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. 2019 Aug 23;11(9):1994.
doi: 10.3390/nu11091994.

Administration of Intravenous Ascorbic Acid-Practical Considerations for Clinicians

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Free PMC article

Administration of Intravenous Ascorbic Acid-Practical Considerations for Clinicians

Scott E Walker et al. Nutrients. .
Free PMC article

Abstract

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.

Keywords: administration; ascorbic acid; drug stability; sepsis.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Chromatogram A represents an 80 mg/mL solution of ascorbic acid (AA) after the addition of sodium hypochlorite, which resulted in degradation of AA, leaving 13.8% of the initial concentration. No degradation products are observed. To confirm specificity, meaning the ‘purity’ of the AA peak, the UV spectrum was compared to the UV spectra observed in a fresh authentic (undegraded) AA peak (overlayed spectra, similarity 99.97%). Chromatogram C represents a 77 mg/mL solution in normal saline (NS) on study day zero. Chromatogram B represents the same 77 mg/mL solution in NS after 10 days storage at room temperature. The observed percentage remaining was 93.36%.

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