Повышенная чувствительность к аскорбиновой кислоте
С осторожностью: гипероксалурия,нарушения функции почек,указания в анамнезе на мочекаменную болезнь,дефицит глюкозо-6-фосфатдегидрогеназы.
Инструкция
Торговое название препарата
Аскорбиновая кислота
Состав
Активное вещество: аскорбиновая кислота 2,5 г.
Описание
Фармакологическое действие - восполняющее дефицит витамина C.
Профилактика и лечение дефицита C;
физические и умственные перегрузки;
дистрофия;
вяло заживающие раны;
переломы костей;
период реконвалесценции после перенесенных заболеваний.
Фармакологические свойства
Метаболическое.
Участвует в окислительно-восстановительных реакциях, метаболизме тирозина , превращении фолиевой кислоты в фолиниевую, метаболизме углеводов, синтезе липидов и белков, метаболизме железа, процессах клеточного дыхания.
Снижает потребность в витаминах B1, B2, A , E , фолиевой кислоте , пантотеновой кислоте , способствует повышению устойчивости организма к инфекциям;
улучшает абсорбцию железа, способствуя его депонированию в редуцированной форме.
Обладает антиоксидантными свойствами.
Необходима для образования внутриклеточного коллагена, требуется для укрепления структуры зубов, костей и стенок капилляров.
Показания к применению
Профилактика и лечение гипо- и авитаминоза витамина С.
Обеспечение повышенной потребности организма в витамине С:
в период роста,
при беременности,
при лактации,
при тяжелых нагрузках,
при переутомлении,
в период реконвалесценции после длительных тяжелых заболеваний.
В зимний период, при повышенном риске развития инфекционных заболеваний.
Противопоказания
Повышенная чувствительность к аскорбиновой кислоте
С осторожностью: гипероксалурия,нарушения функции почек,указания в анамнезе на мочекаменную болезнь,дефицит глюкозо-6-фосфатдегидрогеназы.
Способ применения и дозы
Внутрь, после еды.
1.Таблетки и драже в профилактических целях (в зимне-весенний период и при неполноценном питании):
взрослым - 50-100 мг/сут (детям - 25-75 мг/сут),
при беременности и кормлении грудью - 300 мг/сут в течение 10-15 дней, далее - по 100 мг/сут.
В лечебных целях:
взрослым - по 50-100 мг 3-5 раз в сутки
детям - по 50-100 мг 2-3 раза в сутки.
2.Шипучие таблетки, предварительно растворив таблетку в половине стакана воды,
в профилактических целях - 500 мг/сут.;
с лечебной целью - 1000 мг/сут.
3.Порошок используют для приготовления напитков - взрослым около 1 г (1/3 ч. ложки) на 1 л/сут.
Побочное действие
Головная боль,
чувство усталости,
бессонница,
спазмы желудка,
тошнота и рвота,
ощущение жара,
болезненность в месте инъекции.
Описаны единичные случаи кожных реакций и проявлений со стороны дыхательной системы.
При применении в высоких дозах - гипероксалурия и формирование почечных камней из оксалата кальция.
Передозировка
Симптомы: при длительном применении больших доз (более 1 г) - головная боль, повышение возбудимости ЦНС, бессонница, тошнота, рвота, диарея, гиперацидный гастрит, ульцерация слизистой оболочки ЖКТ, угнетение функции инсулярного аппарата поджелудочной железы (гипергликемия, глюкозурия), гипероксалурия, нефролитиаз (кальция оксалат), повреждение гломерулярного аппарата почек, умеренная поллакиурия (при приеме дозы более 600 мг/сут).Снижение проницаемости капилляров (возможно ухудшение трофики тканей, повышение АД, гиперкоагуляция, развитие микроангиопатий).
Лечение: т.к. выводится через почки, рекомендуется обильное питье.
Взаимодействие с другими лекарственными средствами
При одновременном применении с барбитуратами, примидоном повышается экскреция аскорбиновой кислоты с мочой.
При одновременном применении пероральных контрацептивов уменьшается концентрация аскорбиновой кислоты в плазме крови .
При одновременном применении с препаратами железа аскорбиновая кислота, благодаря своим восстанавливающим свойствам, переводит трехвалентное железо в двухвалентное, что способствует улучшению его абсорбции.
Аскорбиновая кислота в высоких дозах может снижать pH мочи, что при одновременном применении уменьшает канальцевую реабсорбцию амфетамина и трициклических антидепрессантов.
При одновременном применении ацетилсалициловая кислота уменьшает абсорбцию аскорбиновой кислоты примерно на треть.
При одновременном применении с варфарином возможно уменьшение эффектов варфарина.
При одновременном применении аскорбиновая кислота повышает экскрецию железа у пациентов, получающих дефероксамин .
При применении аскорбиновой кислоты в дозе 500 мг/сутки возможно нарушение функции левого желудочка.
При одновременном применении с тетрациклином повышается выведение аскорбиновой кислоты с мочой.
Описан случай уменьшения концентрации флуфеназина в плазме крови у пациента, получавшего аскорбиновую кислоту по 500 мг 2раза/сутки.
Возможно повышение концентрации этинилэстрадиола в плазме крови при его одновременном применении в составе контрацептивов для приема внутрь.
Всасывание аскорбиновой кислоты уменьшается при одновременном употреблении свежих фруктовых или овощных соков, щелочного питья.
Особые указания
При длительном применении аскорбиновой кислоты следует периодически контролировать уровень глюкозы в крови .
Следует с осторожностью применять аскорбиновую кислоту у пациентов с прогрессирующим онкологическим заболеванием - может усугубить течение процесса.
Аскорбиновая кислота повышает абсорбцию железа, ее применение в высоких дозах может быть опасно у пациентов с гемохроматозом, талассемией, полицитемией, лейкемией и сидеробластной анемией.У пациентов с высоким содержанием железа в организме следует применять аскорбиновую кислоту в минимальных дозах.
Аскорбиновая кислота, как восстановитель, может искажать результаты различных лабораторных тестов (содержание в крови глюкозы, билирубина, активность трансаминаз, ЛДГ, содержание глюкозы в моче, в т.ч. обусловливать ложноотрицательные результаты исследования кала на скрытую кровь).
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