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Open AccessArticle

Administration of Intravenous Ascorbic Acid—Practical Considerations for Clinicians

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Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
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Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
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Department of Pharmacy, The Ottawa Hospital and The Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
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Department of Pharmacy, Centre intégré universitaire de santé et de services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
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Department of Medicine, Université de Sherbrooke and Centre de Recherche du Centre intégré universitaire de santé et de services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
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Department of Critical Care Medicine, Sunnybrook Health Sciences Centre and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON M4N 3M5, Canada
*
Authors to whom correspondence should be addressed.
Nutrients 2019, 11(9), 1994; https://doi.org/10.3390/nu11091994
Received: 19 July 2019 / Revised: 17 August 2019 / Accepted: 19 August 2019 / Published: 23 August 2019
Emerging data suggest that intravenous ascorbic acid (AA) may be beneficial in patients with sepsis. Clinicians require data on stability of diluted AA for safe administration. We evaluated the stability of AA diluted in normal saline (NS) or 5% dextrose in water (D5W) solutions over 14 days at 25 °C and at 4 °C, protected from light, using concentrations of 37 mg/mL and 77 mg/mL (Sandoz) and 40 mg/mL and 92 mg/mL (Mylan). We also assessed stability of a 40 mg/mL solution (Mylan) at 25 °C exposed to light for 75 h. Concentrations were measured using liquid chromatographic separation with ultraviolet light detection on days 0, 0.33, 1, 1.33, 2, 3, 4, 7, 10 and 14. By day 14, solutions at 4 °C retained >97.72% of the initial concentration; at 25 °C, solutions retained >88.02% of the initial concentration, but visual changes were evident after day 2. Multiple linear regression demonstrated that study day and temperature (p < 0.001) but not solution type (p = 0.519), concentration (p = 0.677) or manufacturer (p = 0.808) were associated with the percentage remaining. At 75 h, degradation rates were similar in solutions protected from vs. exposed to light. In conclusion, AA solutions are stable for at least 14 days at 4 °C, with protection from light. View Full-Text
Keywords: ascorbic acid; drug stability; administration; sepsis ascorbic acid; drug stability; administration; sepsis
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MDPI and ACS Style

Walker, S.E.; Iazzetta, J.; Law, S.; Kanji, S.; Bolduc, B.; Lamontagne, F.; Adhikari, N.K.J. Administration of Intravenous Ascorbic Acid—Practical Considerations for Clinicians. Nutrients 2019, 11, 1994. https://doi.org/10.3390/nu11091994

AMA Style

Walker SE, Iazzetta J, Law S, Kanji S, Bolduc B, Lamontagne F, Adhikari NKJ. Administration of Intravenous Ascorbic Acid—Practical Considerations for Clinicians. Nutrients. 2019; 11(9):1994. https://doi.org/10.3390/nu11091994

Chicago/Turabian Style

Walker, Scott E.; Iazzetta, John; Law, Shirley; Kanji, Salmaan; Bolduc, Brigitte; Lamontagne, François; Adhikari, Neill K.J. 2019. "Administration of Intravenous Ascorbic Acid—Practical Considerations for Clinicians" Nutrients 11, no. 9: 1994. https://doi.org/10.3390/nu11091994

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