Vitamin C, effervescent tablets 1 g 20 pcs

Pharmacological properties

Ascorbic acid is a vitamin that has metabolic effects, is not formed in the human body, and comes only with food.

With unbalanced and incomplete diet a person has a deficit of ascorbic acid.

Participates in the regulation of redox processes, carbohydrate metabolism, blood coagulation, tissue regeneration.

It increases resistance to infections, reduces vascular permeability, reduces the need for vitamins B1, B2, A, E, folic acid, pantothenic acid.
Participates in metabolism of phenylalanine, tyrosine, folic acid, norepinephrine, histamine, Fe, carbohydrate utilization, synthesis of lipids, proteins, carnitine, immune reactions, serotonin hydroxylation, increases absorption of non-hemin Fe.

It has anti-aggregant and pronounced antioxidant properties.

Regulates H+ transport in many biochemical reactions, improves glucose utilization in the tricarboxylic acid cycle, participates in tetrahydrofolic acid formation and tissue regeneration, synthesis of steroid hormones, collagen, procollagen.

Maintains colloidal state of 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.

By activation of respiratory enzymes in the liver it enhances its detoxifying and protein-forming functions and increases prothrombin synthesis.

Improves bile secretion, restores external secretory function of the pancreas and thyroid.

Regulates immunological reactions (activates synthesis of antibodies, Complement C3 component, interferon), promotes phagocytosis and increases resistance to infections.

Inhibits the release and accelerates degradation of histamine, inhibits the formation of Pg and other mediators of inflammation and allergic reactions.

At low doses (150-250 mg/day orally) it improves complexing function of deferoxamine in chronic intoxication with Fe drugs, which leads to increase of Fe excretion.

Pharmacokinetics

It is absorbed in the gastrointestinal tract (GIT) (mainly in the jejunum).

As dose increases to 200 mg, absorption is up to 140 mg (70%); with further dose increases, absorption decreases (50-20%).

The binding to plasma proteins is 25%. Gastrointestinal diseases (gastric and 12 duodenal ulcer, constipation or diarrhea, helminth infestation, giardiasis), consumption of fresh fruit and vegetable juices and alkaline drinks decrease ascorbate absorption in intestine.

The plasma concentration of ascorbic acid in normal is about 10-20 mcg/ml, the body stores about 1.5 g when taking daily recommended doses and 2.5 g when taking 200 mg/day, time to reach maximum concentration after oral administration is 4 hours.

Easily penetrates into white blood cells, platelets, and then into all tissues; highest concentrations are reached in glandular organs, white blood cells, liver, and lens of the eye;

Deposited in the posterior pituitary gland lobe, adrenal cortex, ocular epithelium, interstitial cells of seminal glands, ovaries, liver, spleen, pancreas, lungs, kidneys, intestinal wall, heart, muscles, thyroid gland; penetrates through the placenta.

The concentration of ascorbic acid in leukocytes and platelets is higher than in red blood cells and plasma.

In deficiency states, the concentration in leukocytes decreases later and more slowly and is considered a better criterion for assessing deficiency than plasma concentration.
Metabolized mainly in the liver to deoxyascorbic acid and then to oxalic acid and diketogulonic acid.

Extracted by the kidneys, through the intestines, with sweat, breast milk as unchanged ascorbate and metabolites.

When high doses are administered, the excretion rate increases dramatically.

Smoking and use of ethanol accelerate the breakdown of ascorbic acid (conversion to inactive metabolites), dramatically reducing the body’s stores.
Excreted by hemodialysis.

Indications

Treatment of vitamin C deficiency.

Composition

1 effervescent tablet 1000 mg contains

the active ingredient:

ascorbic acid 1000.00 mg;

auxiliary substances:

sodium bicarbonate – 821.00 mg,

sodium carbonate – 152.00 mg,

citric acid – 1030.00 mg,

sorbitol – 808.00 mg,

lemon flavoring – 75.00 mg,

riboflavin sodium phosphate – 1.00 mg,

sodium saccharinate – 5.00 mg,

macrogol 6000 – 60.00 mg,

sodium benzoate – 40.00 mg,

povidone-K30 – 8.00 mg.

How to take, the dosage

The drug is taken orally after meals. 1 tablet is dissolved in a glass of water (200 ml).

The tablets should not be swallowed, chewed or crushed in the mouth.

Treatment of vitamin C deficiency: 1000 mg per day.

Treatment and prevention of hypo-and avitaminosis C: 250 mg 1-2 times a day.

In pregnancy, the drug is prescribed in the maximum daily dose of 250 mg for 10-15 days.

Interaction

Increases the blood concentration of benzylpenicillin and tetracyclines;

at a dose of 1 g/day increases the bioavailability of ethinylestradiol (including those included in oral contraceptives).

Improves intestinal absorption of iron preparations (converts trivalent iron to divalent iron); it may increase iron excretion if used concomitantly with deferoxamine.

Reduces the effectiveness of heparin and indirect anticoagulants.

Acetylsalicylic acid (ASA), oral contraceptives, fresh juices and alkaline drinking reduce absorption and assimilation of ascorbic acid.

Concomitant use with ASA increases urinary excretion of ascorbic acid and decreases excretion of ASA. ASA reduces absorption of ascorbic acid by about 30%.

Increases the risk of crystalluria when treated with salicylates and short-acting sulfonamides,

slows renal excretion of acids, increases excretion of drugs with an alkaline reaction (including alkaloids.

reduces the blood concentration of oral contraceptives.

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

Quinoline-type drugs, calcium chloride, salicylates, glucocorticosteroids deplete ascorbic acid reserves with long-term use.

With concomitant use reduces the chronotropic effect of isoprenaline.

With long-term use or use in high doses may disrupt disulfiram-ethanol interaction.

In high doses increases renal excretion of mexiletine.

Barbiturates and primidone increase ascorbic acid excretion in the urine.

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

Special Instructions

Ascorbic acid-rich foods:

Citrus fruits, herbs, vegetables (peppers, broccoli, cabbage, tomatoes, potatoes).

When storing products (including long freezing, drying, pickling, pickling), cooking (especially in copper cookware), chopping vegetables and fruits in salads, making mashed potatoes partial destruction of ascorbic acid occurs (with temperature treatment – up to 30-50%).
Due to ascorbic acid stimulating effect on synthesis of corticosteroid hormones it is necessary to monitor adrenal function and blood pressure.
Long-term use of high doses may suppress pancreatic insulatory apparatus function, therefore it should be controlled regularly during the treatment.

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

The effectiveness of ascorbic acid to prevent cardiovascular disease (CVD) and some types of malignancies is currently considered unproven.

Ascorbic acid is not recommended for use in pyorrhea, infectious gum diseases, hemorrhagic phenomena, hematuria, retinal hemorrhage, immune system disorders, depression not associated with vitamin C deficiency.
Prescription of ascorbic acid to patients with rapidly proliferating and intensively metastasizing tumors may worsen the course of the process.
As a reducing agent ascorbic acid may distort the results of various laboratory tests (blood glucose, bilirubin, activity of “liver” transaminases and LDH).

Contraindications

Hypersensitivity to the drug components.

Childhood under 18 years (for this dosage form).

In long-term use in high doses (more than 500 mg): – Diabetes mellitus, hyperoxaluria,

nephrolithiasis, hemochromatosis, thalassemia.

With caution

Diabetes mellitus, glucose-6-phosphate dehydrogenase deficiency;

Hemochromatosis, sideroblast anemia, thalassemia,

hyperoxaluria, oxalosis, renal stone disease.

Overdose

Symptoms:

with prolonged use of high doses (more than 1000 mg per day), nausea, heartburn, diarrhea,

gastrointestinal mucosa irritation, flatulence, abdominal pain of spastic character,

rapid urination, nephrolithiasis, insomnia, irritability, hypoglycemia.

Treatment:

symptomatic, forced diuresis.

If any side effects occur, discontinue the drug and consult a physician.

Pregnancy use

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

It should be kept 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.

The mother’s diet containing adequate amounts of ascorbic acid is sufficient to prevent deficiency in the infant.

Theoretically, there is a risk to the baby if the mother uses high doses of ascorbic acid (it is recommended that the nursing mother not exceed the daily requirement for ascorbic acid).