Ascorbic acid sachets, 2.5 g

Ascorbic acid has pronounced reducing properties, is involved in the regulation of carbohydrate metabolism, redox processes, blood coagulation, normalization of capillary permeability, tissue regeneration, synthesis of steroid hormones, collagen, procollagen.

Pharmacokinetics

Binding with plasma proteins is 25%. Normal plasma concentration of ascorbic acid is about 10 – 20 µg/ml. It easily penetrates into leukocytes, platelets, and then into all tissues; the highest concentration is reached in glandular organs, leukocytes, liver and eye lens; it penetrates through the placenta. The concentration of ascorbic acid in leukocytes and platelets is higher than in erythrocytes and plasma. In deficiency states, the concentration in leukocytes decreases later and more slowly and is considered a better criterion for assessing deficiency than the concentration in plasma.

It is metabolized primarily in the liver to deoxyascorbic acid and then to oxalic acid and ascorbate-2-sulfate.

Indications

Infectious diseases

• Prevention and treatment of hypo-and avitaminosis of vitamin C;
• As an aid: Hemorrhagic diathesis, nasal, uterine, pulmonary and other bleeding, against the background of radiation sickness; overdose of anticoagulants, infectious diseases and intoxications, liver disease, nephropathy of pregnant women, Addison’s disease, sluggishly healing wounds and bone fractures. Dystrophies and other pathological processes.
• The drug is prescribed at high physical and mental stress, during pregnancy and lactation, during convalescence after severe long-term illnesses.

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Composition

active ingredient: ascorbic acid 2.5 g

How to take, the dosage

Prescribed by a doctor. Ascorbic acid is prescribed orally (after meals). It is prescribed for preventive purposes in adults 0.05 g – 0.1 g a day, during pregnancy, during postpartum period and in case of low vitamin C content in milk of nursing women – 0.3 g a day during 10-15 days, after that 0.1 g a day during the whole period of lactation. Children are prescribed prophylactically 0.025 g 2-3 times a day. Therapeutic doses for adults when administered orally are 0.05-0.1 g 3-5 times a day; for children – 0.05-0.1 g 2-3 times a day.

Interaction

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

Enhances blood concentrations of benzylpenicillin and tetracyclines; at a dose of 1 g / day increases the bioavailability of ethinylestradiol (including those included in oral contraceptives). Reduces the effectiveness of heparin and indirect anticoagulants.

Concomitant use with acetylsalicylic acid increases urinary excretion of ascorbic acid and decreases excretion of acetylsalicylic acid.

Induces the risk of crystalluria during treatment with short-acting salicylates and sulfonamides, slows renal excretion of acids, increases excretion of drugs with an alkaline reaction (including alkaloids), reduces the blood concentration of oral contraceptives. Increases total clearance of ethanol, which in turn reduces the concentration of ascorbic acid in the body.

Drugs of the quinoline series, calcium preparations, salicylates, glucocorticosteroids with long-term use deplete ascorbic acid reserves.

In concomitant use reduces the chronotropic effect of isoprenaline.

In long-term use or use in high doses may prevent the interaction of disulfiram and ethanol. In high doses increases excretion of mexiletine by the kidneys. Barbiturates and primidone increase ascorbic acid excretion with urine.

Decreases therapeutic effects of antipsychotic drugs (neuroleptics) – phenothiazine derivatives, tubal reabsorption of amphetamine and tricyclic antidepressants.

Special Instructions

Because of the stimulating effect of ascorbic acid on the synthesis of corticosteroid hormones, adrenal function and blood pressure should be monitored. High doses of ascorbic acid increase oxalate excretion, 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 “ricochet” scurvy. Prolonged use of high doses may suppress pancreatic insular function, 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. As a reducing agent ascorbic acid may distort the results of various laboratory tests (blood and urine content of glucose, bilirubin, activity of “liver” transaminases and lactate dehydrogenase).

Impact on driving and operating machinery

At the time of treatment, caution should be exercised while driving motor transport and engaging in potentially dangerous activities requiring increased concentration and quick psychomotor reactions.

Contraindications

Hypersensitivity, with long-term use in high doses (more than 500 mg) – diabetes mellitus, hyperoxaluria, nephrolithiasis, hemochromatosis, thalassemia, glucose-6-phosphate dehydrogenase deficiency.

With caution

Sideroblastic anemia, urolithiasis.

Overdose

Symptoms: nephrolithiasis, insomnia, irritability, hypoglycemia.

Treatment: symptomatic, forced diuresis.

Pregnancy use

In pregnancy and during lactation, use only if the estimated benefit to the mother exceeds the potential risk to the fetus and child. The minimum daily requirement of 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 the high doses of ascorbic acid taken by the pregnant woman, and then the newborn may develop “withdrawal” syndrome. The minimum daily requirement during lactation is 80 mg.

A mother’s diet containing an adequate amount of ascorbic acid is sufficient to prevent its deficiency in the infant. Theoretically, there is a danger to the baby when the mother uses high doses of ascorbic acid (it is recommended not to exceed the breastfeeding mother’s daily requirement of ascorbic acid).