Pronunciation:

as-KORE-bik AS-id

Brand Names:

• Ascocid
• C-500
• Cecon
• Cemill 1000
• Cemill 500
• Cevi-Bid
• C-Time w/Rose Hips
• Mega-C
• One-Gram C
• Protexin
• Sunkist Vitamin C
• Ce-Vi-Sol
• Revitalose-C-1000
• Revitonus C-1000 Yellow Ampule
• Vitamin C Powder

Dosage Forms:

• Tablet, Chewable
• Powder
• Powder for Suspension
• Solution
• Powder for Solution
• Capsule, Extended Release
• Tablet, Extended Release
• Capsule
• Tablet
• Wafer
• Liquid

Classifications:

Therapeutic—

Nutritive Agent

Pharmacologic—

Vitamin C (class)

Uses of This Medicine:

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Ascorbic acid, also known as vitamin C, is necessary for wound healing. It is needed for many functions in the body, including helping the body use carbohydrates, fats, and protein. Vitamin C also strengthens blood vessel walls.

Lack of vitamin C can lead to a condition called scurvy, which causes muscle weakness, swollen and bleeding gums, loss of teeth, and bleeding under the skin, as well as tiredness and depression. Wounds also do not heal easily. Your health care professional may treat scurvy by prescribing vitamin C for you.

Some conditions may increase your need for vitamin C. These include:

• AIDS (acquired immune deficiency syndrome)
• Alcoholism
• Burns
• Cancer
• Diarrhea (prolonged)
• Fever (prolonged)
• Infection (prolonged)
• Intestinal diseases
• Overactive thyroid (hyperthyroidism)
• Stomach ulcer
• Stress (continuing)
• Surgical removal of stomach
• Tuberculosis

Also, the following groups of people may have a deficiency of vitamin C:

• Infants receiving unfortified formulas
• Smokers
• Patients using an artificial kidney (on hemodialysis)
• Patients who undergo surgery
• Individuals who are exposed to long periods of cold temperatures

Increased need for vitamin C should be determined by your health care professional.

Vitamin C may be used for other conditions as determined by your health care professional.

Claims that vitamin C is effective for preventing senility and the common cold, and for treating asthma, some mental problems, cancer, hardening of the arteries, allergies, eye ulcers, blood clots, gum disease, and pressure sores have not been proven. Although vitamin C is being used to reduce the risk of cardiovascular disease and certain types of cancer, there is not enough information to show that these uses are effective.

Injectable vitamin C is given by or under the supervision of a health care professional. Other forms of vitamin C are available without a prescription.

For good health, it is important that you eat a balanced and varied diet. Follow carefully any diet program your health care professional may recommend. For your specific dietary vitamin and/or mineral needs, ask your health care professional for a list of appropriate foods. If you think that you are not getting enough vitamins and/or minerals in your diet, you may choose to take a dietary supplement.

Vitamin C is found in various foods, including citrus fruits (oranges, lemons, grapefruit), green vegetables (peppers, broccoli, cabbage), tomatoes, and potatoes. It is best to eat fresh fruits and vegetables whenever possible since they contain the most vitamins. Food processing may destroy some of the vitamins. For example, exposure to air, drying, salting, or cooking (especially in copper pots), mincing of fresh vegetables, or mashing potatoes may reduce the amount of vitamin C in foods. Freezing does not usually cause loss of vitamin C unless foods are stored for a very long time.

Vitamins alone will not take the place of a good diet and will not provide energy. Your body also needs other substances found in food such as protein, minerals, carbohydrates, and fat. Vitamins themselves often cannot work without the presence of other foods.

The daily amount of vitamin C needed is defined in several different ways.

• Recommended Dietary Allowances (RDAs) are the amount of vitamins and minerals needed to provide for adequate nutrition in most healthy persons. RDAs for a given nutrient may vary depending on a person's age, sex, and physical condition (e.g., pregnancy).
• Daily Values (DVs) are used on food and dietary supplement labels to indicate the percent of the recommended daily amount of each nutrient that a serving provides. DV replaces the previous designation of United States Recommended Daily Allowances (USRDAs).

• Recommended Nutrient Intakes (RNIs) are used to determine the amounts of vitamins, minerals, and protein needed to provide adequate nutrition and lessen the risk of chronic disease.

Normal daily recommended intakes for vitamin C are generally defined as follows:

Persons	U.S. (mg)	Canada (mg)
Infants and children Birth to 3 years of age	30–40	20
4 to 6 years of age	45	25
7 to 10 years of age	45	25
Adolescent and adult males	50–60	25–40
Adolescent and adult females	50–60	25–30
Pregnant females	70	30–40
Breast-feeding females	90–95	55
Smokers	100	45–60

Before Using This Medicine:

If you are taking this dietary supplement without a prescription, carefully read and follow any precautions on the label. For this supplement, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Problems in children have not been reported with intake of normal daily recommended amounts.

Older adults—

Problems in older adults have not been reported with intake of normal daily recommended amounts.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this dietary supplement, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this dietary supplement with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Amygdalin
• Deferoxamine

Using this dietary supplement with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Indinavir

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this dietary supplement. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood problems—High doses of vitamin C may cause certain blood problems

• Type 2 diabetes mellitus—Very high doses of vitamin C may interfere with tests for sugar in the urine

• Glucose-6-phosphate dehydrogenase (G6PD) deficiency—High doses of vitamin C may cause hemolytic anemia

• Kidney stones (history of)—High doses of vitamin C may increase risk of kidney stones in the urinary tract

Proper Use of This Medicine:

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (capsules, tablets, oral solution, syrup):
  • To prevent deficiency, the amount taken by mouth is based on normal daily recommended intakes:
    • Adult and teenage males—50 to 60 milligrams (mg) per day.
    • Adult and teenage females—50 to 60 mg per day.
    • Pregnant females—70 mg per day.
    • Breast-feeding females—90 to 95 mg per day.
    • Smokers—100 mg per day.
    • Children 4 to 10 years of age—45 mg per day.
    • Children birth to 3 years of age—30 to 40 mg per day.
    • Adult and teenage males—25 to 40 mg per day.
    • Adult and teenage females—25 to 30 mg per day.
    • Pregnant females—30 to 40 mg per day.
    • Breast-feeding females—55 mg per day.
    • Smokers—45 to 60 mg per day.
    • Children 4 to 10 years of age—25 mg per day.
    • Children birth to 3 years of age—20 mg per day.
  • To treat deficiency:
    • Adults and teenagers—Treatment dose is determined by prescriber for each individual based on the severity of deficiency. The following dose has been determined for scurvy: 500 mg a day for at least 2 weeks.
    • Children—Treatment dose is determined by prescriber for each individual based on the severity of deficiency. The following dose has been determined for scurvy: 100 to 300 mg a day for at least 2 weeks.

For those individuals taking the oral liquid form of vitamin C:

• This preparation is to be taken by mouth even though it comes in a dropper bottle.
• This dietary supplement may be dropped directly into the mouth or mixed with cereal, fruit juice, or other food.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss taking a vitamin for one or more days there is no cause for concern, since it takes some time for your body to become seriously low in vitamins.

Storage—

Store the dietary supplement in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

Vitamin C is not stored in the body. If you take more than you need, the extra vitamin C will pass into your urine. Very large doses may also interfere with tests for sugar in diabetics and with tests for blood in the stool.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common or rare

(with high doses)

Side or lower back pain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common or rare

(with high doses)

Diarrhea

dizziness or faintness (with the injection only)

flushing or redness of skin

headache

increase in urination (mild)

nausea or vomiting

stomach cramps

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.