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

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Route

Oral, IV

Rate of Administration

–

Comments

–

OTHER INFORMATION

No scientific evidence from clinical trial of efficacy in reducing UTI via acidification of urine

In CKD 5 on dialysis, requirements are usually 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 patients due to risk of oxalate formation

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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