Chemical: Drug
vitamin c

PharmGKB contains no dosing guidelines for this . To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.


Annotated Labels

  1. FDA Label for vitamin c and G6PD
  2. HCSC Label for vitamin c and G6PD

last updated 12/18/2013

1. FDA Label for vitamin c and G6PD

Actionable PGx

Summary

MoviPrep, a solution containing Vitamin C, is a laxative used for colon cleansing in preparation for a colonoscopy. Because it contains Vitamin C (ascorbic acid), the label warns that hemolytic reactions are possible in those with G6PD deficiency.

Annotation

Although the Moviprep (polyethylene glycol 3350, sodium sulfate, sodium chloride, potassium chloride, ascorbic acid, sodium ascorbate) drug label does not specifically mention genetic testing, the FDA highlight information regarding G6PD deficient individuals within the Warnings and Precautions section.

Excerpt from the MoviPrep drug label:

Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. Since MoviPrep contains sodium ascorbate and ascorbic acid, MoviPrep should be used with caution in patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, especially G-6-PD deficiency patients with an active infection, with a history of hemolysis, or taking concomitant medications known to precipitate hemolytic reactions.

For the complete drug label text with sections containing pharmacogenetic information highlighted, see the Moviprep drug label.

*Disclaimer: The contents of this page have not been endorsed by the FDA and are the sole responsibility of PharmGKB.

Full label available at DailyMed

Genes and/or phenotypes found in this label

  • G6PD
    • toxicity, Warnings and precautions section
    • source: U.S. Food and Drug Administration

last updated 06/08/2015

2. HCSC Label for vitamin c and G6PD

Actionable PGx

Summary

MoviPrep, a solution containing Vitamin C, is a laxative used for colon cleansing in preparation for a colonoscopy. Because it contains Vitamin C (ascorbic acid), the label warns that hemolytic reactions are possible in those with G6PD deficiency.

Annotation

Excerpt from the MoviPrep (polyethylene glycol 3350, sodium sulphate anhydrous, sodium chloride, potassium chloride, ascorbic acid, sodium ascorbate) product monograph:

Ascorbic acid: Patients with Glucose-6-phosphate dehydrogenase deficiency may be at risk of acute haemolysis due to the presence of ascorbate.

For the complete product monograph text with sections containing pharmacogenetic information highlighted, see the MoviPrep product monograph.

*Disclaimer: The contents of this page have not been endorsed by HCSC and are the sole responsibility of PharmGKB.


PharmGKB contains no Clinical Variants that meet the highest level of criteria.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

? = Mouse-over for quick help

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for vitamin c

Gene ? Variant?
(147)
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available No VIP available VA G6PD A- 202A_376G N/A N/A N/A
No VIP available No Clinical Annotations available VA
G6PD deficiency N/A N/A N/A
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147

Overview

Generic Names
  • AA
  • Ascorbate
  • Ascorbic Acid
  • L-Ascorbate
  • L-Ascorbic Acid
  • L-Lyxoascorbic Acid
  • L-Xyloascorbic Acid
Trade Names
  • Adenex
  • Allercorb
  • Antiscorbic Vitamin
  • Antiscorbutic Vitamin
  • Arco-Cee
  • Ascoltin
  • Ascor-B.I.D.
  • Ascorb
  • Ascorbajen
  • Ascorbicab
  • Ascorbicap
  • Ascorbicin
  • Ascorbin
  • Ascorbutina
  • Ascorin
  • Ascorteal
  • Ascorvit
  • C-Level
  • C-Long
  • C-Quin
  • C-Span
  • C-Vimin
  • Cantan
  • Cantaxin
  • Catavin C
  • Ce Lent
  • Cebicure
  • Cebid
  • Cebion
  • Cebione
  • Cecon
  • Cee-Caps Td
  • Cee-Vite
  • Cegiolan
  • Ceglion
  • Celaskon
  • Celin
  • Cemagyl
  • Cemill
  • Cenetone
  • Cenolate
  • Cereon
  • Cergona
  • Cescorbat
  • Cetamid
  • Cetane
  • Cetane-Caps Tc
  • Cetane-Caps Td
  • Cetebe
  • Cetemican
  • Cevalin
  • Cevatine
  • Cevex
  • Cevi-Bid
  • Cevimin
  • Cevital
  • Cevitamic Acid
  • Cevitamin
  • Cevitan
  • Cevitex
  • Cewin
  • Ciamin
  • Cipca
  • Citriscorb
  • Colascor
  • Concemin
  • Davitamon C
  • Duoscorb
  • Hicee
  • Hybrin
  • IDO-C
  • Kyselina Askorbova
  • Laroscorbine
  • Lemascorb
  • Liqui-Cee
  • Meri-C
  • Natrascorb
  • Planavit C
  • Proscorbin
  • Redoxon
  • Ribena
  • Roscorbic
  • Scorbacid
  • Scorbu-C
  • Secorbate
  • Sodascorbate
  • Testascorbic
  • Vicelat
  • Vicin
  • Vicomin C
  • Viforcit
  • Viscorin
  • Vitace
  • Vitacee
  • Vitacimin
  • Vitacin
  • Vitamisin
  • Vitascorbol
  • Xitix
Brand Mixture Names

PharmGKB Accession Id

PA451898

Type(s):

Drug

Description

A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant.

Source: Drug Bank

Indication

Used to treat vitamin C deficiency, scurvy, delayed wound and bone healing, urine acidification, and in general as an antioxidant. It has also been suggested to be an effective antiviral agent.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

In humans, an exogenous source of ascorbic acid is required for collagen formation and tissue repair by acting as a cofactor in the posttranslational formation of 4-hydroxyproline in -Xaa-Pro-Gly- sequences in collagens and other proteins. Ascorbic acid is reversibly oxidized to dehydroascorbic acid in the body. These two forms of the vitamin are believed to be important in oxidation-reduction reactions. The vitamin is involved in tyrosine metabolism, conversion of folic acid to folinic acid, carbohydrate metabolism, synthesis of lipids and proteins, iron metabolism, resistance to infections, and cellular respiration.

Source: Drug Bank

Pharmacology

Ascorbic Acid (vitamin C) is a water-soluble vitamin indicated for the prevention and treatment of scurvy, as ascorbic acid deficiency results in scurvy. Collagenous structures are primarily affected, and lesions develop in bones and blood vessels. Administration of ascorbic acid completely reverses the symptoms of ascorbic acid deficiency.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic. Ascorbic acid is reversibly oxidised (by removal of the hydrogen from the enediol group of ascorbic acid) to dehydroascorbic acid. The two forms found in body fluids are physiologically active. Some ascorbic acid is metabolized to inactive compounds including ascorbic acid-2-sulfate and oxalic acid.

Source: Drug Bank

Protein Binding

25%

Source: Drug Bank

Absorption

70% to 90%

Source: Drug Bank

Half-Life

16 days (3.4 hours in people who have excess levels of vitamin C)

Source: Drug Bank

Chemical Properties

Chemical Formula

C6H8O6

Source: Drug Bank

Isomeric SMILES

C([C@@H]([C@@H]1C(=C(C(=O)O1)O)O)O)O

Source: OpenEye

Canonical SMILES

OC[C@H](O)[C@H]

Source: Drug Bank

Average Molecular Weight

176.1241

Source: Drug Bank

Monoisotopic Molecular Weight

176.032087988

Source: Drug Bank

SMILES

[H][C@@]1(OC(=O)C(O)=C1O)[C@@H](O)CO

Source: Drug Bank

InChI String

InChI=1S/C6H8O6/c7-1-2(8)5-3(9)4(10)6(11)12-5/h2,5,7-10H,1H2/t2-,5+/m0/s1

Source: Drug Bank

PharmGKB Curated Pathways

Pathways created internally by PharmGKB based primarily on literature evidence.

  1. Oxidative Stress Regulatory Pathway (Erythrocyte)
    A simplified diagram to show several of the regulatory mechanisms that prevent oxidative stress in red blood cells, many of which require NADPH from the Pentose Phosphate Pathway.
  1. Pentose Phosphate Pathway (Erythrocyte)
    A simplified diagram to show the role of G6PD in generating NADPH in red blood cells - this can then be utilized in the Oxidative Stress Regulatory and Methylene Blue Pathways.
  1. Uricosurics Pathway, Pharmacodynamics
    A stylized diagram of a renal proximal tubule cell to show the role of uricosuric drugs in preventing reabsorption of uric acid in human kidney.

External Pathways

Links to non-PharmGKB pathways.

  1. Catecholamines biosynthesis - (Reactome via Pathway Interaction Database)
  2. Norepinephrine Neurotransmitter Release Cycle - (Reactome via Pathway Interaction Database)
  3. Vitamin C (ascorbate) metabolism - (Reactome via Pathway Interaction Database)

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
ALKBH2 (source: Drug Bank)
ALKBH3 (source: Drug Bank)
BBOX1 (source: Drug Bank)
DBH (source: Drug Bank)
EGLN1 (source: Drug Bank)
EGLN2 (source: Drug Bank)
EGLN3 (source: Drug Bank)
KDM5D (source: Drug Bank)
LCT (source: Drug Bank)
LEPRE1 (source: Drug Bank)
LEPREL1 (source: Drug Bank)
LEPREL2 (source: Drug Bank)
OGFOD1 (source: Drug Bank)
OGFOD2 (source: Drug Bank)
P4HA1 (source: Drug Bank)
P4HTM (source: Drug Bank)
PAM (source: Drug Bank)
PHYH (source: Drug Bank)
PLOD1 (source: Drug Bank)
PLOD2 (source: Drug Bank)
PLOD3 (source: Drug Bank)
SLC23A1 (source: Drug Bank)
TMLHE (source: Drug Bank)

Drug Interactions

Interaction Description
indinavir - vitamin c Vitamin C decreases indinavir levels (source: Drug Bank)
vitamin c - deferoxamine Vitamin C may increase the adverse effects of deferoxamine. Transient deterioration of left ventricular function has been observed during concomitant therapy. Use caution during concomitant therapy. (source: Drug Bank)

Curated Information ?

Publications related to vitamin c: 10

No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
PharmGKB summary: uric acid-lowering drugs pathway, pharmacodynamics. Pharmacogenetics and genomics. 2014. McDonagh Ellen M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
PharmGKB summary: methylene blue pathway. Pharmacogenetics and genomics. 2013. McDonagh Ellen M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
PharmGKB summary: very important pharmacogene information for G6PD. Pharmacogenetics and genomics. 2012. McDonagh Ellen M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review. Drug safety : an international journal of medical toxicology and drug experience. 2010. Youngster Ilan, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Glucose-6-phosphate dehydrogenase deficiency. Lancet. 2008. Cappellini M D, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
100 years and counting: prospects for defeating Alzheimer's disease. Science (New York, N.Y.). 2006. Roberson Erik D, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Metoclopramide-induced methemoglobinemia in a patient with co-existing deficiency of glucose-6-phosphate dehydrogenase and NADH-cytochrome b5 reductase: failure of methylene blue treatment. Haematologica. 2001. Karadsheh N S, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Concise review: methemoglobinemia. American journal of hematology. 1993. Mansouri A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Ascorbic-acid-induced haemolysis in G-6-PD deficiency. Lancet. 1990. Mehta J B, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Letter: Ascorbic acid-induced hemolysis in G-6-PD deficiency. Annals of internal medicine. 1975. Campbell G D, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00126
ChEBI:
17208
KEGG Compound:
C00072
KEGG Drug:
D00018
PubChem Compound:
5785
PubChem Substance:
597821
Drugs Product Database (DPD):
583960
BindingDB:
50090256
Therapeutic Targets Database:
DNC000259

Clinical Trials

These are trials that mention vitamin c and are related to either pharmacogenetics or pharmacogenomics.

No trials found.

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Sources for PharmGKB drug information: DrugBank, PubChem.