Vitamin C 250mg Tablets
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; Nutritional Supplement
Pharmacologic Class
Water-soluble vitamin; Antioxidant
Pregnancy Category
Category A (at recommended daily allowance); Category C (for doses exceeding RDA)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Vitamin C is an essential nutrient found in many fruits and vegetables. It helps your body grow and repair tissues, heal wounds, and supports your immune system. It also acts as an antioxidant, protecting your cells from damage.
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 enhance absorption.
Continue taking your medication as prescribed by your doctor or healthcare provider, even if you start feeling better. This will help ensure that you complete the full treatment course and achieve the best possible outcome.
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 heat sources. Keep it in a dry place, avoiding storage in a bathroom or other humid environment. Protect your medication from excessive heat, and keep it out of reach of children and pets. Store all medications in a secure location to prevent accidental ingestion or misuse.
What to Do If You Miss a Dose
If you forget to take 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 the 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 enhance absorption.
Continue taking your medication as prescribed by your doctor or healthcare provider, even if you start feeling better. This will help ensure that you complete the full treatment course and achieve the best possible outcome.
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 heat sources. Keep it in a dry place, avoiding storage in a bathroom or other humid environment. Protect your medication from excessive heat, and keep it out of reach of children and pets. Store all medications in a secure location to prevent accidental ingestion or misuse.
What to Do If You Miss a Dose
If you forget to take 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 the missed one.
Lifestyle & Tips
- Maintain a balanced diet rich in fruits and vegetables (e.g., citrus fruits, berries, bell peppers, broccoli) to ensure adequate Vitamin C intake.
- Smoking depletes Vitamin C levels; smokers may require higher intake.
- Store tablets in a cool, dry place away from direct light and moisture.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
250 mg to 1000 mg daily for supplementation or deficiency prevention
Dose Range:
250 - 2000 mg
Condition-Specific Dosing:
Scurvy (treatment):
100 mg to 250 mg, 1 to 3 times daily for at least 2 weeks
Dietary Supplementation:
250 mg to 1000 mg daily
Upper Limit (UL):
2000 mg daily
Pediatric Dosing
Neonatal:
Not established (typically via breast milk/formula)
Infant:
35-50 mg daily (RDA for 0-12 months); Scurvy: 50-100 mg 3 times daily for 5-7 days
Child:
15-75 mg daily (RDA for 1-13 years); Scurvy: 100-300 mg daily in divided doses for 2-4 weeks
Adolescent:
65-75 mg daily (RDA for 14-18 years); Scurvy: 100-300 mg daily in divided doses for 2-4 weeks
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed
Moderate:
No specific adjustment needed, but high doses may increase risk of oxalate kidney stones
Severe:
Use with caution; high doses may increase risk of oxalate kidney stones. Consider lower doses.
Dialysis:
Ascorbic acid is dialyzable. Supplementation may be needed in patients on chronic dialysis due to increased losses and dietary restrictions. Consult nephrologist.
Hepatic Impairment:
Mild:
No adjustment
Moderate:
No adjustment
Severe:
No adjustment
Pharmacology
Mechanism of Action
Ascorbic acid is a water-soluble vitamin essential for the biosynthesis of collagen, L-carnitine, and neurotransmitters. It is involved in tissue repair, acts as a potent antioxidant, and plays a role in immune function. It also facilitates the absorption of nonheme iron.
Pharmacokinetics
Absorption:
Bioavailability:
70-90% for doses <200 mg; decreases to <50% for doses >1000 mg
Tmax:
2-3 hours
FoodEffect:
Food may slightly delay absorption but does not significantly affect total bioavailability.
Distribution:
Vd:
0.2-0.3 L/kg
ProteinBinding:
Approximately 25%
CnssPenetration:
Limited (actively transported into CSF, but concentrations are lower than in plasma)
Elimination:
HalfLife:
Approximately 8-40 days (body pool dependent); plasma half-life is 30 minutes to 2 hours
Clearance:
Not readily quantifiable as it depends on body pool and renal threshold
ExcretionRoute:
Renal (unchanged and as metabolites)
Unchanged:
Varies with dose; significant amounts excreted unchanged at high doses
Pharmacodynamics
OnsetOfAction:
Days to weeks for clinical effects in deficiency states
PeakEffect:
Not applicable for a vitamin; steady-state levels achieved with regular intake
DurationOfAction:
Dependent on body stores; deficiency symptoms may recur within weeks to months if intake ceases.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
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 help right away:
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 or 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
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
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 help right away:
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 or 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
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Signs of deficiency (scurvy): fatigue, weakness, muscle and joint aches, swollen and bleeding gums, easy bruising, poor wound healing, dry skin and hair.
- Signs of excessive intake: diarrhea, nausea, abdominal cramps, heartburn, headache, flushing, kidney stones (rare, with very high doses in susceptible individuals).
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 as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to avoid potential interactions between this medication and other substances.
* Any existing health problems, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is vital to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust 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 as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to avoid potential interactions between this medication and other substances.
* Any existing health problems, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is vital to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust 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 this drug may interfere with certain laboratory tests. Therefore, be sure to notify all your healthcare providers and laboratory personnel that you are taking this medication.
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 drug. 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 or older and in children under 2 years of age.
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 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 drug. 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 or older and in children under 2 years of age.
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 outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Severe diarrhea
- Nausea
- Abdominal cramps
- Vomiting
- Headache
- Flushing
- Increased risk of kidney stones (especially in individuals with pre-existing renal conditions or history of kidney stones)
What to Do:
Discontinue use. Symptomatic and supportive care. Hydration. In case of severe symptoms or suspected kidney stone formation, seek immediate medical attention. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Major Interactions
- Deferoxamine (increased iron toxicity, especially cardiac)
Moderate Interactions
- Warfarin (may decrease anticoagulant effect at high doses of Vitamin C)
- Oral Contraceptives (may increase estrogen levels)
- Antacids containing aluminum (may increase aluminum absorption)
- Protease Inhibitors (some, e.g., indinavir, may have reduced absorption)
- Chemotherapy agents (potential for antioxidant interference, though clinical significance debated)
Minor Interactions
- Aspirin (may increase urinary excretion of Vitamin C)
- Tetracyclines (may decrease absorption of Vitamin C)
Monitoring
Symptom Monitoring
- Signs of Vitamin C deficiency (e.g., fatigue, gingivitis, petechiae, poor wound healing, joint pain)
- Signs of excessive intake (e.g., gastrointestinal upset, diarrhea, abdominal cramps, nausea)
- Symptoms of kidney stones (e.g., flank pain, hematuria) in susceptible individuals taking high doses
Special Patient Groups
Pregnancy
Ascorbic acid is essential during pregnancy. At recommended daily allowances (RDA), it is considered safe (Category A). Doses significantly above the RDA (e.g., >1000 mg/day) are Category C, meaning animal studies have shown adverse effects or there are no adequate human studies, but potential benefits may warrant use despite potential risks. High doses are generally not recommended unless specifically indicated for deficiency.
Trimester-Specific Risks:
First Trimester:
No known risks at RDA. High doses not recommended.
Second Trimester:
No known risks at RDA. High doses not recommended.
Third Trimester:
No known risks at RDA. High doses not recommended. Some theoretical concerns about rebound scurvy in infants if maternal intake is excessively high, but evidence is limited.
Lactation
Ascorbic acid is excreted into breast milk. It is considered compatible with breastfeeding (L1) at recommended daily allowances. High doses are generally considered safe for the infant, but excessive maternal intake may lead to gastrointestinal upset in the infant.
Infant Risk:
Low risk at typical doses. Potential for GI upset in infant with very high maternal doses.
Pediatric Use
Safe and essential for growth and development at age-appropriate doses. Dosing should be based on age and weight, and specific indications (e.g., deficiency treatment).
Geriatric Use
No specific dose adjustments are typically needed for elderly patients. However, elderly individuals may have reduced dietary intake of Vitamin C, making supplementation beneficial. Monitor for potential interactions with other medications.
Clinical Information
Clinical Pearls
- Vitamin C is a water-soluble vitamin, meaning excess amounts are generally excreted, reducing the risk of toxicity compared to fat-soluble vitamins.
- While high doses are generally well-tolerated, they can cause gastrointestinal upset (diarrhea, nausea) and may increase the risk of kidney stones in susceptible individuals (e.g., those with a history of oxalate stones or renal impairment).
- Ascorbic acid enhances the absorption of nonheme iron, which can be beneficial for individuals with iron deficiency anemia.
- Smokers have lower plasma Vitamin C levels and require a higher daily intake (an additional 35 mg/day) compared to non-smokers.
- Vitamin C is sensitive to heat, light, and air, so proper storage of supplements and cooking methods for food sources are important to preserve its content.
Alternative Therapies
- Dietary sources rich in Vitamin C (e.g., citrus fruits, bell peppers, broccoli, strawberries, kiwi)
- Other antioxidants (e.g., Vitamin E, selenium, beta-carotene) for general antioxidant support, though not direct substitutes for Vitamin C's specific roles.
Cost & Coverage
Average Cost:
$5 - $20 per 100 tablets (250mg)
Generic Available:
Yes
Insurance Coverage:
Generally OTC, not covered by prescription insurance plans. May be covered by FSA/HSA.
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 this medication, don't hesitate to discuss them with 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 seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.