ascorbate; ascorbic acid; vitamin C

^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]^[9]

Indications

(uses)

prevention & treatment of scurvy
acidification of urine
enhanced wound healing
severe burns
hyperuricemia/gout
hawkinsinuria^[8]
alkaptonuria
tyrosinemia, tyrosinemia type 3
homocystinuria
aids iron absorption in iron deficiency anemia^[8]
megaloblastic anemia^[8]

Dosage

prevention & treatment of scurvy
- RDA: 60 mg QD (PO IM, SC,IV)
- average protective dose 70-150 mg QD
- scurvy: 300 mg to 1 g QD
acidification of urine: 4-12 g QD divided TID/QID
enhanced wound healing: 300-500 mg QD for 7-10 days
severe burns: 1-2 g/day
hyperuricemia/gout: 500 mg QD^[4]

Pharmacokinetics

Tissues that accumulate ascorbate include:^[6]

those with > 100 fold blood plasma vitamin C adrenal, pituitary, thymus, corpus luteum, retina
those with 10-50 fold blood plasma vitamin C brain, spleen, lung, testicle, lymph nodes, liver, thyroid, small intestinal mucosa, leukocytes, pancreas, kidney, salivary glands

elimination via kidney

Adverse effects

not common (1-10%)
- hyperoxaluria
- increased risk of calcium oxalate urinary stones^[7]
uncommon (< 1%)
- flushing, faintness, dizziness, headache, nausea/vomiting, heartburn, diarrhea, fatigue

Drug interactions

ascorbate may affect propranolol absorbtion & 1st pass metabolism in the liver
ascorbate may increase serum levels of estrogen
ascorbate may decrease anticoagulant effect of warfarin

Test interactions

may falsely elevate serum creatinine^[3]

Laboratory

Mechanism of action

reducing agent, oxidized to L-dehydroascorbate which is in turn reduced ezymatically or by glutathione
ascorbate is an electron donor for 8 different enzymes
- for 3 of these enzymes, ascorbate is a cofactor in hydroxlation of Lys & Pro in collagen type-1 (& other collagens)
- for 2 of these enzymes, ascorbate is a cofactor in synthesis of carnitine
- ascorbate is a cofactor fof dopamine beta hydroxylase in the biosynthesis of norepinephrine from dopamine
- ascorbate is a cofactor for an enzyme that adds amide groups to peptide hormones, increasing their stability
- ascorbate is a cofactor for an enzyme that modulates tyrosine metabolism
substrate of ascorbate peroxidase^[6]
ascorbate levels in brain exceed those in blood 10-fold
- transported as dehydroascorbate across the blood-brain barrier by GLUT1^[9]

More general terms

More specific terms

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Component of

References

↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
↑ ^3.0 ^3.1 Prescriber's Letter 9(5):28 2002
↑ ^4.0 ^4.1 Journal Watch 25(14):114-15, 2005 Huang HY, Appel LJ, Choi MJ, Gelber AC, Charleston J, Norkus EP, Miller ER 3rd. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial. Arthritis Rheum. 2005 Jun;52(6):1843-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15934094
↑ Department of Veterans Affairs, VA National Formulary
↑ ^6.0 ^6.1 ^6.2 Wikipedia - vitamin C entry http://en.wikipedia.org/wiki/Vitamin_C
↑ ^7.0 ^7.1 Thomas LDK et al Ascorbic Acid Supplements and Kidney Stone Incidence Among Men: A Prospective Study JAMA Intern Med. 2013;():1-2 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23381591 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1568519
↑ ^8.0 ^8.1 ^8.2 ^8.3 Deprecated Reference
↑ ^9.0 ^9.1 PubChem: 44067

Database

Kegg: http://www.genome.jp/dbget-bin/www_bget?
PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=235
PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5785
PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=114765
PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=439159
PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=22878
PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=62785
PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=21967

[ref1-1] Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998

[ref2-2] Kaiser Permanente Northern California Regional Drug Formulary, 1998

[ref3-3] 3.0 ^3.1 Prescriber's Letter 9(5):28 2002

[ref4-4] 4.0 ^4.1 Journal Watch 25(14):114-15, 2005 Huang HY, Appel LJ, Choi MJ, Gelber AC, Charleston J, Norkus EP, Miller ER 3rd. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial. Arthritis Rheum. 2005 Jun;52(6):1843-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15934094

[ref5-5] Department of Veterans Affairs, VA National Formulary

[ref6-6] 6.0 ^6.1 ^6.2 Wikipedia - vitamin C entry http://en.wikipedia.org/wiki/Vitamin_C

[ref7-7] 7.0 ^7.1 Thomas LDK et al Ascorbic Acid Supplements and Kidney Stone Incidence Among Men: A Prospective Study JAMA Intern Med. 2013;():1-2 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23381591 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1568519

[ref8-8] 8.0 ^8.1 ^8.2 ^8.3 Deprecated Reference

[ref9-9] 9.0 ^9.1 PubChem: 44067

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ascorbate; ascorbic acid; vitamin C

Contents

Indications

Dosage

Pharmacokinetics

Adverse effects

Drug interactions

Test interactions

Laboratory

Mechanism of action

More general terms

More specific terms

Additional terms

Component of

References

Database

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ascorbate; ascorbic acid; vitamin C

Indications

Dosage

Pharmacokinetics

Adverse effects

Drug interactions

Test interactions

Laboratory

Mechanism of action

More general terms

More specific terms

Additional terms

Component of

References

Database

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