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Drug overview for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips):
Generic name: ASCORBIC ACID/RUTIN/HESPERIDIN/BIOFLAVONOID, LEMON/ROSE HIPS
Drug class: Vitamin C
Therapeutic class: Electrolyte Balance-Nutritional Products
Ascorbic acid is the functional and principal in vivo form of vitamin C, an essential water-soluble vitamin.
No enhanced Uses information available for this drug.
Generic name: ASCORBIC ACID/RUTIN/HESPERIDIN/BIOFLAVONOID, LEMON/ROSE HIPS
Drug class: Vitamin C
Therapeutic class: Electrolyte Balance-Nutritional Products
Ascorbic acid is the functional and principal in vivo form of vitamin C, an essential water-soluble vitamin.
No enhanced Uses information available for this drug.
DRUG IMAGES
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The following indications for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips) have been approved by the FDA:
Indications:
None.
Professional Synonyms:
None.
Indications:
None.
Professional Synonyms:
None.
The following dosing information is available for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips):
No enhanced Dosing information available for this drug.
Ascorbic acid is usually administered orally. When oral administration is not feasible or when malabsorption is suspected, the drug may be administered IM, IV, or subcutaneously. When given parenterally, utilization of the vitamin reportedly is best after IM administration and that is the preferred parenteral route.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips):
There are 0 contraindications.
There are 1 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Bortezomib/Ascorbic Acid (Vitamin C) SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Vitamin C can form a complex with the boronic acid moiety of the bortezomib molecule, preventing its absorption into cells.(1-4) This may protect normal tissue in the body, which may have higher levels of Vitamin C.(5) CLINICAL EFFECTS: Concurrent administration of Vitamin C may result in decreased bortezomib activity.(1-4) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Instruct patients receiving bortezomib therapy not to begin taking vitamin C supplements without consulting their oncologist first. Patients who are instructed to take vitamin C should follow their oncologist's instructions on how to separate dosages and should be carefully monitored for bortezomib efficacy. DISCUSSION: An in vitro study with human plasma and multiple myeloma cells found that high levels of vitamin C (following 1 gram/day of ascorbic acid for 4 days) decreased bortezomib effectiveness by 26%. An in vivo study in mice found that vitamin C administration with bortezomib completely blocked the response of bortezomib.(6) An in vitro study in rat Schwann cells and myeloma cells(4) and an in vivo study in mice(7) found that delayed administration of vitamin C had no effect on bortezomib effects. In an in vivo study in multiple myeloma patients, concurrent ascorbic acid, arsenic trioxide, bortezomib, and high-dose melphalan in which ascorbic acid was administered close to bortezomib, the combination was safe and well tolerated, but produced no changes in response rates.(8) In another in vivo study in multiple myeloma patients, a regimen of ascorbic acid, bortezomib, and melphalan in which bortezomib was administered in the morning and ascorbic acid in the evening was found to be safe and efficacious, with 74% of patients responding to therapy.(9) |
BORTEZOMIB, BORUZU, VELCADE |
There are 1 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Deferoxamine/Ascorbic Acid (Vitamin C) SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: It is believed that ascorbic acid increases the iron available for chelation from an labile intracellular iron pool. Ascorbic acid may then facilitate iron-induced oxidative tissue damage.(1) CLINICAL EFFECTS: Dietary ascorbic acid may increase the absorption of dietary iron. Supplemental ascorbic acid therapy given during chelation therapy may improve iron output;(1-9) however, excessive dosages may result in cardiac toxicity from iron-induced oxidative tissue damage.(1,2,11-13) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Ascorbic acid intake is often restricted in patients with iron overload; however, it has been used in conjunction with deferoxamine to increase iron excretion.(2) Supplemental ascorbic acid therapy should only be initiated after one month of deferoxamine therapy. Ascorbic acid therapy should only be given in patients receiving deferoxamine regularly and the dose should be given after the infusion has started. The dosage of ascorbic acid should be limited to 50 mg daily in children under 10 years of age; 100 mg daily in older children; and 200 mg daily, in divided doses, in adults.(2) Cardiac function should be monitored in patients receiving concurrent therapy. Discontinue ascorbic acid therapy in patients who develop cardiac dysfunction.(2) DISCUSSION: Supplemental ascorbic acid therapy given during chelation therapy has been shown to improve iron output,(1-9) possibly by increasing iron available for chelation from an labile intracellular iron pool.(1) However, dosages in excess of 500 mg daily have been associated with cardiac dysfunction.(1,2,11-13) |
DEFEROXAMINE MESYLATE, DESFERAL MESYLATE |
The following contraindication information is available for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 1 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Hemolytic anemia from pyruvate kinase and g6PD deficiencies |
There are 3 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Calcium oxalate renal calculi |
| Glucose-6-phosphate dehydrogenase (g6Pd) deficiency |
| Hyperoxaluria |
There are 3 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Hemochromatosis |
| Kidney disease with reduction in glomerular filtration rate (GFr) |
| Sickle cell disease |
The following adverse reaction information is available for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 0 severe adverse reactions.
There are 12 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Abdominal pain with cramps Diarrhea Drowsy Fatigue Flushing Headache disorder Heartburn Hyperoxaluria Increased urinary frequency Insomnia Nausea Vomiting |
The following precautions are available for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for FLEVOXIN (ascorbic acid/rutin/hesperidin/bioflavonoid, lemon/rose hips)'s list of indications:
No ICD codes found for this drug.
No ICD codes found for this drug.
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