Dosing & Uses
Dosage Forms & Strengths
tablets
- 100mg
- 250mg
- 500mg
- 1g
chewable, tablet
- 100mg
- 250mg
- 500mg
capsule, extended release
- 500mg
tablet, extended release
- 500mg
- 1000mg
- 1500mg
crystals
- 120g
- 480g
granules
- 100g
- 500g
- 1000g
injectable solution
- 250mg/mL
- 500mg/mL
oral solution
- 100mg/mL
powder effervescent
- 150g
powder, oral
- 113mg
- 120mg
- 480mg
water, oral
- 500mg
syrup, oral
- 100mg/mL
RDA
Males: 90 mg/day
Females: 75 mg/day
Pregnant: 85 mg/day; not to exceed 2000 mg/day (80 mg if <18 years; not to exceed 1800 mg/day)
Nursing: 120 mg/day; not to exceed 2000 mg/day (115 mg if <18 years old; not to exceed 1800 mg/day)
Urinary Acidification
4-12 g/day PO/IV divided three or four times daily
Ascorbic Acid Deficiency (Scurvy)
Oral prevention: See recommended daily intake
Oral treatment: 250 mg PO QID x 1 week
Treatment with IV ascorbic acid
- Indicated for short term (<1 week) treatment of scurvy in adult and children ≥5 months for whom oral administration is not possible, insufficient, or contraindicated
- 200 mg IV qDay; recommended daily treatment should not exceed 7 days
- If no improvement in scorbutic symptoms, retreat until resolution of scorbutic symptoms is observed
- Also, see Administration
Charcot-Marie-Tooth Disease (Orphan)
Designated orphan indication for Charcot-Marie-Tooth disease type 1A
Orphan designated sponsor
- Murigenetics SAS; Faculte de Medecine Timone; 13005 Marseille, France
Fragile X Syndrome (Orphan)
Orphan designation for fragile X syndrome in combination with alpha-tocopherol
Orphan sponsor
- GenCo Pharmaceuticals LLC; 371 Lake Surprise Road; Cold Spring, New York 10516
Macular Degeneration (Off-label)
500 mg/day PO with other vitamins and minerals
Dosing Consideration
Use with caution in patients with renal impairment (see Warnings)
Limitations of use
- Ascor is not indicated for treatment of vitamin C deficiency that is not associated with signs and symptoms of scurvy
Dosage Forms & Strengths
tablets
- 100mg
- 250mg
- 500mg
- 1g
chewable, tablet
- 100mg
- 250mg
- 500mg
capsule, extended release
- 500mg
tablet, extended release
- 500mg1000mg1500mg
crystals
- 120g
- 480g
granules
- 100g
- 500g
- 1000g
injectable solution
- 250mg/mL
- 500mg/mL
oral solution
- 100mg/mL
powder effervescent
- 150g
powder, oral
- 113mg
- 120mg
- 480mg
water, oral
- 500mg
syrup, oral
- 100mg/mL
RDA
0-6 months: 40 mg/day
6-12 months: 50 mg/day
1-3 years: 15 mg/day
3-8 years: 25 mg/day
8-13 years: 45 mg/day
13-18 years: (male) 75 mg/day; (female) 65 mg/day
UL: 1-3 years: 400 mg/day; 4-8 years old: 600 mg/day; 9-13 years old: 1.2 g/day; 12-18 years old: 1.8 g/day
Urinary Acidification
500 mg/day divided PO/IV TID/QID
Ascorbic Acid Deficiency (Scurvy)
Oral prevention: See recommended daily intake
Oral treatment, infants or children: 100 mg PO TID x 1 week, then 100 mg PO qDay until resolved (typically 1-3 months)
Treatment with IV ascorbic acid
- Indicated for short term (<1 week) treatment of scurvy in children and adolescents ≥5 months for whom oral administration is not possible, insufficient or contraindicated
- <5 months: Safety and efficacy not established
- 5 months to <12 months: 50 mg IV qDay
- 1 year to <11 years: 100 mg IV qDay
- ≥11 years: 200 mg IV qDay; recommended daily treatment should not exceed 7 days
- If no improvement in scorbutic symptoms, retreat until resolution of scorbutic symptoms is observed
- Repeat dosing is not recommended in children and adolescents <11 years
- Also, see Administration
Charcot-Marie-Tooth Disease (Orphan)
Designated orphan indication for Charcot-Marie-Tooth disease type 1A
Orphan designated sponsor
- Murigenetics SAS; Faculte de Medecine Timone; 13005 Marseille, France
Cystic Fibrosis (Orphan)
Orphan designation for cystic fibrosis
Orphan sponsor
- Renovion, Inc; 112 South Duke St; Durham, North Carolina 27701
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (6)
- deferasirox
deferasirox, ascorbic acid. unknown mechanism. Use Caution/Monitor. Coadministration of deferasirox and ascorbic acid has not been formally studied. Doses up to ascorbic acid 200 mg per day have not been associated with adverse consequences.
- deferoxamine
deferoxamine, ascorbic acid. Other (see comment). Use Caution/Monitor. Comment: Ascorbic acid increases the availability of iron for chelation with deferoxamine. Ascorbic acid should be avoided in pts. with cardiac failure undergoing deferoxamine Tx. Clinical cardiac monitoring recommended for pts. supplemented with ascorbic acid.
- dextroamphetamine transdermal
ascorbic acid will decrease the level or effect of dextroamphetamine transdermal by Other (see comment). Modify Therapy/Monitor Closely. Urinary acidifying agents can lower blood levels and efficacy of amphetamines. Increase dose of dextroamphetamine transdermal based on clinical response.
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
ascorbic acid increases levels of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by decreasing hepatic clearance. Use Caution/Monitor. Coadministration of ascorbic acid and certain combined hormonal contraceptives (CHCs) containing EE may increase plasma EE concentrations, possibly by inhibition of conjugation.
- omadacycline
ascorbic acid will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- wheat germ extract
ascorbic acid decreases effects of wheat germ extract by unknown mechanism. Use Caution/Monitor. Mfr. recommends separating by 2 hrs.
Minor (19)
- aluminum hydroxide
ascorbic acid increases levels of aluminum hydroxide by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- aspirin
ascorbic acid will increase the level or effect of aspirin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
aspirin decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown.
ascorbic acid increases levels of aspirin by decreasing renal clearance. Minor/Significance Unknown. - aspirin rectal
ascorbic acid will increase the level or effect of aspirin rectal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
ascorbic acid increases levels of aspirin rectal by decreasing renal clearance. Minor/Significance Unknown.
aspirin rectal decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown.
ascorbic acid will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
ascorbic acid increases levels of aspirin/citric acid/sodium bicarbonate by decreasing renal clearance. Minor/Significance Unknown. - balsalazide
balsalazide decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown.
- bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens decreases levels of ascorbic acid by increasing elimination. Minor/Significance Unknown.
- butabarbital
butabarbital decreases levels of ascorbic acid by increasing elimination. Minor/Significance Unknown.
- butalbital
butalbital decreases levels of ascorbic acid by increasing elimination. Minor/Significance Unknown.
- choline magnesium trisalicylate
ascorbic acid will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
ascorbic acid increases levels of choline magnesium trisalicylate by decreasing renal clearance. Minor/Significance Unknown.
choline magnesium trisalicylate decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown. - conjugated estrogens
conjugated estrogens decreases levels of ascorbic acid by increasing elimination. Minor/Significance Unknown.
- conjugated estrogens, vaginal
conjugated estrogens, vaginal decreases levels of ascorbic acid by increasing elimination. Minor/Significance Unknown.
- copper
ascorbic acid decreases levels of copper by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- diflunisal
diflunisal decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown.
- lornoxicam
ascorbic acid will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- metolazone
ascorbic acid will increase the level or effect of metolazone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- oxytetracycline
oxytetracycline decreases levels of ascorbic acid by increasing elimination. Minor/Significance Unknown.
- phenobarbital
phenobarbital decreases levels of ascorbic acid by increasing elimination. Minor/Significance Unknown.
- rose hips
ascorbic acid will increase the level or effect of rose hips by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- willow bark
ascorbic acid will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
willow bark decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown.
ascorbic acid increases levels of willow bark by decreasing renal clearance. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Flushing
Flank pain
Faintness, headache
Diarrhea, dyspepsia, nausea, vomiting
Hyperoxaluria (large doses)
Warnings
Contraindications
Hypersensitivity
Cautions
Hemolysis has been reported with ascorbic acid in patients with glucose-6-phosphate dehydrogenase deficiency; discontinue treatment if hemolysis is suspected and treat as needed
Ascorbic acid may interfere with laboratory tests based on oxidation-reduction reactions (eg, blood and urine glucose testing, nitrite and bilirubin levels, and leucocyte count testing); delay laboratory tests until 24 hours after ascorbic acid infusion if possible
Oxalate nephropathy and nephrolithiasis
- Acute and chronic oxalate nephropathy reported with prolonged administration of high doses of ascorbic acid
- Increased risk for oxalate nephropathy in patients with renal disease, renal impairment, history of oxalate kidney stones, and geriatric patients
- Monitor renal function; discontinue treatment if oxalate nephropathy develops and treat any suspected oxalate nephropathy accordingly
Drug interactions overview
- Ascorbic acid may decrease effects of erythromycin, kanamycin, streptomycin, doxycycline, and lincomycin; if antibiotic efficacy is suspected, discontinue ascorbic acid
- Limited case reports have suggested interference of ascorbic acid with anticoagulation effects of warfarin; monitor
Amphetamine and other drugs affected by urine pH
- Ascorbic acid may acidify urine
- Lowers amphetamines levels by increasing renal excretion
- May alter excretion of certain drugs affected by urine pH (eg, fluphenazine)
Pregnancy & Lactation
Pregnancy
No adverse developmental outcomes are reported in the published literature
There are no available data on use of Ascor in pregnant women to inform a drug-associated risk of adverse developmental outcomes
Lactation
There are no data on the presence of ascorbic acid in human milk following IV dosing in lactating women
Ascorbic acid is present in human milk after maternal oral intake
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Nutrition
Sources: Citrus fruits, peppers, cabbage, papaya, orange juice, broccoli, guava, carambola, radishes
Function: Required for collagen biosythesis
Deficiency: Scurvy; fatigue, depression, easy bruising & bleeding, weakened cartilage, coiled hairs, difficulty wound healing, thickened skin, abnormal bone growth in infants
Toxicity: Potential for kidney stones, withdrawal from high doses can lead to scurvy, even with "normal" intake
Pharmacology
Mechanism of Action
Necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in conversion of folic acid to folinic acid
Pharmacokinetics
Distribution: Large
Metabolism: Liver
Absorption: Rapidly absorbed
Excretion: Urine
Administration
IV Compatibility
Compatible w/ most common diluents (eg, dextrose solns, NS, LR, Ringer's, ½NS, dextrose-saline, dextrose-LR)
IV Preparation
Dilute with large volume of compatible fluid to minimize adverse reactions
IV ascorbic acid (Ascor) is supplied as a pharmacy bulk package (PBP)
Intended for dispensing of single doses to multiple patients in a pharmacy admixture program and is restricted to the preparation of admixtures for infusion
Use only in a suitable ISO Class 5 work area such as a laminar flow hood (or an equivalent clean air compounding area)
Open vials are to be used within 4 hr
Prior to administration, the final diluted solution for infusion must be isotonic (undiluted the osmolarity is ~5,900 mOsmol/L)
Calculate the osmolarity of the intended admixture for infusion
Add daily dose directly to an appropriate volume of a suitable infusion solution (eg, 5% Dextrose Injection)
Do not mix with solutions containing elemental compounds that cause reduction (eg, copper)
Final concentration of ascorbic acid admixture solution for infusion: 1-25 mg/mL
Visually inspect for particulate matter and discoloration prior to administration; solution should appear colorless to pale yellow
Immediately use as a slow IV infusion
IV Administration
Consider IV or IM administration when PO is not feasible
Avoid rapid infusion
Infusion rate of diluted Ascor solution
- 5 months-12 months: 1.3 mg/minute
- 1-11 years: 3.3 mg/minute
- >11 years: 33 mg/minute
Oral Administration
Take with or without meals
Storage
Unopened IV vials: Store in refrigerator at 2-8°C (36-46°F); protect from light; contains no preservatives
Opened IV vials: Use within 4 hr of vial entry; discard remaining portion
Tablets: Store at room temperature at 15-30°C (59-86°F)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Vitamin C With Rose Hips oral - | 1,000 mg tablet |  | |
| ascorbic acid (vitamin C) injection - | 500 mg/mL vial |  | |
| ascorbic acid (vitamin C) oral - | 250 mg tablet |  | |
| ascorbic acid (vitamin C) oral - | 125 mg chewable tablet |  | |
| ascorbic acid (vitamin C) oral - | 1,000 mg tablet |  | |
| ascorbic acid (vitamin C) oral - | 500 mg capsule |  | |
| ascorbic acid (vitamin C) oral - | 500 mg chewable tablet |  | |
| ascorbic acid (vitamin C) oral - | 500 mg tablet |  | |
| ascorbic acid (vitamin C) oral - | 500 mg tablet |  | |
| Special C oral - | 500-10-10-200 mg tablet |  | |
| Vitamin C oral - | 125 mg chewable tablet | | |
| Vitamin C oral - | 500 mg tablet | | |
| Vitamin C oral - | 500 mg tablet |  | |
| Vitamin C oral - | 500 mg tablet |  | |
| Vitamin C oral - | 1,000 mg tablet |  | |
| Vitamin C oral - | 500 mg tablet |  | |
| Vitamin C oral - | 125 mg chewable tablet |  | |
| Vitamin C oral - | 500 mg tablet | | |
| Vitamin C oral - | 250 mg tablet |  | |
| Vitamin C oral - | 1,000 mg tablet |  | |
| Vitamin C oral - | 250 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
ascorbic acid (vitamin C) injection
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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