Vitamin C

General characteristics. Structure:

Active agent: ascorbic acid of 1 g

Excipients: Natrii hydrocarbonas, sodium carbonate, citric acid, sorbitol, fragrance lemon, sodium Riboflavinum phosphate, sodium saccharinate, macrogoal 6000, Natrium benzoicum, K-30 povidone.

Active agent: ascorbic acid of 250 mg

Excipients: Natrii hydrocarbonas, sodium carbonate, citric acid, sucrose, fragrance orange, sodium Riboflavinum phosphate, sodium saccharinate, macrogoal.

Pharmacological properties:

Ascorbic acid is vitamin, has metabolic effect, is not formed in a human body, and arrives only with food. At unbalanced and defective food of people has deficiency in ascorbic acid.
Participates in regulation of oxidation-reduction processes, carbohydrate metabolism, coagulability of blood, an angenesis; increases resistance of an organism to infections, reduces vascular permeability, reduces the need for B1, V2, A, E vitamins, folic acid, pantothenic acid.
Participates in metabolism of phenylalanine, tyrosine, folic acid, Norepinephrinum, histamine, iron, utilization of karbogidrat, synthesis of lipids, proteins, a carnitine, immune responses, a serotonin hydroxylation, strengthens absorption of negeminovy iron. Has the antiagregantny and expressed antioxidant properties.
Regulates hydrogen transport in many biochemical reactions, improves use of glucose in a cycle of tricarboxylic acids, participates in formation of tetrahydrofolic acid and an angenesis, synthesis of steroid hormones, collagen, procollagen.
Maintains colloidal state of intercellular substance and normal permeability of capillaries (oppresses hyaluronidase).
Activates proteolytic enzymes, participates in exchange of aromatic amino acids, pigments and cholesterol, promotes accumulation in a glycogen liver. Due to activation of respiratory enzymes in a liver strengthens its disintoxication and belkovoobrazovatelny functions, increases synthesis of a prothrombin.
Improves bile secretion, recovers vneshnesekretorny function of a pancreas and incretory - thyroid.
Regulates immunological reactions (activates synthesis of antibodies, C3 component of a complement, interferon), promotes phagocytosis, increases body resistance to infections. Slows down release and accelerates degradation of a histamine, formation of prostaglandins and other mediators of an inflammation and allergic reactions oppresses.
In low doses (150-250 mg/days inside) improves complexing function of Deferoxaminum at chronic intoxication drugs iron that leads to strengthening of excretion of the last.

Pharmacokinetics. It is absorbed in a GIT (preferential in a jejunum). With increase in a dose up to 200 mg about 140 mg (70%) are soaked up; at further increase in a dose absorption decreases (50-20%). Communication with proteins of plasma - 25%. Gastrointestinal diseases (a peptic ulcer of a stomach and duodenum, locks or diarrhea, a helminthic invasion, a lambliasis), the use of fresh fruit and vegetable juice, alkaline drink reduce absorption of an ascorbate in intestines.

Concentration of ascorbic acid in plasma normal makes about 10-20 mkg/ml, stocks in an organism - about 1.5 g at reception of the daily recommended doses and 2.5 g at reception of 200 mg/days, time of achievement of Cmax after intake - 4 h. Easily gets into leukocytes, thrombocytes, and then - into all fabrics; the greatest concentration is reached in ferruterous bodies, leukocytes, a liver and lens; it is deposited in a back share of a hypophysis, bark of adrenal glands, an eye epithelium, interstitial cells of seminal glands, ovaries, a liver, a spleen, a pancreas, lungs, kidneys, an intestines wall, heart, muscles, a thyroid gland; gets through a placenta. Concentration of ascorbic acid in leukocytes and thrombocytes is higher, than in erythrocytes and in plasma. At scarce states concentration in leukocytes decreases later and more slowly and is considered as the best criterion for evaluation of deficit, than concentration in plasma.

It is metabolized preferential in a liver in dezoksiaskorbinovy and further in oxalacetic and diketogulonic acids.

It is removed by kidneys, through intestines, with then, breast milk in the form of not changed ascorbate and metabolites.

At purpose of high doses removal speed sharply amplifies. Smoking and the use of ethanol accelerate destruction of ascorbic acid (transformation into inactive metabolites), sharply reducing stocks in an organism. It is removed at a hemodialysis.

Indications to use:

For the tablets containing 1000 mg of ascorbic acid
— treatment of deficit of vitamin C.

For the tablets containing 250 mg of ascorbic acid
Treatment and prevention hypo - and avitaminosis With, including caused by a condition of the increased need for ascorbic acid at:
— the raised exercise and intellectual stresses;
— in complex therapy of catarrhal diseases, SARS;
— at asthenic states;
— during recovery after the postponed diseases.
— pregnancy (especially polycarpous, against the background of nicotine or medicinal addiction).

Route of administration and doses:

Drug is accepted inside after food. 1 tablet is dissolved in a glass of water (200 ml). Tablets should not be swallowed, chewed and rassasyvat in an oral cavity.
Treatment of deficit of vitamin C: on 1000 mg/days.
Treatment and prevention hypo - and avitaminosis With: on 250 mg of 1-2 times/days.
At pregnancy appoint drug in the maximum daily dose - 250 mg within 10-15 days.

Features of use:

Products rich with ascorbic acid: citrus, greens, vegetables (pepper, broccoli, headed cabbage, tomatoes, potatoes). At storage of products (including long freezing, drying, a pickles, pickling), cooking (especially in copper ware), crushing of vegetables and fruit in salads, preparation of puree there is a partial destruction of ascorbic acid (at temperature processing - to 30-50%).

In connection with a promoting effect of ascorbic acid on synthesis of corticosteroid hormones it is necessary to monitor function of adrenal glands and the ABP.

At prolonged use of high doses oppression of function of the insulyarny device of a pancreas therefore in the course of its treatment it is regularly necessary to control is possible. At patients with the increased content of iron in an organism it is necessary to apply ascorbic acid in the minimum doses.

Now consider unproven efficiency of use of ascorbic acid for prevention of diseases of cardiovascular system and some types of malignant tumors.

Ascorbic acid is not recommended to be applied at a pyorrhea, infectious diseases of gums, the hemorrhagic phenomena, a hamaturia, an eye retinal apoplexy, disturbances of immune system, the depression which is not connected with deficit of vitamin C.

Purpose of ascorbic acid to patients with quickly proliferating and intensively metastasizing tumors can aggravate the course of process.

Ascorbic acid as a reducer can distort results of various laboratory tests (content in blood of glucose, bilirubin, activity of hepatic transaminases and LDG).

Side effects:

From TsNS: at prolonged use of high doses (more than 1000 mg) - a headache, increase in excitability of TsNS, sleeplessness.

From the alimentary system: irritation of a mucous membrane of a GIT, at prolonged use of high doses - nausea, vomiting, diarrhea, hyperacid gastritis, an ultseration of a mucous membrane of a GIT.

From endocrine system: oppression of function of the insulyarny device of a pancreas (hyperglycemia, glycosuria).

From an urinary system: a moderate pollakiuria (at reception of a dose more than 600 mg/days), at prolonged use of high doses - a hyperoxaluria, a nephrolithiasis (from oxalate calcium), damage of the glomerular device of kidneys.

From cardiovascular system: at prolonged use of high doses - decrease in permeability of capillaries (deterioration in a trophicity of fabrics, increase in the ABP, hypercoagulation, development of mikroangiopatiya is possible).

Allergic reactions: skin rash, dermahemia.

Laboratory indicators: thrombocytosis, giperprotrombinemiya, erythropenia, neutrophylic leukocytosis, hypopotassemia.

Others: a hypervitaminosis, disbolism, feeling of heat, at prolonged use of high doses - a delay of sodium and liquid, disturbance of exchange of zinc, copper.

Interaction with other medicines:

Increases concentration in blood of benzylpenicillin and tetracyclines; in a dose of 1 g / increases bioavailability of ethinylestradiol (including being a part of oral contraceptives).

Improves absorption in intestines of iron preparations (transfers trivalent iron to bivalent), can increase removal of iron at simultaneous use from deferoksa of nomas.

Reduces efficiency of heparin and indirect anticoagulants.

Acetylsalicylic acid (ASK), oral contraceptives, fresh juice and alkaline drink reduce absorption and digestion of ascorbic acid.

At simultaneous use with ASK removal with urine of ascorbic acid increases and removal of ASK decreases. ASK reduces absorption of ascorbic acid approximately by 30%.

Increases risk of development of a crystalluria at treatment by salicylates and streptocides of short action, slows down removal by kidneys of acids, increases removal of the drugs having alkali reaction (including alkaloids), reduces concentration in blood of oral contraceptives.

Increases the general clearance of ethanol which, in turn, reduces concentration of ascorbic acid in an organism.

Medicines of a quinolinic row, Calcii chloridum, salicylates, glucocorticosteroids at prolonged use exhaust reserves of ascorbic acid.

At simultaneous use reduces chronotropic action of an izoprenalin.

At prolonged use or use in high doses Disulfiramum ethanol can break interaction.

In high doses increases removal of a meksiletin kidneys.

Barbiturates and Primidonum increase removal of ascorbic acid with urine.

Reduces therapeutic action of neuroleptics - derivatives of a fenotiazin, a canalicular reabsorption of amphetamine and tricyclic antidepressants.

Contraindications:

— children's age up to 18 years (for this dosage form);
— at prolonged use in high doses (more than 500 mg): diabetes mellitus, hyperoxaluria, nephrolithiasis, hemochromatosis, thalassemia;
— hypersensitivity to drug components

With care: diabetes mellitus, deficit glyukozo-6-fosfatdegidrogenazy, hemochromatosis, sideroblastny anemia, thalassemia, hyperoxaluria, oxarods, urolithiasis.

Use of the drug VITAMIN C at pregnancy and feeding by a breast
The minimum daily need for ascorbic acid for II and III trimesters of pregnancy - about 60 mg. It must be kept in mind that the fruit can adapt to high doses of ascorbic acid which is accepted by the pregnant woman, and then at the newborn development of a withdrawal is possible.
The minimum daily requirement in the period of a lactation - 80 mg. Mother's diet containing adequate amount of ascorbic acid is sufficient for prevention of deficit at the baby. Theoretically there is a danger to the child at use by mother of high doses of ascorbic acid (it is recommended not to exceed the nursing mother of daily need for ascorbic acid).

Use for children
It is contraindicated:
— children's age up to 18 years (for this dosage form).

Overdose:

Symptoms: at prolonged use of high doses (more than 1000 mg/days) nausea, heartburn, diarrhea, irritation of a mucous membrane of a GIT, a meteorism, abdominal pain of spastic character, the speeded-up urination, a nephrolithiasis, sleeplessness, irritability, a hypoglycemia are possible.

Treatment: symptomatic, artificial diuresis. At manifestation of any side effects it is necessary to stop administration of drug and to see a doctor.

Storage conditions:

To store in the dry, protected from light place, at a temperature from 15 °C to 25 °C. To store in the place, unavailable to children.

Issue conditions:

Without recipe

Packaging:

Tablets sparkling 250 mg: 20 pieces.
Tablets sparkling 1 g: 20 pieces.