Ascorutin

Ascorutin is a combination drug that includes two active components: ascorbic acid (vitamin C) and rutoside (also known as rutin). This drug is widely used in medical practice to strengthen the vascular wall, reduce the permeability of capillaries and increase their stability. Ascorutin finds use in the complex therapy of various diseases associated with increased bleeding and weakness of blood vessels.

Pharmacological action

1. Ascorbic acid:

   • It is a powerful antioxidant that helps protect cells from free radical damage.
   • Promotes the synthesis of collagen, essential for maintaining the integrity of skin, blood vessels, bones and cartilage.
   • Improves iron absorption and helps strengthen the immune system.

2. Rutoside (rutin):

   • Stabilizes cell membranes, reduces capillary permeability and fragility.
   • It has antioxidant properties, reduces inflammation and protects vitamin C from oxidation.

Indications Ascorutin

1. Vitamin C and P deficiency: "Ascorutin" can be used to compensate for vitamin C and P deficiencies in the body, especially when there is insufficient intake of the nutrients from food.
2. Gum Bleeding: Vitamin C strengthens the vascular wall and promotes healing of micro-injuries and minor bleeding such as bleeding gums.
3. Vascular Strengthening: Rutina helps strengthen blood vessel walls, reduces their fragility and increases their resistance to damage.
4. Increased vascular permeability and fragility: Ascorutin may be recommended for the treatment of conditions associated with increased capillary permeability and fragility, such as varicose veins, capillarotoxicosis and other vascular diseases.
5. Prevention of Vascular Complications: Vitamin C and P may help prevent the development of vascular complications such as thrombosis, thrombophlebitis, and other vascular diseases.
6. Joint use with some drugs: Sometimes "Ascorutin" can be prescribed as an additional remedy in the treatment of some diseases together with other medicines, for example, in the treatment of hemorrhoids or inflammatory processes in the bladder.

Release form

Oral tablets:

• Standard dosages of ascorbic acid and rutoside in one tablet are typically 50 mg of each component.
• Tablets often have the greenish-yellow color characteristic of rutin.
• Packs may vary in the number of tablets, but standard packs contain 30, 50, or 100 tablets.

Pharmacodynamics

1. Ascorbic acid (vitamin C):

   • Antioxidant Action: Vitamin C is a powerful antioxidant that protects cells from damage caused by free radicals.
   • Involved in collagen synthesis: Vitamin C is essential for the production of collagen, a protein that provides strength and elasticity to skin, blood vessels, bones and other tissues.
   • Increase iron absorption: Ascorbic acid helps to improve iron absorption from food.
   • Involvement in the immune response: Vitamin C contributes to normal immune system function.
   • Antihistamine action: In some cases ascorbic acid may have antihistamine action.

2. Rutizide (rutin):

   • Strengthening of the vascular wall: Rutizide helps to strengthen the vascular wall and improves its elasticity.
   • Anti-inflammatoryeffects: Rutizide has anti-inflammatory properties and may help reduce inflammation in blood vessels.
   • Antiaggregant action: Rutizide may reduce the ability of platelets to clot and form clots in the blood.

Pharmacokinetics

1. Absorption: Ascorbic acid and rutoside are absorbed from the gastrointestinal tract into the blood. Vitamin C is absorbed actively, partly via sodium-dependent vitamin C-transport protein. Vitamin P may also improve vitamin C absorption by strengthening capillary walls.
2. Distribution: After absorption, ascorbic acid and rutoside are distributed to tissues and organs where they can fulfill their biological functions. Vitamin C is widely distributed in body tissues, and vitamin P can enhance capillary blood flow.
3. Metabolism: Ascorbic acid and rutoside can be metabolized in the liver and other body tissues, forming metabolites that are then excreted through the kidneys.
4. Excretion: The main route of excretion of ascorbic acid and rutoside from the body is through the kidneys in the form of metabolites and/or unchanged substances.

Dosing and administration

Method of Application

Ascorutin is taken orally after meals to minimize possible irritation of the gastrointestinal tract. Tablets should not be chewed, they should be swallowed whole, drinking enough water.

Dosage

For adults

• Prevention of vitamin C and rutin deficiency:
  • 1 tablet (containing 50 mg ascorbic acid and 50 mg rutoside) once daily.
• Treatment:
  • 1-2 tablets 2-3 times a day. Duration of the treatment course is usually 2-3 weeks, depending on the doctor's recommendations.

For children over 3 years old

• Prevention:
  • 1 tablet once daily.
• Treatment:
  • 1 tablet 2-3 times a day. The course of treatment is also determined by the doctor, but usually does not exceed 2-3 weeks.

Use Ascorutin during pregnancy

1. First trimester:

   • In the first trimester of pregnancy, the use of Ascorutin is usually not recommended, as this is a critical period of formation of fetal organs. The effect of rutoside on fetal development during this period can be unpredictable, so many experts advise avoiding its use.

2. Second and third trimesters:

   • In the second and third trimesters of pregnancy, Ascorutin can be prescribed by a doctor, but only on strict indications. Potential indications include prevention of varicose veins, hemorrhoids, strengthening the vascular wall and reducing capillary permeability. The drug may also be recommended to improve iron absorption in the treatment or prevention of iron deficiency anemia.

Recommendations for use

• Dosage control: It is necessary to strictly follow the recommended dosage and course of treatment prescribed by a doctor. Unauthorized changes in the dose or duration of administration may be dangerous.
• Condition monitoring: It is important to see your doctor regularly to monitor your health and fetal development. This will allow possible side effects or adverse reactions to be detected in time.

Possible risks

• Hypervitaminosis: Excess vitamin C can lead to hypervitaminosis, especially if taken in doses higher than recommended. This can cause gastrointestinal disorders, kidney stones, and other problems.
• Effect on fetus: Despite the lack of reliable data on teratogenic effects of rutoside, its effect on fetal development has not been fully studied, which requires extreme caution when using it during pregnancy.

Contraindications

1. Hypersensitivity: People with known hypersensitivity to ascorbic acid, rutin or any other components of the drug should avoid its use.
2. Thrombophlebitis and Thrombosis: Because rutin may improve microcirculation and has anticoagulation properties, Ascorutin should be taken with caution for thrombophlebitis or thrombosis.
3. Increased blood clotting: Ascorutin should be taken with caution in patients with blood clotting disorders or taking anticoagulants, as rutin may increase these effects.
4. Diabetes Mellitus: Patients with diabetes should use Ascorutin with caution, as ascorbic acid may increase blood glucose levels.
5. Renal insufficiency: In patients with renal insufficiency, caution may be required when using Ascorutin due to the possibility of accumulation of metabolites in the body.
6. Pregnancy and lactation: Use of "Ascorutin" in high doses during pregnancy and lactation may require consultation with a doctor.
7. Pediatric age: "Ascorutin" can be prescribed to children, but the dosage should be adjusted to the age and weight of the child.

Side effects Ascorutin

1. Gastrointestinal disorders:

   • Nausea, vomiting, diarrhea, stomach cramps, heartburn, or stomach discomfort, especially if the drug is taken on an empty stomach.

2. Allergic Reactions:

   • Skin rashes, itching, hives, Quincke's edema. Although rare, these reactions require immediate medical attention.

3. Headache and dizziness:

   • In some cases, taking Ascorutin may cause headache and slight dizziness.

4. High blood pressure:

   • Ascorbic acid in high doses can lead to an increase in blood pressure, which requires caution when using it in people with hypertension.

5. Sleep disturbances and excitability:

   • Cases of sleep disorders and hyperexcitability when taking the drug have been noted, especially in children and people with increased nervous excitability.

6. Changes in laboratory values:

   • With prolonged use, there may be an effect on laboratory blood parameters, including sugar and cholesterol levels.

7. Other reactions:

   • Increased frequency of urination, changes in menstrual cycle in women.

Overdose

When considering the effects of an overdose of Ascorutin (a combination of ascorbic acid and rutin), it is important to evaluate the roles and interactions of its individual components, especially at high doses:

1. Increased risk of oxalate kidney stones: Ascorbic acid (vitamin C), when consumed in excessive amounts, can be metabolized to oxalate, which can combine with calcium to form calcium oxalate stones. High doses of vitamin C are associated with an increased risk of this condition in predisposed individuals (Barness, 1975).
2. Possible gastrointestinal disorders: Overdose of ascorbic acid may cause gastrointestinal disorders such as diarrhea and abdominal pain. This is due to the osmotic effect of unabsorbed vitamin C in the gastrointestinal tract (Barness, 1975).
3. Changes in antioxidant and anti-inflammatory functions: Ascorbic acid and rutin are antioxidants. In synergy, they can enhance protective effects against oxidative stress, but an imbalance (due to overdose) can upset this balance, leading to less effective control of free radical damage and inflammatory responses in the body.
4. Effect on blood sugar levels: There is evidence to suggest that excessive consumption of these compounds may interfere with blood glucose regulation. It has been shown in studies that preparations containing ascorbic acid and rutin can modulate blood sugar levels, which can be problematic when taken in excessive amounts, especially for people with diabetes (Polushina et al., 2000).
5. Interference with medical tests: High levels of ascorbic acid can interfere with a variety of laboratory tests, including those to measure blood glucose and cholesterol levels, potentially leading to misleading results and complicating medical evaluation (Barness, 1975).

Interactions with other drugs

1. Drugs that increase anticoagulant effect: Ascorbic acid may increase iron absorption, so its administration simultaneously with iron-containing drugs may enhance their effect.
2. Drugs that enhance iron absorption: Rutoside may improve iron absorption from food, so its concomitant administration with iron-containing drugs may increase their effectiveness.
3. Drugs that reduce the anticoagulant effect: Ascorbic acid may reduce the effectiveness of anticoagulants such as warfarin or heparin.
4. Drugs that increase urine acidity: Ascorbic acid can increase urine acidity, which may affect the effectiveness of some diuretics.
5. Drugs that enhance capillaroprotective effect: Rutoside, as part of Ascorutin, may enhance the capillaroprotective effect of other drugs.