Vitamin C, effervescent tablets 250 mg 20 pcs

Pharmacological properties

Ascorbic acid is a vitamin, has metabolic action,

It is not formed in the human body, but comes only with food.

In an unbalanced and incomplete diet, a person is deficient in ascorbic acid.

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

Fe, carbohydrate utilization, synthesis of lipids, proteins, carnitine, immune reactions, serotonin hydroxylation, increases absorption of non-hemin Fe.
Has anti-aggregant and pronounced antioxidant properties.
Regulates H+ transport in many biochemical reactions, improves glucose utilization in the tricarboxylic acid cycle,

Participates in the formation of tetrahydrofolic acid 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 activating respiratory enzymes in the liver it increases its detoxifying and protein-forming functions and increases prothrombin synthesis.
It improves bile secretion, restores external secretory function of the pancreas and thyroid.
Regulates immunological reactions (activates the synthesis of antibodies, C3 component of complement, interferon),

Phagocytosis promotes, increases resistance to infection.

Inhibits release and accelerates degradation of histamine, inhibits formation of Pg and other mediators of inflammation and allergic reactions.
In low doses (150-250 mg/day orally) it improves complexing function of deferoxamine in chronic intoxication with Fe, which leads to increased excretion of Fe.

Pharmacokinetics

Absorbed in the gastrointestinal tract (GIT) (mainly in the jejunum).

With increasing dose up to 200 mg absorbed up to 140 mg (70%); with further increasing dose 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 drinking reduce ascorbate absorption in intestine.

The concentration of ascorbic acid in plasma is normally about 10-20 mcg/ml, the body stores about 1.5 g when taking the daily recommended doses and 2.5 g when taking 200 mg/day,time to maximum concentration after oral administration – 4 hours.
Easily penetrates into leukocytes, platelets, and then into all tissues;

The highest concentration is reached in glandular organs, leukocytes, liver and eye lens;

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 white blood cells 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 concentrations.
Metabolized primarily in the liver to deoxyascorbic acid and then to oxalic and diketogulonic acids.
Excreted by the kidneys, through the intestines, with sweat, breast milk as unchanged ascorbate and metabolites.
In high doses 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 reserves.
Excreted by hemodialysis.

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Indications

Treatment and prevention of hypo- and avitaminosis C., including those due to the condition of increased need for ascorbic acid in:

– increased physical and mental exertion;

– in the treatment of colds, SARS;

– in asthenic conditions;

– in the recovery period after illness.

– pregnancy (especially multiple, against a background of nicotine or drug addiction).

Composition

1 effervescent tablet 250 mg contains the active ingredient:

ascorbic acid 250.00 mg;

excipients:

sodium bicarbonate – 721.00 mg,

sodium carbonate – 152.00 mg,

citric acid – 1300.00 mg,

sucrose – 962.00 mg,

orange flavoring – 90.00 mg,

riboflavin sodium phosphate – 1.00 mg,

sodium saccharinate – 3.50 mg,

macrogol 6000 – 80.00 mg,

sodium benzoate – 20.00 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.

The 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).

Enhances intestinal absorption of iron preparations (converts trivalent iron to divalent iron),

May increase iron excretion if used concomitantly with deferoxamine.

Decreases 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.

The absorption of ascorbic acid is reduced by about 30%.

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

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

decreases the blood concentration of oral contraceptives.

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

Drugs of the quinoline series, calcium chloride, salicylates,

Glucocorticosteroids deplete ascorbic acid reserves with long-term use.

In concomitant use reduces the chronotropic effect of isoprenaline.

In long-term use or use in high doses may interfere with the disulfiram-ethanol interaction.

In high doses increases excretion of mexiletine by the kidneys.

Barbiturates and primidone increase ascorbic acid excretion in the urine.

Decreases the therapeutic effect of antipsychotic drugs (neuroleptics) – phenothiazine derivatives,

The tubal reabsorption of amphetamine and tricyclic antidepressants.

Special Instructions

Ascorbic acid-rich foods:

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

When storing food (including long freezing, drying, pickling, marinating),

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 the stimulating effect of ascorbic acid 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, so it should be controlled regularly during the treatment.

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

Askorbic acid is currently considered unproven to be effective in preventing cardiovascular diseases (CVDs) and some types of malignancies.

Ascorbic acid is not recommended for use in pyorrhea, infectious gum disease, hemorrhagic phenomena,

hematuria, retinal hemorrhage, immune system disorders, depression not related to vitamin C deficiency.

Prescribing ascorbic acid to patients with rapidly proliferating and intensely 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 components of the drug.

Children under 18 years of age (for this dosage form).

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:

In long-term use of high doses (more than 1000 mg per day), nausea, heartburn, diarrhea,

gastrointestinal mucosal irritation, flatulence, abdominal pain of a spastic nature,

Periodic urination, nephrolithiasis, insomnia, irritability, hypoglycemia.

Treatment: symptomatic, forced diuresis.

In case of any side effects the drug should be discontinued and a physician should be consulted.

Pregnancy use

The minimum daily requirement for ascorbic acid in the second and third 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 an adequate amount 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 of ascorbic acid).