Vitamin C 1000mg W/ Rose Hips Tabs
It is used to treat or prevent vitamin C deficiency.It is used to treat scurvy.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Vitamin; Antioxidant; Nutritional Supplement
Pharmacologic Class
Water-soluble vitamin
Pregnancy Category
Category A (for dietary intake); Category C (for doses exceeding RDA)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Vitamin C is an important vitamin that helps your body in many ways, like boosting your immune system, helping your body heal, and protecting your cells from damage. It's found in many fruits and vegetables. This supplement provides a high dose of Vitamin C, often with rose hips, which are a natural source of Vitamin C and other beneficial plant compounds.
How to Use This Medicine
Taking Your Medication
To get the most benefit from your medication, take it exactly as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. It's recommended to take this medication with a meal to help your body absorb it properly. Continue taking your medication as prescribed by your doctor or healthcare provider, even if you start to feel better.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication, store it at room temperature, away from direct light and moisture. Keep it in a dry place, such as a closet or drawer, and avoid storing it in the bathroom. Protect your medication from heat sources, and keep it out of reach of children and pets. Store all your medications in a secure location to prevent accidental ingestion or misuse.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
To get the most benefit from your medication, take it exactly as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. It's recommended to take this medication with a meal to help your body absorb it properly. Continue taking your medication as prescribed by your doctor or healthcare provider, even if you start to feel better.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication, store it at room temperature, away from direct light and moisture. Keep it in a dry place, such as a closet or drawer, and avoid storing it in the bathroom. Protect your medication from heat sources, and keep it out of reach of children and pets. Store all your medications in a secure location to prevent accidental ingestion or misuse.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
Lifestyle & Tips
- Take with food if stomach upset occurs.
- Stay well-hydrated, especially with higher doses, to help prevent kidney stone formation.
- Do not exceed recommended doses without consulting a healthcare professional.
- Maintain a balanced diet rich in fruits and vegetables, as supplements are not a substitute for a healthy diet.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
1000 mg once daily (as a supplement)
Dose Range:
500 - 2000 mg
Condition-Specific Dosing:
Dietary Supplementation:
500-2000 mg daily
Scurvy (treatment):
100-250 mg 1-3 times daily for at least 2 weeks
Common Cold (prophylaxis/reduction of duration):
250-1000 mg daily (evidence mixed)
Urinary Acidification:
4-12 g daily in divided doses
Pediatric Dosing
Neonatal:
Not established (consult pediatrician for specific needs)
Infant:
Not established (RDA: 40-50 mg/day for 0-12 months)
Child:
RDA: 15-45 mg/day (1-8 years); UL: 400-1200 mg/day (1-8 years). Supplementation typically 250-500 mg daily if needed.
Adolescent:
RDA: 65-75 mg/day (9-18 years); UL: 1800-2000 mg/day (9-18 years). Supplementation typically 500-1000 mg daily if needed.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed for typical supplemental doses.
Moderate:
No specific adjustment needed for typical supplemental doses. High doses may increase risk of oxalate kidney stones.
Severe:
Use with caution. High doses (e.g., >1000 mg/day) may increase risk of oxalate nephropathy, especially in patients with pre-existing renal disease or on dialysis. Avoid high doses.
Dialysis:
Avoid high doses. Ascorbic acid is dialyzable. Consult nephrologist for appropriate dosing.
Hepatic Impairment:
Mild:
No adjustment needed.
Moderate:
No adjustment needed.
Severe:
No adjustment needed.
Pharmacology
Mechanism of Action
Ascorbic acid (Vitamin C) is an essential water-soluble vitamin that acts as a potent antioxidant, protecting cells from oxidative damage. It is a co-factor for several enzymatic reactions, including those involved in collagen synthesis (hydroxylation of proline and lysine), carnitine synthesis, and neurotransmitter synthesis (e.g., norepinephrine). It also plays a role in immune function, iron absorption, and cholesterol metabolism. Rose hips provide additional natural vitamin C and bioflavonoids, which may enhance the absorption and utilization of ascorbic acid.
Pharmacokinetics
Absorption:
Bioavailability:
70-90% for doses <200 mg; decreases to <50% for doses >1000 mg due to saturable active transport.
Tmax:
2-4 hours
FoodEffect:
Food may slightly delay absorption but does not significantly affect the extent of absorption.
Distribution:
Vd:
0.2-0.3 L/kg (widely distributed in body tissues, with highest concentrations in adrenal glands, pituitary, brain, and leukocytes)
ProteinBinding:
Approximately 25%
CnssPenetration:
Yes (actively transported into CSF and brain tissue)
Elimination:
HalfLife:
Approximately 10-20 days (body pool dependent); shorter with high doses (e.g., 2-3 hours for plasma half-life after high IV doses).
Clearance:
Renal clearance is dose-dependent; increases with higher doses.
ExcretionRoute:
Renal (glomerular filtration and tubular reabsorption). Unmetabolized ascorbic acid is excreted in urine.
Unchanged:
Varies with dose; significant amounts excreted unchanged at high doses.
Pharmacodynamics
OnsetOfAction:
Not applicable (nutrient, effects are gradual and cumulative)
PeakEffect:
Not applicable
DurationOfAction:
Not applicable
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of kidney problems, including:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Feeling extremely tired or weak
Dark urine or yellowing of the skin and eyes
Back pain, abdominal pain, or blood in the urine, which may indicate a kidney stone
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for advice:
Diarrhea
Upset stomach
Vomiting
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor.
Reporting Side Effects
To report side effects, you can contact the FDA at 1-800-332-1088 or visit their website at https://www.fda.gov/medwatch. Your doctor is also available to provide guidance on managing side effects.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of kidney problems, including:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Feeling extremely tired or weak
Dark urine or yellowing of the skin and eyes
Back pain, abdominal pain, or blood in the urine, which may indicate a kidney stone
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for advice:
Diarrhea
Upset stomach
Vomiting
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor.
Reporting Side Effects
To report side effects, you can contact the FDA at 1-800-332-1088 or visit their website at https://www.fda.gov/medwatch. Your doctor is also available to provide guidance on managing side effects.
Seek Immediate Medical Attention If You Experience:
- Severe diarrhea or abdominal cramps (may indicate excessive dose)
- Symptoms of kidney stones (severe back or side pain, blood in urine, painful urination) - seek immediate medical attention
- Unusual bruising or bleeding (if taking anticoagulants and high doses of Vitamin C)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins.
* Any existing health problems, as this medication may interact with other drugs or health conditions.
To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or change the dosage of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins.
* Any existing health problems, as this medication may interact with other drugs or health conditions.
To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or change the dosage of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This is crucial because it may affect the results of certain laboratory tests. Therefore, be sure to notify all your healthcare providers and laboratory personnel that you are taking this drug.
If you have diabetes (high blood sugar), it is important to discuss this with your doctor. Additionally, if you are following a low-salt or salt-free diet, you should consult with your doctor to ensure safe use of this medication.
There is a rare risk of developing kidney stones or severe kidney problems associated with long-term use of high doses of this medication. This risk may be increased in individuals who have a history of kidney problems or kidney stones. Furthermore, the risk may be higher in people aged 65 and older, as well as in children under the age of 2.
Do not exceed the prescribed duration of treatment with this medication. It is also important to exercise caution if you have low levels of the enzyme glucose-6-phosphate dehydrogenase (G6PD), as this may increase the risk of anemia. Individuals of African, South Asian, Middle Eastern, and Mediterranean descent may be more likely to have low G6PD levels.
If you are pregnant, planning to become pregnant, or are breastfeeding, you must discuss the potential benefits and risks of this medication with your doctor to ensure the best possible outcome for you and your baby.
If you have diabetes (high blood sugar), it is important to discuss this with your doctor. Additionally, if you are following a low-salt or salt-free diet, you should consult with your doctor to ensure safe use of this medication.
There is a rare risk of developing kidney stones or severe kidney problems associated with long-term use of high doses of this medication. This risk may be increased in individuals who have a history of kidney problems or kidney stones. Furthermore, the risk may be higher in people aged 65 and older, as well as in children under the age of 2.
Do not exceed the prescribed duration of treatment with this medication. It is also important to exercise caution if you have low levels of the enzyme glucose-6-phosphate dehydrogenase (G6PD), as this may increase the risk of anemia. Individuals of African, South Asian, Middle Eastern, and Mediterranean descent may be more likely to have low G6PD levels.
If you are pregnant, planning to become pregnant, or are breastfeeding, you must discuss the potential benefits and risks of this medication with your doctor to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Gastrointestinal upset (nausea, vomiting, diarrhea, abdominal cramps)
- Headache
- Flushing
- Fatigue
- Insomnia
- Increased urination
- Increased risk of kidney stones (oxalate nephropathy) with chronic very high doses
What to Do:
Discontinue use. Symptomatic and supportive care. For severe symptoms or suspected kidney stones, seek immediate medical attention. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Moderate Interactions
- Warfarin (may decrease anticoagulant effect at very high doses, though clinical significance is debated)
- Chemotherapy agents (potential to interfere with efficacy of some agents, e.g., bortezomib, due to antioxidant properties; clinical relevance debated)
- Oral contraceptives (may increase estrogen levels, though minor)
- Statins (potential to reduce efficacy of some statins when combined with other antioxidants, but specific to Vitamin C is unclear)
- Desferrioxamine (may increase iron toxicity in patients with hemochromatosis)
Minor Interactions
- Aluminum-containing antacids (may increase aluminum absorption)
- Aspirin (may increase urinary excretion of Vitamin C and decrease aspirin levels)
- Barbiturates (may increase Vitamin C excretion)
- Tetracycline (may increase Vitamin C excretion)
- Iron supplements (enhances non-heme iron absorption)
Monitoring
Baseline Monitoring
Dietary intake of Vitamin C
Rationale: To assess need for supplementation and prevent excessive intake.
Timing: Prior to initiation of supplementation.
Renal function (eGFR, creatinine)
Rationale: High doses of Vitamin C can increase oxalate excretion, potentially leading to kidney stone formation, especially in individuals with pre-existing renal impairment.
Timing: Prior to initiation of high-dose supplementation (>1000 mg/day).
Routine Monitoring
Symptoms of deficiency (e.g., fatigue, gum bleeding, bruising)
Frequency: Periodically, especially if supplementation is for deficiency.
Target: Absence of symptoms
Action Threshold: Worsening or new symptoms may indicate inadequate dosing or other issues.
Symptoms of excess (e.g., GI upset, diarrhea, abdominal cramps)
Frequency: Periodically, especially with high doses.
Target: Absence of symptoms
Action Threshold: Presence of symptoms may indicate excessive dosing; reduce dose.
Urine oxalate levels (for high-dose, long-term use in susceptible individuals)
Frequency: Annually or as clinically indicated.
Target: Normal range
Action Threshold: Elevated levels may indicate increased risk of kidney stones; consider reducing dose or discontinuing.
Symptom Monitoring
- Gastrointestinal upset (nausea, vomiting, diarrhea, abdominal cramps)
- Headache
- Flushing
- Fatigue
- Insomnia
- Increased urination
- Symptoms of kidney stones (flank pain, hematuria) with very high doses
Special Patient Groups
Pregnancy
Generally considered safe at recommended dietary intake levels. High doses (above the UL of 2000 mg/day) should be avoided unless specifically advised by a healthcare provider, as safety data for very high doses in pregnancy are limited.
Trimester-Specific Risks:
First Trimester:
No known specific risks at recommended doses.
Second Trimester:
No known specific risks at recommended doses.
Third Trimester:
No known specific risks at recommended doses. High doses may theoretically lead to 'rebound scurvy' in the infant post-delivery, though this is rare and debated.
Lactation
Considered safe and compatible with breastfeeding at recommended doses. Vitamin C is naturally present in breast milk. High doses are generally not recommended without medical advice.
Infant Risk:
L1 (Safest) - No adverse effects expected in breastfed infants at typical maternal doses.
Pediatric Use
Dosing should be based on age-appropriate Recommended Dietary Allowances (RDAs) and Tolerable Upper Intake Levels (ULs). High doses should be avoided due to potential for gastrointestinal upset and increased risk of kidney stones. Consult a pediatrician for specific dosing recommendations.
Geriatric Use
Generally safe. No specific dose adjustments are typically needed for healthy older adults. However, older adults may have reduced renal function, increasing the risk of oxalate stone formation with very high doses. Monitor for gastrointestinal side effects.
Clinical Information
Clinical Pearls
- Vitamin C absorption is saturable; taking very high doses (e.g., >1000 mg) at once does not significantly increase the amount absorbed and leads to increased urinary excretion.
- For optimal absorption of higher doses, consider splitting the dose throughout the day (e.g., 500 mg twice daily instead of 1000 mg once daily).
- Rose hips are a natural source of Vitamin C and bioflavonoids, which may aid in absorption and provide additional antioxidant benefits.
- While often used for common cold prevention/treatment, evidence for significant benefit is mixed, with some studies showing modest reduction in duration or severity, particularly in individuals under physical stress.
- High doses of Vitamin C can interfere with certain laboratory tests, such as urine glucose tests (false negatives) and stool occult blood tests (false negatives). Inform healthcare providers if taking high doses.
- Patients prone to kidney stones (especially oxalate stones) should use high-dose Vitamin C with caution and ensure adequate hydration.
Alternative Therapies
- Dietary sources of Vitamin C (citrus fruits, berries, kiwi, bell peppers, broccoli)
- Other antioxidants (e.g., Vitamin E, Selenium, Glutathione, Alpha-lipoic acid)
- Multivitamins containing Vitamin C
Cost & Coverage
Average Cost:
$5 - $25 per 100 tablets (1000mg)
Generic Available:
Yes
Insurance Coverage:
Not typically covered by insurance as it is a dietary supplement.
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.