Ascorbic acid / iron polysaccharide Side Effects
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]
Nausea, diarrhea, and abdominal cramps have been reported to be associated with ascorbic acid doses exceeding 2 g per day, although there have been some reports with as little as 1 g per day.
Esophagitis has been reported to be associated with prolonged or increased contact of ascorbic acid tablets with the esophageal mucosa.
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]
The majority of hemolysis reports have been associated with patients receiving ascorbic acid who had concurrent glucose-6-phosphate dehydrogenase deficiency.[Ref]
Hematologic side effects of ascorbic acid have included hemolysis.[Ref]
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Some side effects may not be reported. You may report them to the FDA.