Adequate intake needed to prevent scurvy and provide antioxidant protection.
Adequate vitamin C intake can be accomplished through consumption of foodstuffs. Citrus fruits, tomatoes, and potatoes are the major contributors of vitamin C in the diet of US adults and children.
Recommended Dietary Allowances (RDA) in adults based on near maximal neutrophil concentrations with minimal urinary excretion of ascorbate.
Requirements slightly lower in women than men based on water-soluble nature of the vitamin and the larger lean body mass and total body water in males relative to females.
Adequate intake (AI) established for infants ≤6 months of age based on observed mean vitamin C intake of infants fed principally human milk; AI for infants 7–12 months of age based on vitamin C intake from human milk and solid food.
RDA for children 1–18 years of age based on data in adults.
Macular Degeneration
Suggested as a component of high-dose antioxidant supplements with zinc to reduce risk of developing advanced age-related macular degeneration† in high-risk patients (i.e., those with intermediate stage age-related macular degeneration or advanced stage macular degeneration in only one eye).
Methemoglobinemia
Has been used in the treatment of idiopathic methemoglobinemia†.
Dosage and Administration
Administration
Usually administered orally. May be administered by IM, IV, or sub-Q injection when oral administration is not feasible or when malabsorption is suspected.
Parenteral Administration
Preferred parenteral method of administration is IM.
Pressure may build within the vial during storage. Exercise care when withdrawing a dose and/or insert a vent needle (e.g., empty sterile syringe) into the vial to release the pressure.
IV Administration
Dilution
For solution and drug compatibility, see Compatibility under Stability.
Dilute with large volume of compatible parenteral fluid to minimize adverse reactions. Avoid rapid infusion.
100–300 mg daily for 1 month or until full recovery.
Dietary and Replacement Requirements
Oral
Infants ≤6 months of age: Recommended AI is 40 mg (about 6 mg/kg) daily.
Infants 7–12 months of age: Recommended AI is 50 mg (about 6 mg/kg) daily.
Children 1–3 years of age: RDA is 15 mg daily.
Children 4–8 years of age: RDA is 25 mg daily.
Children 9–13 years of age: RDA is 45 mg daily.
Boys 14–18 years of age: RDA is 75 mg daily.
Girls 14–18 years of age: RDA is 65 mg daily.
Adults
Scurvy
Treatment
Oral or IV
300 mg–1 g daily for 1 month or until full recovery.
Dietary and Replacement Requirements
Oral
Men ≥19 years of age: RDA is 90 mg daily.
Women ≥19 years of age: RDA is 75 mg daily.
Macular Degeneration
Oral
500 mg in combination with beta carotene 15 mg, vitamin E 400 units, and zinc (as zinc oxide) 80 mg, with copper (as cupric oxide) 2 mg (to prevent anemia) daily has been used.†
Idiopathic Methemoglobinemia
Oral
300–600 mg daily in divided doses has been used.†
Special Populations
Pregnant Women
RDA for pregnant women 14–18 years of age is 80 mg daily.
RDA for pregnant women 19–50 years of age is 85 mg daily.
Requirements increased in pregnant women to ensure transfer of adequate amounts of the vitamin to the fetus.
Lactating Women
RDA for lactating women 14–18 or 19–50 years of age is 115 or 120 mg daily, respectively.
Requirements increased in lactating women to ensure adequate concentration of the vitamin in milk.
Smokers
RDA increased by 35 mg daily.
Smoking increases oxidative stress and metabolic turnover of vitamin C.
Kidney stone (renal calculus) formation reported in individuals with renal disease receiving large dosages of ascorbic acid; excess ascorbic acid intake not associated with kidney stone formation in healthy individuals.
Aluminum Content
Some ascorbic acid injection preparations contain aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.
Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum >4–5 mcg/kg daily accumulate aluminum at levels associated with CNS and bone toxicity. Tissue loading may occur at even lower rates of administration.
Specific Populations
Pregnancy
Category C.
Lactation
Distributed into milk. Caution if parenteral preparation is used in nursing women.
Common Adverse Effects
Relatively nontoxic; nausea, vomiting, heartburn, fatigue, flushing, headache, insomnia, sleepiness, and other GI disturbances (diarrhea, transient colic, abdominal cramps, flatulent distention) reported.
An essential water-soluble vitamin present in fresh fruits and vegetables. Vitamin C refers to both ascorbic acid and dehydroascorbic acid (DHA); both compounds exhibit antiscorbutic activity.
An antioxidant and a cofactor in enzymatic and metabolic processes.
Required for collagen formation and tissue repair.
Advice to Patients
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses.
Importance of proper dietary habits, including taking appropriate AI or RDA of vitamin C.
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.
Importance of informing patients of other important precautionary information. (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Ascorbic acid and sodium ascorbate are also commercially available in combination with other vitamins, minerals, amino acids, analgesic-antipyretics, antihistamines, anti-inflammatory agents, cough suppressants, expectorants, infant formulas, protein supplements, and herbal supplements. For IV infusion, ascorbic acid or sodium ascorbate is also commercially available in combination with other vitamins in caloric and electrolyte solutions.
Calcium Ascorbate
Routes
Dosage Forms
Strengths
Brand Names
Manufacturer
Bulk
Powder*
Oral
Tablets
610 mg (500 mg of ascorbic acid)*
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Calcium ascorbate is also commercially available in combination with other vitamins.
Comparative Pricing
This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 09/2009. For the most current and up-to-date pricing information, please visit www.drugstore.com. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.
† Use is not currently included in the labeling approved by the US Food and Drug Administration.
Remember, keep this and all other medicines out of the reach of children,
never share your medicines with others, and use this medication only for the indication prescribed.
Sign up with Facebook
