Wednesday 2 May 2018

High-dose intravenous vitamin C at home

I want to try to do a drop of high-dosage vitamin C at home.

In some studies, such solutions were used:
- Ascorbic acid MEGA-C-PLUS®, 500 mg / mL (25g / 50mL) from Merit Pharmaceuticals
(in the Riordan Clinic https://riordanclinic.org/research-study/vitamin-c-research-ivc-protocol)
- Ascorbic acid, 500 mg / mL (25g / 50mL) from Mylan Institutional, LLC NDC # 67457-118-50
- Ascorbic acid, 500 mg / mL (25g / 50mL) from McGuff Pharmaceuticals, Inc. Item # 008232
(in this study https://www.cell.com/cancer-cell/fulltext/S1535-6108(17)30062-4)
- Ascorbic acid, 500 mg / mL (25g / 50mL) from Bioniche Pharma (Rosemont IL)
(in this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260161/)

Maybe someone knows some kind of pharmacy or clinic in the US where I can buy (with a prescription) this ascorbic acid 500mg/ml?

1. In the protocol of the Riordan Clinic (https://riordanclinic.org/research-study/vitamin-c-research-ivc-protocol/) details how to dilute Ascorbic acid, 500 mg / mL.





2. This study also details how to prepare a solution of ascorbic acid 500 mg / ml:



3. Description of infusion in this study:
"For the first 2 IVC doses, the initial infusion rate was 0.5 g/min, starting at 15 g of vitamin C with an appropriate amount of carrier fluid (sterile water and ringer’s lactate, depending on the concentration of ascorbic acid infused). For the next 2 doses, 25 g of vitamin C was given at 0.5 g/min, with an appropriate amount of carrier fluid, with addition of 200 mg of magnesium chloride to prevent vascular spasm. For the subsequent 2 doses, 50 g of vitamin C was given at 0.5 g/min with an appropriate amount of carrier fluid and 200 mg of magnesium chloride. After the first 6 doses, 75 g of vitamin C was given at 0.5 g/min with an appropriate amount of carrier fluid and 200 mg of magnesium chloride. Vitamin C dosage was then increased to 100 g with 400 mg of magnesium chloride for patients with extremely aggressive tumors."

4. Description of infusion in this study:
"Vitamin C infusates were prepared using ascorbic acid 500 mg/mL for injection USP (supplied as single-use 50 mL glass ampules) as a gift from Alveda Pharma Canada, Ltd. The stock solution was diluted in sterile water to achieve an osmolarity of approximately 900 mOsm/L. Any air bubbles formed during preparation were promptly evacuated. The solutions were delivered to the clinical research unit covered by an opaque bag, allowed to come to ambient temperature, and infused by calibrated infusion pump within one hour of preparation. Water and other drinks (preferably sugar-free) were provided and the patients encouraged to consume them freely before, during and after IVC infusions. The dose of vitamin C was 1.5 g/kg body weight when the body mass index (BMI) was 30 kg/m2 or less, and normalized to the body weight corresponding to BMI 24 kg/m2 for patients with a BMI > 30. The vitamin was infused at a constant rate over a period of 90 minutes for doses up to 90 g, and over a period 120 minutes for doses > 90 g."
"When the dose is less than 15 g the stock solution is diluted with lactated Ringer’s to guarantee sufficiently high osmolality to permit intravenous administration. When the dose is equal to or greater than 15 g, the infusate is brought to the required concentration using sterile water to achieve an osmolality between 500 and 900 mOsm/L. The osmolality maybe calculated from the molecular weight of AA assuming it is completely dissociated in aqueous solution. Examples are given as follows.
15 g (30 mL stock qs 300 mL using sterile water): 570 mOsm/L.
30 g (60 mL stock qs 500 mL using water): 684 mOsm/L.
60 g (120 mL stock qs 900 mL using water): 760 mOsml/L.
70 g (140 mL stock qs 1100 mL using water): 725 mOsml/L.
80 g (160 mL stock qs 1100 mL using water): 829 mOsml/L.
90 g (180 mL stock qs 110 mL using water): 933 mOsml/L.
100 g (200 mL stock qs 1200 mL using water): 950 mOsml/L.
110 g (220 mL stock qs 1400 mL using water): 896 mOsml/L.
120 g (240 mL stock qs 1400 mL using water): 977 mOsml/L.
130 g (260 mL stock qs 1600 mL using water): 926 mOsml/L.
140 g (280 mL stock qs 1800 mL using water): 887 mOsml/L.
 Intravenous infusions are administered via a peripheral or central intravenous catheter at a rate of 0.5 g/minute to approximately 1 g/minute, and not usually faster than approximately 1 g/minute. At the dose of 1.5 g/kg an infusion will typically last 105 minutes."

5. https://pdfs.semanticscholar.org/864a/c9c15a0d529702662135020d5b1323dab276.pdf?_ga=2.149448115.464894850.1525286351-1963972769.1523462509
"In this study, we used MEGA-C-ACID PLUS® (500 mg/ml, Merit Pharmaceuticals, Los Angeles, California). This source of AA was used because other clinical preparations in Japan contained preservatives, and there was no data regarding the safety of these substances when administrated at high doses.
AA was given through a central vein catheter on days 7, 9, 11, 14, 16, and 18 during the 2nd course of the CHASER regimen (Fig. 1). A small test dose of 15 g AA in 250 ml Ringer's lactate solution was administered at a rate of 0.5 g/min on day 7, and then 75 g of AA dissolved in 1,000 ml of distilled water was administered at a rate of 1 g/min on each of the other days listed above.
In order to prevent hypocalcemia due to the chelating effect of AA, 0.5 g magnesium sulfate was added to every 500 ml of AA solution."

6. https://link.springer.com/article/10.1007%2Fs00280-013-2179-9
Phase I clinical trial to evaluate the safety, tolerability, and pharmacokinetics of high-dose intravenous ascorbic acid in patients with advanced cancer.
"The solution to be infused contained the appropriate amount of ascorbic acid in sterile water for injection with calcium chloride, magnesium chloride, and potassium chloride.
Incipient changes during the study: the concentrations of calcium and magnesium in the infusion solution were reduced to the same concentrations that appear in blood (5 and 2 mEq/L, respectively). In addition, potassium was lowered to 16.7 mEq/L, which delivers 10 mEq/h, an infusion rate that is considered safe for all patients. Ascorbic acid remained at 100 g/L and was infused at 1 g/min."
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In the American clinic Riordan, as seen from the attached table, 75 grams of ascorbic acid is diluted with 750cc of sterile water (probably this is water for injections). But why is the final volume 750cc? Can anyone help to understand the string from the table, for example about 75 grams?
* cc = cubic centimeter

14 comments:

  1. Have you looked for clinics offering intravenous vitamin C/ascorbic acid therapy close to you? Such clinics do exist in North America. Trying intravenous injections at home sounds a bit risky unless you have an experienced nurse to assist.

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    2. You're right, Stephen. It's a very big risk to do it all (like a cocktail of medicines) by yourself. But there is not a single doctor who can participate in this. Russian oncologists (even the most expensive !!!) offer only standard options (Stupp or Avastin + Irinotecan protocol). I'm very scared to do what we do.

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    3. I wasn't aware you were already doing home intravenous injections with a nurse.

      Intravenous DCA was described in one small study from Medicor Cancer Center in Canada:

      http://alternative-therapies.com/at/web_pdfs/s202khan.pdf

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  3. It is interesting, from what dose of intravenous vitamin C (in grams) begin proaxidant (and not anxidant) properties of vitamin C?

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    1. Refer to this study:
      https://www.ncbi.nlm.nih.gov/pubmed/17502596
      Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo.

      See figure 4C and 4D in the PDF (page 4). Significant generation of hydrogen peroxide (H2O2) in extracellular fluid required ascorbate radical concentrations above 100 nanomolar (nM) in the extracullular fluid (figure 4C), but high levels of hydrogen peroxide required ascorbate radical concentration of over 200 nM in extracellular fluid.

      In figure 4D, high levels of hydrogen peroxide required ascorbic acid concentrations of 8 millimolar (mM) in extracullular fluid.

      In figure 2C, 8 mM of ascorbic acid in extracellular fluid corresponded to about 5 mM in plasma.

      However, this same study says that hydrogen peroxide (H2O2) concentrations of at least 25 micromolar were toxic to cancer cells in vitro, which means even higher plasma levels of ascorbic acid than 5 mM might be required.

      The target plasma ascorbate concentration in the 2017 clinical trial was 20 mM (Schoenfeld 2017).


      See also
      Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice
      https://www.ncbi.nlm.nih.gov/pubmed/18678913

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    2. Thank you, Stephen.
      Yesterday, with great excitement after many letters to European doctors and analysis of all practices, we started using high-dose intravenous drops of vitamin C from European Pascorbin. If everything works out, I'll write a report about it.

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    3. Thanks for input, I hope it works out!

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  4. Published results of the study for 4 patients: Temozolomide and Ascorbic Acid in Treating Patients With Recurrent High-Grade Glioma.
    But I can not quite understand the results ...

    https://clinicaltrials.gov/ct2/show/results/NCT02168270

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    1. The "results" for this trial is that there were no results. It was a trial designed to find the maximum tolerated dose and safety of ascorbic acid, but no patients were evaluable for these endpoints or secondary endpoints because all four had early disease progression, and so the study was terminated.

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  5. Not an encouraging study (2018):

    http://www.turkishneurosurgery.org.tr/pdf/pdf_JTN_1956.pdf
    https://www.ncbi.nlm.nih.gov/pubmed/28191621

    "Ascorbic acid decreases the cytotoxic and genotoxic effect
    of the etoposide and etoposide-temozolomide combination,
    but it has no meaningful effect on temozolomide’s toxicity."

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  6. Hi. I ordered my ascorbic acid on amazon or Ebay. It is advertised for oral. But they said it is the same thing as what they use for IVs.

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  7. I believe the reason the total volume is 750 is because the equivalent of what is added to the bag (i.e., vit. C added, magnesium chloride added, etc.) is withdrawn from the bag medium (e.g., sterile water).

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