Vitamin C 500mg 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, Cofactor
Pregnancy Category
Category A (for recommended daily allowance); Category C (for doses exceeding recommended daily allowance)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Vitamin C is an essential nutrient that your body needs for many important functions, like building healthy skin, bones, and blood vessels. It's also a powerful antioxidant that helps protect your cells from damage and supports your immune system. Since your body can't make Vitamin C, you need to get it from your diet or supplements.
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 to feel better. This will help ensure that you receive the full benefits of the treatment.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication, store it at room temperature, away from direct light. Keep it in a dry place, avoiding storage in a bathroom where moisture and humidity can affect the medication. Protect the medication from heat sources, 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 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 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 to feel better. This will help ensure that you receive the full benefits of the treatment.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication, store it at room temperature, away from direct light. Keep it in a dry place, avoiding storage in a bathroom where moisture and humidity can affect the medication. Protect the medication from heat sources, 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 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 the missed one.
Lifestyle & Tips
- Maintain a balanced diet rich in fruits and vegetables (citrus fruits, berries, bell peppers, broccoli are excellent sources).
- Smoking depletes Vitamin C, so smokers may need higher intake.
- Store tablets in a cool, dry place away from direct light and moisture.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
500 mg to 1000 mg once daily
Dose Range:
500 - 2000 mg
Condition-Specific Dosing:
RDA:
75-90 mg/day
Smokers:
Add 35 mg/day to RDA
Deficiency (Scurvy):
100-250 mg 1-3 times daily for at least 2 weeks
Pediatric Dosing
Neonatal:
Not established (typically obtained via breast milk/formula)
Infant:
40-50 mg/day (RDA)
Child:
15-45 mg/day (RDA, age-dependent); 100-300 mg/day for deficiency
Adolescent:
65-75 mg/day (RDA, age-dependent); 100-300 mg/day for deficiency
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed for typical supplementation doses.
Moderate:
No specific adjustment needed for typical supplementation doses. High doses may increase risk of oxalate nephropathy.
Severe:
Use with caution. High doses (e.g., >1000 mg/day) may increase risk of oxalate nephropathy and accumulation. Consider lower doses.
Dialysis:
Ascorbic acid is dialyzable. Supplementation may be needed due to loss during dialysis, but high doses should be avoided due to oxalate risk.
Hepatic Impairment:
Mild:
No adjustment needed.
Moderate:
No adjustment needed.
Severe:
No adjustment needed.
Pharmacology
Mechanism of Action
Ascorbic acid is a potent antioxidant and a cofactor for several enzymatic reactions. It is essential for the biosynthesis of collagen, L-carnitine, and certain neurotransmitters. It is involved in protein metabolism, immune function, and the absorption of nonheme iron. It also regenerates other antioxidants like vitamin E.
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 absorption.
Distribution:
Vd:
0.2-0.3 L/kg
ProteinBinding:
Approximately 25%
CnssPenetration:
Limited, but present in CSF at concentrations similar to plasma.
Elimination:
HalfLife:
Approximately 10-20 hours (dose-dependent, shorter with higher doses due to saturation of reabsorption)
Clearance:
Renal clearance is significant, especially at higher doses.
ExcretionRoute:
Renal (unchanged and as metabolites)
Unchanged:
Up to 80-90% at low doses; decreases significantly at higher doses due to saturation of renal reabsorption.
Pharmacodynamics
OnsetOfAction:
Nutritional effects are gradual, over days to weeks.
PeakEffect:
Not applicable for a vitamin's general effect; plasma levels peak within 2-3 hours.
DurationOfAction:
Plasma levels return to baseline within 24 hours, but tissue saturation can last longer.
Confidence:
Medium
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 do not go away, contact your doctor:
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 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 do not go away, contact your doctor:
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:
- Seek medical attention if you experience severe diarrhea, persistent nausea, or signs of kidney stones (e.g., severe back pain, blood in urine) after taking high doses.
- Consult a doctor if you suspect a deficiency (scurvy symptoms like bleeding gums, easy bruising, poor wound healing).
Before Using This Medicine
Before taking this medication, it is essential to inform your doctor about the following:
Any allergies you have, including allergies to this drug, any of its components, or other substances, such as foods or medications. Be sure to describe the symptoms you experienced as a result of the allergy.
Potential interactions with other medications or health conditions. To ensure safe use, disclose all of your current medications, including prescription and over-the-counter drugs, natural products, and vitamins, to both your doctor and pharmacist.
All of your health problems, as they may affect the safety of taking this medication.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor to confirm that it is safe to do so with your current regimen and health status.
Any allergies you have, including allergies to this drug, any of its components, or other substances, such as foods or medications. Be sure to describe the symptoms you experienced as a result of the allergy.
Potential interactions with other medications or health conditions. To ensure safe use, disclose all of your current medications, including prescription and over-the-counter drugs, natural products, and vitamins, to both your doctor and pharmacist.
All of your health problems, as they may affect the safety of taking this medication.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor to confirm that it is safe to do so with your current regimen and health status.
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 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 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 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 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 possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Diarrhea
- Nausea
- Abdominal cramps
- Headache
- Insomnia
- Heartburn
- Kidney stones (rare, in predisposed individuals with very high doses)
What to Do:
Discontinue use. Symptoms are usually mild and resolve upon cessation. Drink plenty of fluids. For severe symptoms or suspected kidney stones, seek medical attention. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Major Interactions
- Deferoxamine (increased iron toxicity, especially cardiac)
- Warfarin (potential for decreased anticoagulant effect, though clinical significance debated)
Moderate Interactions
- Oral Contraceptives (may increase estrogen levels)
- Chemotherapy agents (potential for interference with efficacy, especially for agents relying on oxidative stress)
- Statins (potential for reduced efficacy of statins when taken with other antioxidants, though specific for Vitamin C is less clear)
- Aluminum-containing antacids (increased aluminum absorption)
- Protease inhibitors (potential for reduced absorption/efficacy)
Minor Interactions
- Aspirin (may increase urinary excretion of Vitamin C)
- Barbiturates (may increase urinary excretion of Vitamin C)
- Tetracycline (may increase urinary excretion of Vitamin C)
Monitoring
Symptom Monitoring
- Signs of deficiency (scurvy): fatigue, weakness, joint pain, gum inflammation, poor wound healing, petechiae, bruising.
- Signs of excess (high doses): diarrhea, nausea, abdominal cramps, headache, insomnia, kidney stones (rare, in susceptible individuals).
Special Patient Groups
Pregnancy
Essential during pregnancy. Recommended daily allowance (RDA) is 85 mg/day. Doses up to 2000 mg/day are generally considered safe, but excessive doses (above 2000 mg/day) should be avoided as they may be associated with rebound scurvy in the infant post-delivery.
Trimester-Specific Risks:
First Trimester:
Generally safe at RDA; higher doses should be discussed with a healthcare provider.
Second Trimester:
Generally safe at RDA; higher doses should be discussed with a healthcare provider.
Third Trimester:
Generally safe at RDA; higher doses should be discussed with a healthcare provider. Avoid excessive doses to prevent rebound scurvy in neonate.
Lactation
Compatible with breastfeeding. Ascorbic acid is excreted into breast milk. RDA for lactating women is 120 mg/day. Doses up to 2000 mg/day are generally considered safe and do not pose a risk to the infant.
Infant Risk:
L1 (Compatible)
Pediatric Use
Safe and essential for growth and development within recommended daily allowances. Dosing should be age-appropriate. High doses should be avoided due to potential for gastrointestinal upset and theoretical risk of kidney stones.
Geriatric Use
No specific dose adjustments are typically needed. However, elderly patients may have reduced renal function, increasing the risk of oxalate accumulation with very high doses. Monitor for signs of gastrointestinal upset.
Clinical Information
Clinical Pearls
- Vitamin C is water-soluble, meaning excess amounts are generally excreted, reducing the risk of toxicity compared to fat-soluble vitamins, but very high doses can still cause side effects.
- Absorption of Vitamin C decreases significantly at doses above 1000 mg, making higher single doses less efficient.
- While often taken for cold prevention, evidence for its efficacy in preventing common colds is limited, though it may slightly reduce duration or severity in some individuals, especially those under physical stress.
- Vitamin C enhances the absorption of nonheme iron (iron from plant sources), so it's beneficial to take iron supplements or iron-rich plant foods with Vitamin C.
Alternative Therapies
- Dietary sources of Vitamin C (e.g., citrus fruits, bell peppers, broccoli, strawberries)
- Other antioxidants (e.g., Vitamin E, Beta-carotene, Selenium)
Cost & Coverage
Average Cost:
$5 - $20 per 100 tablets (500mg)
Generic Available:
Yes
Insurance Coverage:
Over-the-counter (OTC), generally not covered by insurance unless prescribed for a specific medical condition (e.g., severe deficiency).
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more details. 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 information about the medication taken, the amount, and the time it happened.