Paracetamol + Ascorbic Acid

Uses

What is paracetamol + ascorbic acid used for?

Paracetamol + ascorbic acid is a combination of the analgesic paracetamol (internationally known as acetaminophen) and vitamin C. It has analgesic (pain-relieving) and antipyretic (fever-reducing) actions and is one of the most taken over-the-counter drugs.

Vitamin C is a water-soluble vitamin that is derived from and naturally found in citrus fruit such as lemons and oranges, along with various other fruits and vegetables. It plays an important role in various cellular functions such as collagen production and is a potent antioxidant that guards against free radical damage and boosts immunity.

Paracetamol + ascorbic acid is mainly indicated to treat the following:

• Cold and flu symptoms

How should I take paracetamol + ascorbic acid?

Paracetamol + ascorbic acid is available as an oral tablet or capsule. The oral tablets and capsules should be taken by mouth without chewing or crushing it. The tablets should be taken with food to prevent gastric irritation.

How do I store this drug?

This drug should be stored at room temperature (<30°C) and be protected from light and moisture. Do not allow this product to freeze. Always check the label before using this product. For safety, keep out of the reach of children and pets.

Do not use if the printed expiration date has passed, the product seal has been broken, or the product has changed in color, odor, or consistency.

Do not dispose of this product by pouring it down the drain, toilet, or into the environment. Ask your pharmacist regarding the proper way and location of disposal.

Precautions & warnings

What should I know before using paracetamol + ascorbic acid?

Both paracetamol and ascorbic acid are generally safe to take. High doses of paracetamol may result in liver damage with prolonged use, especially when it is taken with alcohol or other drugs that are extensively metabolized by the liver.

As a water-soluble vitamin, ascorbic acid toxicity is extremely rare. Despite this, avoid prolonged, high doses of vitamin C as the protective benefit does not increase beyond the recommended doses. In rare cases, high-dose vitamin C supplementation can increase the risk of gastrointestinal disturbances, iron overload, and kidney stones.

Before using this medication, inform your doctor if:

• You have ever had an allergic reaction to paracetamol or ascorbic acid
• You have a history of allergy to other medications, food, or other substances
• You are taking other medications
• You have underlying health conditions

Is it safe during pregnancy or breastfeeding?

This drug combination is generally safe for pregnant women, however, there is no data available from controlled human studies that determine this preparation’s safety during pregnancy. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as determined by your doctor.

This drug may be excreted in breast milk. This drug should be used while breastfeeding only if the potential benefit justifies the potential risk to the child, as determined by your doctor.

Side effects

What side effects can occur when using this drug?

All drugs have the potential to elicit side effects even with normal use. Many side effects are dose-related and will resolve when it is adjusted or at the end of therapy.

Potential side effects while using this drug include:

• Nausea
• Diarrhea
• Stomach upset
• Abdominal cramps
• Fatigue
• Heartburn
• Headache
• Flushing
• Hyperoxaluria and kidney stone formation

You may experience some, none, or other side effects not mentioned above. If you have any concerns about a side effect or it becomes bothersome, consult your doctor or pharmacist.

Interactions

What drugs may interact with paracetamol + ascorbic acid?

This drug may interact with other medications. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and inform your doctor and pharmacist.

Known drugs and their interactions with paracetamol + ascorbic acid includes:

• Metoclopramide, domperidone
  • Increased paracetamol absorption
• Cholestyramine
  • Decreased paracetamol absorption
• Anticoagulants
  • Increased risk of bleeding
• Vitamin C supplements, deferoxamine
  • Increased risk of cardiac disorders

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Your dose may need to be adjusted, substituted with another drug, or discontinue using the drug.

Does food or alcohol interact with paracetamol + ascorbic acid?

The absorption rate is slightly decreased with food, however, taking it with a meal prevents gastrointestinal distress. This drug should not be taken with alcohol as it may increase the risk of gastrointestinal discomfort, bleeding, and hepatotoxicity.

Inform your doctor or pharmacist if you have any concerns regarding food-drug interactions.

What health conditions may interact with paracetamol + ascorbic acid?

This drug should be taken with caution if you have any of the following conditions or risk factors:

• G6PD deficiency
• History of kidney or liver impairment
• Alcohol dependency

Inform your doctor or pharmacist if you have any concerns regarding specific health conditions.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using paracetamol + ascorbic acid.

What is the dose of paracetamol + ascorbic acid for an adult?

• Oral: take as instructed based on the preparation’s label.
• Maximum dose for paracetamol is 4 g per day
• Maximum dose for ascorbic acid is 2 g per day

What is the dose of paracetamol + ascorbic acid for a child?

• Oral: take as instructed based on the preparation’s label.
• Maximum dose for paracetamol is 2 g per day
• Maximum dose for ascorbic acid is 400 mg to <2 g per day
• Do not give paracetamol to children under 2 months old

How is paracetamol + ascorbic acid available?

This drug is available in the following dosage forms and strengths:

Paracetamol

• Tablet: 80 mg, 325 mg, 500 mg, 650 mg
• Syrup/suspension: 100 mg/mL, 120 mg/5 mL, 250 mg/5 mL
• Solution for injection: 10 mg/mL, 150 mg/mL
• Rectal suppository: 125 mg, 250 mg, 500 mg

Ascorbic acid

• Tablet: 250 mg, 500 mg, 1000 mg
• Gummy bears 60 mg
• Syrup: 100 mg/mL, 500 mg/5 mL
• Solution for injection: 100 mg/mL

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room. Symptoms of overdose may include:

• Paleness
• Nausea, vomiting
• Anorexia
• Abdominal pain
• Metabolic acidosis
• Glucose metabolism disturbances
• Liver damage may occur 12 to 48 hours after overdose

In severe cases:

• Encephalopathy
• Hemorrhage
• Hypoglycemia
• Cerebral edema
• Acute renal failure
• Death

The antidote for paracetamol overdose and toxicity is N-acetylcysteine (NAC) and should be used within 8 hours up to 24 hours after ingestion. Activated charcoal may be administered within 1 hour after ingestion.

What should I do if I miss a dose?

If you miss a dose of this drug, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.