Ascorbic acid / iron polysaccharide Side Effects
Esophagitis has been reported to be associated with prolonged or increased contact of ascorbic acid tablets with the esophageal mucosa.
Gastrointestinal side effects of ascorbic acid have included nausea, diarrhea, abdominal cramps, and esophagitis. Gastrointestinal side effects of iron polysaccharide have been reported the most frequently. They have included nausea, vomiting, diarrhea, constipation, abdominal pain, flatulence, and heartburn.[Ref]
Hyperoxaluria with ascorbic acid is reported to be dose-related.[Ref]
Conditional scurvy is reported to occur following excessive doses of ascorbic acid over a prolonged period of time. The mechanism of action for this condition is thought to be that large doses of ascorbic acid condition the patient over time for rapid clearance of ascorbic acid resulting in scurvy. The plasma levels of ascorbic acid appear to remain within normal limits. The actual existence of conditional scurvy remains controversial.
Iron overload (i.e., hemosiderosis) has been reported in patients genetically predisposed, or have underlying disorders, that augment the absorption of iron. It has also occurred following administration of excessive parenteral iron therapy, combination of oral and parenteral iron, or in patients with hemoglobinopathies that were erroneously diagnosed as iron deficiency anemia. Hemosiderosis is treated with repeated phlebotomy or long-term administration of deferoxamine. The liver is particularly susceptible to toxicity in iron-overload states.[Ref]
Other side effects from ascorbic acid have included flank pain in less than 1% of patients. Conditional scurvy has also been reported. Other side effects of iron polysaccharide have included iron overload (hemosiderosis). Secondary hemochromatosis due to prolonged iron ingestion has been reported rarely.[Ref]
Hematologic side effects of ascorbic acid have included hemolysis.[Ref]
The majority of hemolysis reports have been associated with patients receiving ascorbic acid who had concurrent glucose-6-phosphate dehydrogenase deficiency.[Ref]
More about ascorbic acid / iron polysaccharide
Related treatment guides
1. Hathcock JN "Vitamins and minerals: Efficacy and safety." Am J Clin Nutr 66 (1997): 427-37
2. Wingard RL, Parker RA, Ismail N, Hakim RM "Efficacy of oral iron therapy in patients receiving recombinant human erythropoietin." Am J Kidney Dis 25 (1995): 433-9
3. Levine M, Dhariwal KR, Welch RW, Wang Y, Park JB "Determination of optimal vitamin C requirements in humans." Am J Clin Nutr 62(6 Suppl) (1995): s1347-56
4. Glassman E "Oral iron therapy with ferrous fumarate and polysaccharide iron complex." ANNA J 19 (1992): 277-8,323
5. "How much vitamin C do you need?" JAMA 281 (1999): 1460
6. KleinSchwartz W "Toxicity of polysaccharid-iron complex exposures reported to poison control centers." Ann Pharmacother 34 (2000): 165-9
7. "Multum Information Services, Inc. Expert Review Panel"
Some side effects may not be reported. You may report them to the FDA.