Ascorbic acid/carbonyl iron Disease Interactions

There is no excretory mechanism for iron. Iron will correct only hemoglobin abnormalities due to iron deficiency and should not be used to treat conditions such as thalassemia, hemosiderosis, hemochromatosis, normocytic anemia (unless iron deficiency exists), or in patients receiving blood transfusions. Clinical monitoring of erythropoietic function and ferritin levels is recommended.

Acute hemolysis following administration of high doses of ascorbic acid in patients with glucose-6-phosphate deficiency (G6PD) has been reported. Ascorbic acid should be administered cautiously and dosages modified in patients with G6PD.

Large doses of ascorbic acid have lead to hyperoxaluria in 5% of patients. Ascorbic acid can acidify urine resulting in precipitation of urate, cystine, or oxalate stones. Ascorbic acid should be administered cautiously and dosages modified in patients predisposed to renal stones. Clinical monitoring of urinalysis for pH and crystal formation is recommended.

Ascorbic acid preparations contain sodium. The sodium content should be considered when used in patients with sodium restricted diets and conditions require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

Ascorbic acid is removed by dialysis.