as-KOR-bik A-sid

• Treatment of ascorbic acid deficiency.
• Supplemental therapy in some GI diseases during long-term parenteral nutrition or chronic hemodialysis.
• Treatment and prevention of scurvy.

• Necessary for collagen formation and tissue repair.
• Involved in oxidation reduction reactions; tyrosine, folic acid, iron, and carbohydrate metabolism; lipid and protein synthesis; cellular respiration; and resistance to infection.

• Replacement in deficiency states.
• Supplementation during increased requirements.

Absorption: Actively absorbed after oral administration by a saturable process. IV administration results in complete bioavailability.

Distribution: Widely distributed. Crosses the placenta; enters breast milk.

Metabolism/Excretion: Converted to compounds that are excreted by the kidneys.

Half-life: 7.4 hr.

Contraindicated in:

• Tartrazine hypersensitivity (some oral products contain tartrazine — FDC yellow dye #5).

Use Cautiously in:

• Renal impairment (↑ risk for nephrolithiasis)
• Recurrent kidney stones (↑ risk for nephrolithiasis)
• Glucose 6–phosphate dehydrogenase deficiency (↑ risk for hemolysis; avoid exceeding US recommended daily allowance)
• OB: Lactation: Avoid exceeding US recommended daily allowance
• Pedi: Children <2 yr (↑ risk for nephrolithiasis); children <5 mo (safety and effectiveness of IV formulation not established)
• Geri: ↑risk for nephrolithiasis.

CNS: drowsiness, fatigue, headache, insomnia.

Derm: flushing.

GI: cramps, diarrhea, heartburn, nausea, vomiting.

GU: oxalate nephropathy, nephrolithiasis.

Hemat: deep vein thrombosis, hemolysis (in G6PD deficiency).

Local: pain at subcut, IM, or IV sites.

Drug-Drug:

• If urinary acidification occurs, may ↑ excretion and ↓ effects of mexiletine,amphetamine, fluphenazine, or tricyclic antidepressants.
• Large doses (>10 g/day) may ↓ response to warfarin.
• ↑iron toxicity when given concurrently with deferoxamine.
• May ↓ effects of erythromycin, streptomycin, doxycycline, and bleomycin.

• PO (Adults): Scurvy — 500 mg/day for at least 14 days. Prevention of deficiency — 50–100 mg/day.
• PO (Children): Scurvy — 100–300 mg/day for at least 14 days. Prevention of deficiency — 30–45 mg/day.
• IM (Adults): Scurvy — 100–500 mg/day for at least 14 days.
• IM (Children): Scurvy — 100–300 mg/day for at least 14 days.
• IV (Adults and Children 11 yr): Scurvy (treatment) — 200 mg once daily for up to 7 days; if no improvement in symptoms, retreat until symptoms resolve.
• IV (Children 1–10 yr): 100 mg once daily for up to 7 days. Retreatment is not recommended.
• IV (Children 5 mo-<1 yr): 50 mg once daily for up to 7 days. Retreatment is not recommended.

• Often ordered as a part of multivitamin supplementation, because inadequate diet often results in multiple-vitamin deficiency.
• PO: Extended-release tablets and capsules should be swallowed whole without crushing, breaking, or chewing; contents of capsules may be mixed with jelly or jam. Chewable tablets should be chewed well or crushed before swallowing. Oral solution may be taken directly by mouth or mixed with fruit juice, cereal, or other food.
• IM: IM is usually the preferred parenteral route.

IV Administration:

• Continuous Infusion:
  Diluent: Dilute dose in 1000 mL D5W, D10W, 0.9% NaCl, 0.45% NaCl, LR or Ringer’s solution, dextrose/saline or dextrose/Ringer’s combinations.
• Rate: Infuse slowly.
• Y-Site Compatibility:
  • alfentanil
  • amikacin
  • atracurium
  • atropine
  • aztreonam
  • bumetanide
  • buprenorphine
  • butorphanol
  • calcium chloride
  • calcium gluconate
  • cefazolin
  • cefotaxime
  • cefotetan
  • cefoxitin
  • cefuroxime
  • chlorpromazine
  • clindamycin
  • cyanocobalamin
  • cyclosporine
  • dexamethasone
  • digoxin
  • diphenhydramine
  • dobutamine
  • dopamine
  • doxycycline
  • enalaprilat
  • ephedrine
  • epinephrine
  • epoetin alfa
  • esmolol
  • famotidine
  • fentanyl
  • fluconazole
  • folic acid
  • furosemide
  • gentamicin
  • glycopyrrolate
  • heparin
  • hydrocortisone
  • imipenem/cilastatin
  • indomethacin
  • insulin
  • isoproterenol
  • ketorolac
  • labetalol
  • lidocaine
  • magnesium sulfate
  • mannitol
  • meperidine
  • methyldopate
  • methylprednisolone
  • metoclopramide
  • metoprolol
  • morphine
  • multivitamins
  • nafcillin
  • nalbuphine
  • naloxone
  • nitroglycerin
  • norepinephrine
  • ondansetron
  • oxacillin
  • oxytocin
  • penicillin G
  • phenobarbital
  • phentolamine
  • phenylephrine
  • phytonadione
  • potassium chloride
  • procainamide
  • prochlorperazine
  • promethazine
  • propranolol
  • protamine
  • pyridoxine
  • rantidine
  • sodium bicarbonate
  • streptokinase
  • succinylcholine
  • sufentanil
  • theophylline
  • thiamine
  • tobramycin
  • vancomycin
  • vasopressin
  • verapamil
  • warfarin
• Y-Site Incompatibility:
  • aminophylline
  • azathioprine
  • ceftazidime
  • ceftriaxone
  • chloramphenicol
  • dantrolene
  • diazepam
  • diazoxide
  • erythromycin
  • etomidate
  • ganciclovir
  • hydralazine
  • hydroxycobalamin
  • midazolam
  • minocycline
  • nitroprusside
  • papaverine
  • pentamidine
  • pentobarbital
  • phenytoin
  • thiopental
  • trimethoprim/sulfamethoxazole
.

Ascor, Ascorbicap, Cebid, Cecon, Cecore-500, Cemill, Cenolate, Cetane, Cevalin, Cevi-Bid, Flavorcee, Mega-C/A Plus, Ortho/CS, Sunkist

Apo-C

Therapeutic Classification: vitamins

Pharmacologic Classification: water soluble vitamins

(Generic available)

• Chewable tablets: 60 mg^OTC; 100 mg^OTC; 250 mg^OTC; 500 mg^OTC; 1 g^OTC;
• Extended-release capsules: 500 mg^OTC;
• Extended-release tablets: 500 mg^OTC; 1 g^OTC; 1.5 g^OTC;
• Oral solution: 50 mg/0.6 mL^OTC; 100 mg/mL^OTC;
• Syrup: 250 mg/5 mL^OTC;
• Solution for injection: 222 mg/mL; 250 mg/mL; 500 mg/mL ;
• Tablets: 25 mg^OTC; 50 mg^OTC; 100 mg^OTC; 125 mg^OTC; 250 mg^OTC; 500 mg^OTC; 1 g^OTC; 1.5 g^OTC;
• In combination with: other vitamins and minerals in multivitamin preparations.