In patients with normal cardiac function ascorbic acid
should be introduced 1 month after starting
desferrioxamine.
lINTERACTIONS→Appendix 1 : ascorbic acid
lSIDE-EFFECTSDiarrhoea.drug tolerance.gastrointestinal
disorder.hyperoxaluria.oxalate nephrolithiasis.polyuria
lPRESCRIBING AND DISPENSING INFORMATIONIt is rarely
necessary to prescribe more than 100 mg daily except early
in the treatment of scurvy.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: tablet, oral suspension, oral solution
Tablet
EXCIPIENTS:May contain Aspartame
▶Ascorbic acid (Non-proprietary)
Ascorbic acid 50 mgAscorbic acid 50 mg tablets| 28 tabletG
£ 15. 05 DT = £ 15. 05 | 28 tabletsDT = £ 15. 05
Ascorbic acid 100 mgAscorbic acid 100 mg tablets| 28 tabletG
£ 14. 30 DT = £ 14. 30 | 28 tabletsDT = £ 14. 30
Ascorbic acid 200 mgAscorbic acid 200 mg tablets| 28 tabletsDT
=£ 19. 86 | 28 tabletG£ 19. 86 DT = £ 19. 86
Ascorbic acid 250 mgAscorbic acid 250 mg tablets|
1000 tabletPs
Ascorbic acid 500 mgAscorbic acid 500 mg tablets| 28 tabletG
£ 26. 87 DT = £ 26. 87 | 28 tabletsDT = £ 26. 87
Chewable tablet
CAUTIONARY AND ADVISORY LABELS 24
EXCIPIENTS:May contain Aspartame
▶Ascur(Ennogen Healthcare Ltd)
Ascorbic acid 100 mgAscur 100 mg chewable tablets| 30 tablet
£ 3. 95
Ascorbic acid (as Sodium ascorbate) 500 mgAscur 500 mg
chewable tablets sugar-free| 30 tablet £ 2. 99
Capsule
▶Ascorbic acid (Non-proprietary)
Ascorbic acid 500 mgVitamin C 500 mg capsules| 60 capsule £ 7. 73
| 180 capsule £ 19. 82
Combinations available:Vitamins A, C and D,p. 626VITAMINS AND TRACE ELEMENTS›VITAMIN D
AND ANALOGUESVitamin D and analogues f
(systemic)
lCONTRA-INDICATIONSHypercalcaemia.metastatic
calcification
lSIDE-EFFECTS
▶Common or very commonAbdominal pain.headache.
hypercalcaemia.hypercalciuria.nausea.skin reactions
▶UncommonAppetite decreased.constipation.thirst.
vomiting
SIDE-EFFECTS, FURTHER INFORMATION
OverdoseSymptoms of overdosage include anorexia,
lassitude, nausea and vomiting, diarrhoea, constipation,
weight loss, polyuria, sweating, headache, thirst, vertigo,
and raised concentrations of calcium and phosphate in
plasma and urine.
lPREGNANCYHigh doses teratogenic inanimalsbut
therapeutic doses unlikely to be harmful.
lBREAST FEEDINGCaution with high doses; may cause
hypercalcaemia in infant—monitor serum-calcium
concentration.
lMONITORING REQUIREMENTSImportant: all patients
receiving pharmacological doses of vitamin D should have
their plasma-calcium concentration checked at intervals
(initially once or twice weekly) and whenever nausea or
vomiting occur.eiiiiFaboveAlfacalcidol
(1a-Hydroxycholecalciferol)
lINDICATIONS AND DOSE
Hypophosphataemic rickets|Persistent hypocalcaemia
due to hypoparathyroidism or
pseudohypoparathyroidism
▶BY MOUTH, OR BY INTRAVENOUS INJECTION
▶Child 1 month–11 years: 25 – 50 nanograms/kg once daily,
dose to be adjusted as necessary; maximum
1 microgram per day
▶Child 12–17 years: 1 microgram once daily, dose to be
adjusted as necessary
Persistent neonatal hypocalcaemia
▶BY MOUTH, OR BY INTRAVENOUS INJECTION
▶Neonate: 50 – 100 nanograms/kg once daily, dose to be
adjusted as necessary, in resistant cases higher doses
may be needed; increased if necessary up to
2 micrograms/kg daily.Prevention of vitamin D deficiency in renal or cholestatic
liver disease
▶BY MOUTH, OR BY INTRAVENOUS INJECTION
▶Neonate: 20 nanograms/kg once daily, dose to be
adjusted as necessary.▶Child 1 month–11 years (body-weight up to
20 kg): 15 – 30 nanograms/kg once daily (max. per dose
500 nanograms)
▶Child 1 month–11 years (body-weight 20 kg and
above): 250 – 500 nanograms once daily, dose to be
adjusted as necessary
▶Child 12–17 years: 250 – 500 nanograms once daily, dose
to be adjusted as necessary
DOSE EQUIVALENCE AND CONVERSION
▶One drop of alfacalcidol 2 microgram/mL oral drops
contains approximately 100 nanograms alfacalcidol.lCAUTIONSNephrolithiasis.take care to ensure correct
dose in infants
lINTERACTIONS→Appendix 1 : vitamin D substances
lSIDE-EFFECTS
▶Common or very commonAbdominal discomfort.
hyperphosphataemia
▶UncommonAsthenia.diarrhoea.malaise.myalgia.
urolithiases
▶Rare or very rareDizziness
▶Frequency not knownConfusion.renal impairment
lRENAL IMPAIRMENT
MonitoringMonitor plasma-calcium concentration in
renal impairment.
lMONITORING REQUIREMENTSMonitor plasma-calcium
concentration in patients receiving high doses.
lDIRECTIONS FOR ADMINISTRATIONFor injection, shake
ampoule for at least 5 seconds before use, and give over
30 seconds.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Solution for injection
EXCIPIENTS:May contain Alcohol, propylene glycol
▶One-Alpha(LEO Pharma)
Alfacalcidol 2 microgram per 1 mlOne-Alpha 2 micrograms/ 1 ml
solution for injection ampoules| 10 ampouleP£ 41. 13
One-Alpha 1 micrograms/ 0. 5 ml solution for injection ampoules|
10 ampouleP£ 21. 57630 Vitamin deficiency BNFC 2018 – 2019
Blood and nutrition9