Do You Know? - 03

Do You Know?

Paracetamol and Vitamin C @ Ascorbic Acid

Paracetamol is commonly used medication in daily life. 

Have a fever?

Pop a paracetamol. 

Have minor muscle ache? 

Paracetamol helps.

However, do you know that there is a possible drug interaction between paracetamol and high dose vitamin C @ ascorbic acid?

In 1970s, a study conducted revealed that high dose vitamin C (>3g) led to an increase in paracetamol concentration with concomitant ingestion of both products.

It was proposed that the increment in paracetamol concentration may be due to competition between paracetamol and vitamin C for sulphate pool in the body. Less parcetamol is being metabolized due to competitive inhibition of sulphate conjugation.

So what problem may arise from this ?

Patients who are taking daily dose of paracetamol, ie. Osteoarthritis patients, in conjunction with high dose vitamin C may have increased risk of paracetamol toxicity.

So, always remember to remind patient regarding this if they are taking high dose of daily vitamin C.

References:

Jaccob, A. A., Ahmed, Z. H., & Aljasani, B. M. (2019). Vitamin C, omega-3 and paracetamol pharmacokinetic interactions using saliva specimens as determiners. Journal of basic and clinical physiology and pharmacology, 30(5), 10.1515/jbcpp-2019-0011. 

Available from:

https://doi.org/10.1515/jbcpp-2019-0011

Houston, J. B., & Levy, G. (1976). Drug biotransformation interactions in man VI: acetaminophen and ascorbic acid. Journal of pharmaceutical sciences, 65(8), 1218–1221.

Available from: 

https://doi.org/10.1002/jps.2600650822