VITADOX VITAMIN C ​ ​GUMMIES

Indications

• Vitamin C deficiency
• Scurvy
• Adjunct therapy in iron overload conditions

Dosage

Children: Child 1 month–3 years: 125–250 mg daily in 1–2 divided doses; Child 4–11 years: 250–500 mg daily in 1–2 divided doses; Child 12–17 years: 0.5–1 g daily in 1–2 divided doses.

Adults: 500 mg daily, taken in 1-2 divided doses, depending on the clinical condition and dietary needs.

Mechanism of action

Ascorbic acid functions primarily as a reducing agent, facilitating enzymatic reactions in the body, including the hydroxylation of proline and lysine in collagen synthesis. It also plays a role in the absorption of iron from the gastrointestinal tract and enhances the immune response.

Pharmacodynamics

Ascorbic acid is crucial for the maintenance of connective tissue and is involved in the metabolism of several amino acids. Its antioxidant properties help to mitigate oxidative stress and may play a role in reducing the risk of chronic diseases.

Pharmacokinetics

Ascorbic acid is absorbed in the intestines and is widely distributed throughout the body. The renal clearance of ascorbic acid is dose-dependent, with higher doses leading to increased excretion. The half-life varies but is generally around 15 to 30 minutes in healthy individuals, with tissue saturation levels influencing its retention.

Contra-indications

• Hypercalcaemia
• Hyperoxaluria
• Patients with cardiac dysfunction

Adverse effects

• Abdominal pain
• Headache
• Nausea
• Vomiting
• Diarrhoea
• Constipation
• Weight loss
• Polyuria
• Sweating
• Thirst
• Vertigo

Interactions

• Increases risk of cardiovascular adverse effects with iron chelators
• Increases risk of cardiovascular adverse effects with deferiprone
• Increases risk of cardiovascular adverse effects with desferrioxamine

Precautions

• Use with caution in patients with iron overload
• Monitor for symptoms of overdose

Pregnancy

High doses teratogenic in animals but therapeutic doses unlikely to be harmful.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Ascorbic acid 50 mg tablets
• Ascorbic acid 100 mg tablets
• Ascorbic acid 200 mg tablets
• Ascorbic acid 250 mg tablets
• Ascorbic acid 500 mg capsules

Indications

• Cardiovascular diseases
• Chronic inflammation
• Oxidative stress-related conditions

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing recommendations.

Adults: Refer to the BNF for specific dosing guidelines as doses can vary based on formulation and indication.

Mechanism of action

Bioflavonoids, such as Rutin, exhibit antioxidant effects by enhancing the activity of antioxidant enzymes, activating the Nrf2/HO-1 pathway, increasing glutathione levels, and reducing malondialdehyde. Their anti-inflammatory actions involve the inhibition of pro-inflammatory cytokines and enzymes, while their antiapoptotic effects include the inhibition of free radicals and various caspases, as well as the elevation of antiapoptotic proteins.

Pharmacodynamics

Bioflavonoids demonstrate a wide range of pharmacological effects, including antioxidant, anti-inflammatory, and cytoprotective actions. The modulation of intracellular signaling pathways contributes to the reduction of oxidative stress and inflammation, which may help in preventing chronic diseases such as cardiovascular diseases and cancer.

Pharmacokinetics

The pharmacokinetics of bioflavonoids depend on their solubility and absorption characteristics. They are generally well-absorbed in the gastrointestinal tract, and their bioavailability can be influenced by food intake. Metabolism primarily occurs in the liver, with conjugation to glucuronides and sulfates, and they are excreted via urine. The half-life varies among different bioflavonoids.

Pregnancy

There is insufficient evidence to establish the safety of bioflavonoids during pregnancy. Consult a healthcare provider for advice.

Breast-feeding

Limited data is available on the excretion of bioflavonoids in human milk. Caution is advised when administering to breastfeeding women.

Storage

Store in a cool, dry place, away from light and moisture.

Formulations

• Rutin
• Quercetin
• Hesperidin

Mechanism of action

A 2022 review of Rutin focused on its protective effects on the heart, liver, and kidneys against various chemical and natural toxins. The antioxidant effects involve enhancement of various antioxidant enzymes, Nrf2/HO-1 pathway activation, Glutathione (GSH) elevation, and malondialdehyde (MDA) reduction. The anti-inflammatory effects involve inhibition of IL-1β, IL-6, TGF-β1, COX-2, iNOS, TLR4, and XO. The antiapoptotic effects involve inhibition of free radicals, caspase-3/-7/-9, hsp70, HMGB1, and p53, and elevation of antiapoptotic protein Bcl-2.