatically. Smoking and consumption of ethanol accelerate the breakdown of ascorbic acid (conversion into inactive metabolites), dramatically reducing body stores.

It is excreted during hemodialysis.

Indications of the drug Ascorbic acid

• prevention and treatment of hypo- and vitamin C deficiency;

• states of increased need for ascorbic acid;

• period of artificial feeding and intensive growth;

• unbalanced diet;

• increased mental and physical stress;

• the period of convalescence after serious illness;

• alcoholism;

• burn disease;

• febrile condition against the background of acute respiratory diseases, acute respiratory viral infections;

• long-term chronic infections;

• nicotine addiction;

• stressful condition;

• postoperative period, pregnancy (multiple fetuses, against the background of nicotine or drug addiction);

• chronic intoxication with iron preparations (as part of complex therapy with deferoxamine);

• idiopathic methemoglobinemia.

Dosage regimen

The drug is taken orally after meals.

For prophylaxis: adults 0.05-0.1 g (1-2 pills) / day, children from 5 years old - 0.05 g (1 pills) / day.

For treatment: adults 0.05-0.1 g (1-2 pills) 3-5 times / day, children from 5 years old - 0.05-0.1 g (1-2 pills) 2-3 times / day.

During pregnancy and lactation - 0.3 g (6 tablets) / day for 10-15 days, then 0.1 g (2 tablets) / day.

Side effect

If any side effects occur, you should stop taking the drug and consult a doctor.

From the side of the central nervous system: headache, feeling of fatigue, with prolonged use of large doses - increased excitability of the central nervous system, sleep disturbances.

From the digestive system: irritation of the gastrointestinal tract mucosa, nausea, vomiting, diarrhea, stomach cramps.

From the endocrine system: suppression of the function of the insular apparatus of the pancreas (hyperglycemia, glucosuria).

From the urinary system: when used in high doses - hyperoxalaturia and the formation of urinary stones and calcium oxalate.

From the side of the cardiovascular system: thrombosis, when used in high doses, an increase in blood pressure, the development of microangiopathies, myocardial dystrophy.

Allergic reactions: skin rash; rarely - anaphylactic shock.

Laboratory indicators: thrombocytosis, hyperprothrombinemia, erythropenia, neutrophilic leukocytosis, hypokalemia.

Others: hypovitaminosis, a feeling of heat, with prolonged use of large doses - sodium (Na +) and fluid retention, impaired metabolism of zinc (Zn2 +), copper (Cu2 +).

Contraindications for use

• thrombophlebitis;

• tendency to thrombosis;

• diabetes;

• deficiency of sucrase / isomaltase, fructose intolerance,
  glucose-galactose malabsorption;

• hypersensitivity.

With care: hyperoxalaturia, renal failure, hemochromatosis, thalassemia, polycythemia, leukemia, sideroblastic anemia, glucose-6-phosphate dehydrogenase deficiency, sickle cell anemia, progressive malignant diseases.

Application during pregnancy and lactation

The minimum daily requirement for ascorbic acid in the II-III trimesters of pregnancy is about 60 mg.

The minimum daily requirement during lactation is 80 mg. A mother's diet containing an adequate amount of ascorbic acid is sufficient to prevent vitamin C deficiency in an infant (it is recommended that a nursing mother does not exceed the maximum daily requirement for ascorbic acid).

Application in children

For prevention: children from 5 years old - 0.05 g (1 tablet) / day.

For treatment: children from 5 years old - 0.05-0.1 g (1-2 tablets) 2-3 times / day.

special instructions

Due to the stimulating effect of ascorbic acid on the synthesis of corticosteroid hormones, it is necessary to monitor renal function and blood pressure.

With prolonged use of large doses, it is possible to suppress the function of the insular apparatus of the pancreas, therefore, in the course of treatment, it must be regularly monitored.

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

Prescribing ascorbic acid to patients with rapidly proliferating and intensely metastatic tumors can aggravate the process.

Ascorbic acid, as a reducing agent, can distort the results of various laboratory tests (blood glucose, bilirubin, transaminase activity, lactate dehydrogenase).

Influence on the ability to drive vehicles and use mechanisms

Ascorbic acid does not affect the speed of psychomotor reactions when driving and working with precise mechanisms.

Overdose

Symptoms: if you take more than 1 g / day, heartburn, diarrhea, difficulty urinating or urine staining red, hemolysis are possible. (in patients with glucose-6-phosphate dehydrogenase deficiency).

Treatment: symptomatic, forced diuresis.

Drug interactions

Increases blood concentration of benzylpenicillin and tetracyclines; at a dose of 1 g / day increases the bioavailability of ethinylestradiol.

Improves the absorption of iron preparations in the intestine (converts ferric iron to bivalent); may increase the excretion of iron when used concomitantly with deferoxamine.

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

With simultaneous use with ASA, the urinary excretion of ascorbic acid increases and the excretion of ASA decreases. ASA reduces the absorption of ascorbic acid by about 30%.

Increases the risk of crystalluria during treatment with salicylates and sulfonamides - short-acting, 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 ethanol clearance, which, in turn, reduces the concentration of ascorbic acid in the body.

Quinoline drugs (fluoroquinolones, etc.), calcium chloride, salicylates, GCS, with prolonged use, deplete the reserves of ascorbic acid.

With simultaneous use, it reduces the chronotropic effect of isoprenaline.

With prolonged use or use in high doses, the interaction of disulfiram-ethanol may be disrupted.

In high doses, it increases the renal excretion of mexiletine.

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

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