Background Vitamin C is perceived by the public as a “miracle-pill” capable to heal various illnesses, even cancer. Several in vitro and in vivo studies suggest that ascorbic acid in pharmacologic concentration exerts anticancer effect, however current clinical evidence (mainly based on case studies) about the therapeutic effect of high-dose intravenous (iv.) vitamin C is ambiguous.
Purpose One of our oncology patients who refused further chemotherapy required and was given vitamin C intravenous treatment. The aim of this study was to investigate the role of the clinical pharmacist in the preparation of the high dose vitamin C infusion.
There are two methods to prepare the infusion: diluting from a registered iv. product or preparing parenteral medication from the active ingredient. Although we used the first method (registered product), we decided to investigate the second method as an alternative for future patients. We collected data about the stability of ascorbic acid in different solutions, the technology of the preparation, the quality control and the storage of the infusion.
Material and methods Two different methods of preparation of concentrates for infusion were examined and compared. Both solutions were diluted aseptically to the concentration of 3 m/V % which was the highest concentration that can be administered to the patient.
After diluting with different vehicles at different pH, the concentration of the active ingredient in the solutions was measured after the preparation and after storing at different temperatures.
Results Concentrates must be filtered instead of sterilisation. The stability of ascorbic acid was mainly affected only by two conditions (pH, temperature). Ascorbic acid was more stable in the pH range of 4.0–5.0°C and in frozen condition.
Conclusion Results from my study can help in establishing a standard formula and recommendations on preparing a stable ascorbic acid concentrate for infusion in hospital pharmacies which have a sterile compounding license.
References and/or acknowledgements No conflict of interest.
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