Large doses may cause gastrointestinal disorders including diarrhoea. Large doses may also result in hyperoxaluria and renal oxalate calculi may form if urine is acidic. Doses of 600mg or more daily have a diuretic action. Stop treatment and treat symptomatically.
Hyperoxaluria
Incompatible with ferric salts, oxidising agents, and salts of heavy metals, particularly copper.
Injections of Cemill 1000 have been reported to be incompatible with aminophylline, bleomycin sulphate, erythromycin lactobionate, nafcillin sodium, nitrofurantoin sodium, conjugated oestrogens, sodium bicarbonate and sulphafurazole diethanolamine. Occasional incompatibility, depending on pH or concentration, has occurred with chloramphenicol sodium succinate.
Large doses may cause gastrointestinal disorders including diarrhoea. Large doses may also result in hyperoxaluria and renal oxalate calculi may form if the urine becomes acidic. Doses of 600mg or more daily have a diuretic action. Induced tolerance with prolonged use of large doses can result in symptoms of deficiency when intake is reduced to normal.
None stated
The prevention and treatment of scurvy, or other conditions requiring vitamin C supplementation, where the deficiency is acute or oral administration is difficult.
ATC Code: A11G A01
Cemill 1000, a water-soluble vitamin, is essential for formation of collagen and intercellular material, and therefore necessary for the development of cartilage, bone, teeth and for the healing of wounds. It is also essential for the conversion from folic acid to folinic acid, facilitates iron absorption from the gastro-intestinal tract and influences haemoglobin formation and erythrocyte maturation.
Distribution - widely distributed in body tissues with about 25% bound to plasma proteins. Large amounts are present in leucocytes and platelets. Cemill 1000 crosses the placenta.
Metabolism - readily oxidised to dehydroCemill 1000 where some is metabolised to oxalic acid and the inactive ascorbate - 2 - sulphate. Metabolic turnover appears to be greater in females than males.
Excretion - large doses are rapidly excreted in the urine when in excess of the requirements of the body and after an intravenous dose, about 40% is excreted in 8 hours, which is increased to about 70% after tissue saturation. The amount of unchanged drug is dose dependent; in women the excretion of Cemill 1000 appears to vary with the stage of the menstrual cycle and it is decreased when taking oral contraceptives.
Cemill 1000 is excreted in breast milk.
Oxalic acid and ascorbate - 2 - sulphate are excreted in the urine.
Cemill 1000 should be given with care to patients with underlying renal failure due to the risk of formation of renal oxalate calculi. Tolerance may be induced in patients taking high doses.
Large doses of Cemill 1000 have resulted in haemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Cemill 1000 injection is unlikely to affect the patient's ability to drive or use machinery.
Route of Administration: Parenteral
Adults
0.5 to 1g daily for scurvy, 200 to 500mg daily for preventative therapy.
Children
100 to 300mg daily for curative purposes, or 30mg daily for protective treatment.
Elderly
No special dosage requirements have been suggested.
None stated
