Nutrivit-C100 mg/5 ml

Established Uses

Nutrivit-C is established for:

• Prevention and treatment of Nutrivit-C deficiency (scurvy)
• Dietary supplementation when intake from food is inadequate, including in smokers (who have higher requirements), people with very limited or restrictive diets, and certain malabsorption conditions

Guideline-Supported / Adjunct Uses

• As an adjunct to enhance absorption of non-heme dietary or supplemental iron in the management of iron-deficiency anemia
• As part of the AREDS/AREDS2 antioxidant-vitamin combination, used under an ophthalmologist's guidance to slow progression of intermediate-to-advanced age-related macular degeneration in high-risk patients (the evidence supports the antioxidant combination as a whole, not Nutrivit-C alone)

Popular but Unproven or Limited-Evidence Uses

• Prevention or treatment of the common cold: regular supplementation with Nutrivit-C may modestly shorten cold duration and severity in the general population, and may reduce incidence specifically in people under brief periods of extreme physical exertion or cold exposure (e.g., marathon runners, soldiers). It does not reliably prevent colds in the general population, and starting Nutrivit-C after symptoms begin has not been shown to help
• General "immune boosting," prevention of cardiovascular disease, or cancer prevention: current randomized-trial evidence does not support routine Nutrivit-C supplementation for these purposes in people who are not deficient

Active ingredient: Vitamin C [Ascorbic acid]. Locally marketed strengths of Vitamin C [Ascorbic acid] include 250 mg and 500 mg chewable tablets, 500 mg oral sachets, 1000 mg effervescent tablets, 100 mg/5 mL syrup, and 500 mg/5 mL injection.

Nutrivit-C is an essential, water-soluble vitamin that the body needs for normal growth, tissue repair, wound healing, and immune and antioxidant function, but cannot make on its own. Nutrivit-C is used to prevent and treat Nutrivit-C deficiency (scurvy) and as a dietary supplement when intake from food is insufficient. Nutrivit-C also helps the body absorb iron from food and supplements. It is available in several oral forms (tablets, chewable tablets, effervescent tablets, syrup) and as an injection used under medical supervision. As with any supplement, Nutrivit-C should be taken at doses appropriate to individual needs, since very high doses carry the risks described later in this leaflet.

Vitamin / Antioxidant supplement

Vitamin C [Ascorbic acid] is absorbed from the small intestine mainly by active, sodium-dependent transport. Absorption is efficient at usual dietary and supplemental doses but becomes less efficient at very large single oral doses, and oral dosing produces substantially lower blood levels than intravenous administration. Once absorbed, Vitamin C [Ascorbic acid] is distributed throughout body tissues and fluids, reaching higher concentrations in tissues such as the eyes, adrenal glands, and white blood cells than in plasma. It is metabolized to dehydroascorbic acid and further breakdown products, including oxalate. Once tissue stores are saturated, additional absorbed Vitamin C [Ascorbic acid] and its metabolites are excreted primarily in the urine, and Vitamin C [Ascorbic acid] is also removed by hemodialysis.

• Standard tablets: swallow whole with a full glass of water; may be taken with or without food
• Chewable tablets: chew thoroughly before swallowing
• Effervescent tablets: dissolve completely in a glass of water (or as directed on the label) and drink once the fizzing has stopped
• Syrup: measure the dose using the cup/spoon provided rather than an average household spoon
• If Nutrivit-C causes stomach upset, take it with food or a meal
• Very large single doses of Nutrivit-C are absorbed less efficiently; if a healthcare professional prescribes a high daily dose, they may advise splitting it into two or more smaller doses through the day
• Take Nutrivit-C at approximately the same time each day for consistent supplementation
• Do not exceed the dose of Nutrivit-C recommended by a healthcare professional or stated on the product label

• Iron supplements or iron-rich foods: Nutrivit-C enhances absorption of non-heme dietary and supplemental iron by reducing ferric (Fe3+) iron to the more absorbable ferrous (Fe2+) form; this is sometimes used intentionally to treat iron-deficiency anemia, but may be unwanted in iron-overload conditions (see Use in Special Populations)
• Warfarin: case reports describe reduced anticoagulant effect (lower INR) with high-dose Nutrivit-C; this is classified as a minor interaction, but patients on warfarin should keep their Nutrivit-C intake consistent and inform their doctor before starting, stopping, or changing the dose
• Chemotherapy and radiation therapy: high-dose Nutrivit-C, particularly given intravenously, may theoretically protect tumor cells from the oxidative damage caused by certain chemotherapeutic agents and radiotherapy; patients undergoing cancer treatment should consult their oncologist before taking Nutrivit-C or other antioxidant supplements, especially at high doses
• Aluminum-containing antacids or phosphate binders: Nutrivit-C increases intestinal absorption of aluminum, which can accumulate to harmful levels in people with kidney impairment; people with renal disease should avoid aluminum-containing products together with high-dose Nutrivit-C unless a doctor advises otherwise
• Deferoxamine (iron-chelation therapy): Nutrivit-C increases iron mobilization during deferoxamine treatment; this combination is used under specialist supervision (for example, in thalassemia) because inappropriate dosing has been linked to cardiac stress
• Niacin–simvastatin combination therapy: Nutrivit-C taken together with other antioxidants may blunt the HDL-cholesterol-raising effect of combined niacin–simvastatin therapy

Common Side Effects

At usual recommended doses, Nutrivit-C is generally well tolerated. At higher doses, it may cause nausea, abdominal cramps, diarrhea, bloating or flatulence, and heartburn.

Serious Side Effects – Seek Medical Attention

• Kidney stones with long-term high-dose use (see Precautions and Warnings for details)
• Acute hemolysis (breakdown of red blood cells) in people with G6PD deficiency who take high doses of Nutrivit-C (see Precautions and Warnings for details)
• Signs of an allergic reaction — rash, itching, swelling, severe dizziness, or difficulty breathing

If any of these occur, stop Nutrivit-C and contact a doctor promptly, or seek emergency care for a severe allergic reaction.

Pregnancy

Nutrivit-C is an essential nutrient and is needed in slightly higher amounts during pregnancy (RDA of 80 mg/day for ages 14–18 years and 85 mg/day for ages 19–50 years); supplementation at these RDA levels is generally considered appropriate when dietary intake is insufficient. However, very high doses (several grams per day) are not recommended during pregnancy — case reports describe a possible association between very high maternal intake and scurvy-like symptoms in the newborn shortly after birth, thought to reflect a rebound effect once the infant's higher in-utero exposure stops. Pregnant women should stay within RDA/UL levels for Nutrivit-C unless a doctor specifically advises otherwise, and should consult their doctor before starting any Nutrivit-C supplement.

Breastfeeding

Nutrivit-C is needed in higher amounts during breastfeeding (RDA of 115 mg/day for ages 14–18 years and 120 mg/day for ages 19–50 years) and is transferred into breast milk; supplementation at RDA levels is generally considered compatible with breastfeeding. Breastfeeding women should avoid high-dose Nutrivit-C supplementation beyond the Tolerable Upper Intake Level unless a doctor directs otherwise, and should consult their doctor before use.

• Kidney stone risk with high-dose, long-term use: regularly taking Nutrivit-C well above the RDA, particularly at gram-level doses, can increase urinary oxalate and the risk of calcium oxalate kidney stones; people with a personal or family history of kidney stones, hyperoxaluria, or renal impairment should avoid high-dose Nutrivit-C unless specifically advised and monitored by a doctor
• G6PD deficiency: high doses of Nutrivit-C, especially given intravenously, have been reported to trigger acute hemolysis in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency; people with known G6PD deficiency should limit themselves to standard dietary-supplement doses and tell their doctor about this condition before considering high-dose use
• Iron-overload conditions (e.g., hemochromatosis, thalassemia): Nutrivit-C increases dietary iron absorption and can worsen iron overload; people with hemochromatosis or other iron-overload disorders should avoid high-dose Nutrivit-C unless a doctor directs otherwise
• Renal impairment, including hemodialysis: people with significant kidney impairment may need individualized dosing of Nutrivit-C, and high-dose use in this group can also increase absorption of aluminum from aluminum-containing medicines (see Interactions)
• Interference with laboratory tests: high-dose Nutrivit-C can cause false results on certain laboratory tests, such as some urine glucose tests and stool occult-blood tests; tell the laboratory or your doctor if you are taking high-dose Nutrivit-C before testing
• Not a substitute for medical treatment: popular claims that Nutrivit-C prevents or cures the common cold, COVID-19, or other infections are not well supported by strong clinical evidence at a population level; Nutrivit-C should not replace medically indicated treatment or vaccination

Nutrivit-C has low acute toxicity because it is water-soluble and excess amounts are generally eliminated in urine. Very high oral doses can cause gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal cramps; long-term excessive intake carries the risks described in Precautions and Warnings (kidney stones, and hemolysis in people with G6PD deficiency). No single universal toxic threshold dose has been established for Nutrivit-C. If someone has taken a large amount of Nutrivit-C beyond the recommended dose, do not induce vomiting unless a doctor or poison-control service specifically directs it, and contact a doctor or your local emergency/poison-control service promptly, especially if the amount taken was large or the person is a child.

Store Nutrivit-C below 30°C in a dry place, protected from light and moisture, and out of the reach of children. Always follow the specific storage instructions on the product label or pack, since these can vary between formulations (tablet, syrup, effervescent tablet, or injection).

• Children: requirements for Nutrivit-C vary by age (see Pediatric Uses); use age-appropriate dosing and consult a pediatrician for suspected deficiency
• Elderly: the RDA for Nutrivit-C is generally the same as for other adults, and no specific dose reduction is required for age alone, though age-related dietary insufficiency is a recognized risk factor for deficiency
• Renal impairment: see Precautions and Warnings; dose individualization is needed, particularly in hemodialysis patients, and caution is required with concurrent aluminum-containing medicines
• Hepatic impairment: no specific dose adjustment for Nutrivit-C is well established from available sources; standard supplementation doses are generally used, and a doctor should be consulted before any high-dose use
• G6PD deficiency: see Precautions and Warnings; avoid high-dose or intravenous use of Nutrivit-C
• History of kidney stones or hyperoxaluria: see Precautions and Warnings; avoid high-dose, prolonged use of Nutrivit-C
• Hemochromatosis or other iron-overload disorders: avoid high-dose Nutrivit-C, since it increases iron absorption
• Pregnancy and breastfeeding: see Pregnancy and Lactation

• Dietary supplementation: Nutrivit-C taken to meet daily nutritional needs can generally be continued long term at RDA-level doses when dietary intake is insufficient
• Scurvy treatment: therapeutic doses of Nutrivit-C are typically continued for about 1 to 3 months, or until clinical signs and symptoms fully resolve, then reduced to a maintenance/dietary level as advised by the prescriber
• Common-cold or other short-term supportive use: typically limited to the period of increased need (for example, during a cold, or a short period of intense physical exertion) rather than indefinite high-dose use
• Any high-dose or long-duration use of Nutrivit-C beyond RDA levels should be reviewed periodically by a healthcare professional, given the risks described in Precautions and Warnings

Water-soluble vitamin; essential nutrient; antioxidant supplement

Vitamin C [Ascorbic acid] is a water-soluble essential nutrient and reducing agent (antioxidant) that the body cannot synthesize on its own. It donates electrons to neutralize reactive oxygen species, protecting cells, lipids, proteins, and DNA from oxidative damage, and helps regenerate other antioxidants such as vitamin E. Vitamin C [Ascorbic acid] also acts as an essential cofactor for a family of enzymes, including those required for collagen synthesis (prolyl and lysyl hydroxylases), carnitine synthesis, and the synthesis of certain neurotransmitters such as norepinephrine, and it enhances intestinal absorption of non-heme dietary iron by reducing ferric iron to the ferrous form.

Nutrivit-C is required for normal growth, tissue repair, and health in children, and the RDA increases with age: approximately 15 mg/day for ages 1–3 years, 25 mg/day for ages 4–8 years, 45 mg/day for ages 9–13 years, and 65–75 mg/day for ages 14–18 years (75 mg for males, 65 mg for females). For treatment of confirmed Nutrivit-C deficiency (scurvy) in children, a pediatrician may prescribe Nutrivit-C at doses up to about 300 mg/day, continued until symptoms resolve. Infants fed exclusively boiled or evaporated milk (which destroys Nutrivit-C) are at particular risk of deficiency and may need Nutrivit-C supplementation as advised by a pediatrician. High-dose supplementation of Nutrivit-C beyond the age-specific Tolerable Upper Intake Level is not recommended in children without medical supervision.