Ascorbic acid

CLINICAL USE

  • Acidification of urine
  • Vitamin C deficiency

    DOSE IN NORMAL RENAL FUNCTION

    Up to 4 g daily in divided doses

    Prophylaxis: 25–75 mg daily

    Therapeutic: 250 mg daily in divided doses

    IV: 0.5–1 g daily

    Preventative therapy: 200–500 mg daily

    PHARMACOKINETICS

  • Molecular weight                           :
    176.1
  • %Protein binding                           :
    25
  • %Excreted unchanged in urine     :
    Minimal1
  • Volume of distribution (L/kg)       :
    No data
  • half-life – normal/ESRD (hrs)      :
    3–4/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           :
    Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :
    Dialysed. Dose as in normal renal
    function
  • HD                     :
    Dialysed. Dose as in normal renal
    function
  • HDF/high flux   :
    Dialysed. Dose as in normal renal
    function
  • CAV/VVHD      :
    Dialysed. Dose as in normal renal
    function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
    None known

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral, IV

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

  • No scientific evidence from clinical trial ofefficacy in reducing UTI via acidification
    of urine
  • In CKD 5 on dialysis, requirements areusually about 75–90 mg per day. (Kalanter-
    Zadeh K, Kopple JD. Trace elements and
    vitamins in maintenance dialysis patients.
  • Try to use lower doses in CKD 5 patientsdue to risk of oxalate formation
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