VITAMIN C
IV Vitamin C dosing depends heavily on the indication, patient's health status, and whether it's being used as supportive therapy (wellness) or adjunctive medical treatment (e.g., oncology, infections, fatigue, wound healing).
Wellness & General Use
Typical dose range: 2,000–10,000 mg (2–10 g) IV infusion.
Frequency: Fortnightly.
High-Dose Vitamin C (MUST HAVE MEDICAL ADVICE FROM DOCTOR IN WRITING)
Dose range: 25,000–75,000 mg (25–75 g) IV infusion, sometimes higher.
Frequency: 2–3 times per week (oncology protocols often use this).
Notes: Requires prior G6PD testing to avoid hemolysis, and renal function monitoring. Infusion usually delivered over 1.5–3 hours with fluids (e.g., sodium chloride, compound sodium lactate).
Safety & Clinical Considerations
Screen patients for renal function, oxalate kidney stones, and G6PD deficiency. Large doses can cause osmotic diuresis, GI upset (if oral), or vein irritation. Always adjust based on patient tolerance, indication, and supervising doctor's protocol.
✅ For wellness clinics, most stick to 2–10 g weekly.
✅ For therapeutic/oncology use, 25–75 g 2–3x weekly is common under medical oversight.
Clinical Protocol - IV Vitamin C
1. Purpose
To provide safe administration of intravenous Vitamin C (ascorbic acid) for wellness and therapeutic indications, while ensuring compliance with clinical governance and TGA guidelines.
Indications
- General wellness, fatigue, immune support
- Recovery from illness, travel, stress
- Adjunctive therapy (oncology, wound healing, infections) – must be under medical directive
Contraindications
- Known G6PD deficiency (risk of hemolysis at high doses)
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- History of oxalate kidney stones
- Hemochromatosis or high iron stores
- Known hypersensitivity to Vitamin C
Screening Requirements
- Medical history and informed consent form completed
- Baseline bloods (renal function, electrolytes, liver function)
- G6PD testing required for doses > 15 g
- Assess hydration status
Dosing Tiers & Frequency
A. Wellness & Preventative Care
- 2–10 g Vitamin C IV (diluted in 250–500 mL NS or CSL)
- Infuse over 45–90 min
- Frequency: weekly to fortnightly
B. Moderate Dose (Recovery, Fatigue, Viral Support)
- 10–25 g Vitamin C IV (in 500 mL NS/CSL)
- Infuse over 60–120 min
- Frequency: 1–2x weekly
C. High Dose / Medical Adjunctive (e.g., Oncology, Complex Illness)
- 25–75 g Vitamin C IV (in 500–1000 mL NS/CSL)
- Infuse over 1.5–3 hrs
- Frequency: 2–3x weekly
- Requires medical oversight and close monitoring
Preparation
- Dilute Vitamin C in appropriate carrier fluid
- Ensure aseptic technique
- Protect solution from light (ascorbic acid degrades quickly)
Monitoring
- Before infusion: BP, HR, SpO₂, baseline blood glucose if diabetic
- During infusion: monitor vitals every 15–30 min, watch for vein irritation, nausea, dizziness
- After infusion: observe for 15–20 min before discharge
Adverse Reactions
Mild: vein irritation, headache, nausea, osmotic diuresis
Severe: hemolysis in G6PD deficiency, renal stress, hypotension (rare)
Management: stop infusion, supportive care, escalate as per emergency protocols
Aftercare
- Encourage oral hydration (1–2 L/day)
- Advise patient may feel more energy or mild diuresis
- Report any flank pain, hematuria, or severe fatigue
Clinical Governance
- All staff must be trained in IV cannulation, infusion management, and anaphylaxis response
- Consent and documentation must be completed for every treatment
- Ensure compliance with TGA advertising guidelines: avoid therapeutic claims unless backed by evidence and medical oversight
References
Australian Injectable Drugs Handbook
https://aidh.hcn.com.au/browse/s/sodium_ascorbate
STABILITY
Store at 2 to 8 °C. Protect from light.
No Incompatibles
REFERENCES
- Product information. Available from www.tga.gov.au. Accessed 11/02/2023.
- ASHP Injectable drug information 2021. Bethesda, MD: American Society of Health-System Pharmacists; 2021.
- Ascor. US prescribing information. Santa Ana, CA: McGuff Pharmaceuticals. Approved 1974. Updated October 2017. Available from www.dailymed.nlm.nih.gov. Accessed 11/02/2023.
- Ascorbic acid. In: IV index [internet]. Trissel's 2 clinical pharmaceutics database (parenteral compatibility). Ann Arbour, MI: Merative. Accessed 11/02/2023.