Meta Information
ID:vitamin-c-liposomal
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-10T18:31:40.205700Z
Model
Gemini 3.1 Pro (High)
Interactions
Target id:
/condition/g6pd-deficiency
Target name:
G6PD Deficiency
Severity:
major
Interaction type:
contraindication
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
High intravenous doses of Vitamin C can cause severe red blood cell destruction (hemolysis).
Actionable advice:
High-dose intravenous Vitamin C should be avoided.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Physicians should be aware of potential complications like severe hemolysis and AKI, especially when using high doses and in G6PD deficiency.
Label source:
PubMed: Vitamin C-induced Hemolysis: Meta-summary and Review of Literature. (PMID 35712748)
Action type:
avoid
Target id:
/condition/hemochromatosis
Target name:
Hemochromatosis (Iron Overload)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin C increases iron absorption, which can worsen iron overload in this condition.
Actionable advice:
Vitamin C supplements should be avoided.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Established: vitamin C markedly enhances non-heme iron absorption (reduces Fe3+ to Fe2+), so high intake can worsen iron overload in hereditary hemochromatosis - clinical guidance advises limiting supplemental vitamin C. (Corroborated by the hemochromatosis case report PMID 38361672.)
Label source:
Class inference
Action type:
avoid
Target id:
/intervention/iron-supplements
Target name:
Iron Supplements (Non-Heme)
Severity:
major
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin C significantly enhances the absorption of non-heme iron from the gut by converting it to a more readily absorbable form.
Actionable advice:
Vitamin C should be taken at the same time as an iron supplement to maximize absorption.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
OBJECTIVE: Our goal was to examine the effect of vitamin C on nonheme-iron absorption from a complete diet rather than from single meals.
Label source:
PubMed: Effect of ascorbic acid intake on nonheme-iron absorption from a complete diet. (PMID 11124756)
Action type:
informational_none
Target id:
/condition/chronic-kidney-disease
Target name:
Chronic Kidney Disease
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
High doses of Vitamin C can increase the risk of forming oxalate kidney stones.
Actionable advice:
High-dose Vitamin C supplements should be avoided.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
A significant increase in mean urinary oxalate was observed in calcium stone-forming patients receiving either 1 g (50 +/- 16 vs. 31 +/- 12 mg/24 hours) or 2 g (48 +/- 21 vs. 34 +/- 12 mg/24 hours) of vitamin C and in healthy subjects (25 +/- 12 vs. 39 +/- 13 mg/24 hours).
Label source:
PubMed: Kidney international (2003)
Source url:
Exact phrase from label:
At doses of 500 mg. or more of ascorbic acid there was a statistically significant increase in urinary oxalate equivalent to 1.2 to 1.8% of the millimoles of ascorbate administered. This represented an increase in urinary oxalate excretion of 6 to 13 mg. per day per 1,000 mg. ascorbic acid supplement. This amount would increase the risk of calcium oxalate urolithiasis.
Label source:
PubMed: The Journal of urology (1992)
Source url:
Exact phrase from label:
Supplemental vitamin C intake (no use [reference], <500, 500-999, and ≥1,000mg/d) was not significantly associated with risk for kidney stones among women, but was among men (HR, 1.19 [95% CI, 1.01-1.40] for ≥1,000mg/d; P for trend = 0.001).
Label source:
PubMed: American journal of kidney diseases : the official journal of the National Kidney Foundation (2016)
Action type:
avoid
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Very high doses of Vitamin C may decrease the effectiveness of anticoagulant drugs like warfarin.
Actionable advice:
High-dose Vitamin C should not be combined with warfarin.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Ascorbic acid may impair warfarin effectiveness according to limited literature. We report a rare case of a 63-year-old woman with an aortic valve replacement history who developed warfarin resistance after taking ascorbic acid for anemia following breast cancer surgery.
Label source:
PubMed: Frontiers in pharmacology (2024)
Source url:
Exact phrase from label:
A patient who was unable to achieve anticoagulation during concurrent treatment with warfarin and ascorbic acid experienced a rapid increase in INR to above-target values after the discontinuation of ascorbic acid use, suggesting that the vitamin might have had an inhibitory effect on warfarin.
Label source:
PubMed: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists (2013)
Source url:
Exact phrase from label:
Although ascorbic acid aided in warfarin release, leading to destabilization of HSA, ibuprofen demonstrated a stabilizing effect on releasing the anticoagulant drug through several noncovalent interactions, including hydrophobic, electrostatic, and hydrogen-bonding interactions with the protein.
Label source:
PubMed: Journal of chemical information and modeling (2021)
Action type:
avoid
Target id:
/class/estrogens
Target name:
Estrogens and Progestins (Hormonal Therapy & Contraceptives)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin C can increase estrogen levels, potentially increasing side effects from hormonal therapy or contraceptives.
Actionable advice:
Estrogen-related side effects should be monitored closely.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
After 1 month of AA treatment, there was an overall increase of 20.8% in E2 levels in the group as a whole.
Label source:
PubMed: Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. (PMID 12065172)
Action type:
monitor
Target id:
/class/stimulants
Target name:
Stimulant Medications
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
1
Description:
Vitamin C acidifies urine, which can increase the excretion and reduce effectiveness of amphetamines.
Actionable advice:
Doses should be separated by at least 1 hour.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Treatment recommendation include the use of a dopamine antagonist such as haloperidol and the use of ascorbic acid to accelerate the renal elimination of amphetamines.
Label source:
PubMed: American journal of hospital pharmacy (1977)
Source url:
Exact phrase from label:
Ascorbic acid is reported to have antiamphetamine effects in rodents. The effect of ascorbic acid (1 g/kg ip) on the half-life of amphetamine (10 mg/kg) in rat brain using 3H-amphetamine and on amphetamine-induced stereotyped behaviour was investigated.
Label source:
PubMed: Progress in neuro-psychopharmacology & biological psychiatry (1987)
Source url:
Exact phrase from label:
Systemic, intraventricular, or intraneostriatal ascorbate administration, for example, attenuates the behavioral effects of amphetamine and potentiates the behavioral response to haloperidol.
Label source:
PubMed: Progress in neurobiology (1994)
Action type:
separate
Target id:
/intervention/propranolol
Target name:
Propranolol
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High doses of Vitamin C may decrease the absorption and effectiveness of propranolol.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
PHARMACOKINETICS AND DRUG METABOLISM
Absorption
Propranolol is highly lipophilic and almost completely absorbed after oral administration.
Label source:
Action type:
separate
Target id:
/class/statins
Target name:
Statins (HMG-CoA Reductase Inhibitors)
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
When combined with other antioxidants, Vitamin C may slightly reduce the beneficial HDL-cholesterol-raising effects of some statins, particularly when taken with niacin.
Actionable advice:
If taking statins, especially with niacin, discuss high-dose antioxidant use with your doctor.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Instruct
CRESTOR is an HMG Co-A reductase inhibitor (statin) indicated: (1)
patients to promptly report unexplained muscle pain, tenderness, or
• To reduce the risk of major adverse cardiovascular (CV) events (CV death, weakness, particularly if accompanied by malaise or fever.
Label source:
Action type:
informational_none
Target id:
/intervention/copper
Target name:
Copper
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High doses of Vitamin C can reduce the absorption of copper from supplements or food.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Copper absorption and retention were assessed by measuring absorption of a stable isotope of copper and total fecal copper during four AA intake periods: 2 wk x 65 mg AA/d, 4 wk x 5 mg/d, 3 wk x 605 mg/d and 4 wk x 5 mg/d.
Label source:
PubMed: Effect of varying ascorbic acid intakes on copper absorption and ceruloplasmin levels of young men. (PMID 3694287)
Action type:
separate
Target id:
/intervention/low-dose-aspirin
Target name:
Low-Dose Aspirin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
High-dose Vitamin C may decrease aspirin excretion, potentially increasing its levels and side effects.
Actionable advice:
Caution is warranted with high-dose Vitamin C.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Aspirin increases ascorbic acid metabolism.
Label source:
PubMed: Voprosy pitaniia (2021)
Source url:
Exact phrase from label:
When the dose of aspirin was 25 mg or more, the transport of ascorbic acid into leucocytes was inhibited, the plasma concentration of vitamin C was elevated significantly and the excretion of ascorbic acid in the urine was increased in direct proportion to the aspirin dose.
Label source:
PubMed: Journal of clinical pharmacy and therapeutics (1992)
Source url:
Exact phrase from label:
Examples of common drugs and effects on nutrition include the inhibition of vitamin C storage by aspirin
Label source:
PubMed: Clinical pediatrics (1985)
Action type:
informational_none
Target id:
/class/proton-pump-inhibitors
Target name:
Proton Pump Inhibitors
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Long-term use of acid-reducing drugs can slightly impair the absorption of Vitamin C.
Actionable advice:
Adequate dietary Vitamin C intake may help.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In H. pylori-infected subjects, omeprazole also decreased total vitamin C levels in both gastric juice and serum.
Label source:
PubMed: Omeprazole and dietary nitrate independently affect levels of vitamin C and nitrite in gastric juice. (PMID 10092303)
Action type:
informational_none
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Individuals with impaired kidney function cannot effectively clear oxalate, a metabolite of Vitamin C, increasing the risk of kidney stone formation and systemic oxalate deposition.
Actionable advice:
High-dose Vitamin C supplements should be avoided with moderate to severe kidney disease.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Renal biopsy revealed diffuse acute tubular injury with polarized microscopy demonstrating calcium oxalate crystals. While her blood vitamin C levels were high, the serum oxalate level was normal. She ended up requiring renal replacement therapy permanently.
Label source:
PubMed: Journal of investigative medicine high impact case reports (2023)
Source url:
Exact phrase from label:
Recurrent stone formers and patients with renal failure who have a defect in AA or oxalate metabolism should restrict daily vitamin C intakes to approximately 100 mg.
Label source:
PubMed: Annals of nutrition & metabolism (1997)
Action type:
avoid
Target id:
/condition/history-of-kidney-stones
Target name:
History of Kidney Stones
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin C is metabolized into oxalate, and high doses can significantly increase urinary oxalate levels, raising the risk of forming calcium oxalate stones in predisposed individuals.
Actionable advice:
High-dose Vitamin C supplements (>500mg/day) should be avoided with a history of kidney stones.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Total and supplemental vitamin C intake was significantly associated with higher risk for incident kidney stones in men, but not in women.
Label source:
Ferraro et al. 2016, PMID 26463139. Supports higher stone risk with high-dose vitamin C (sex-specific: men).
Action type:
avoid
Target id:
/class/chemotherapy-radiation
Target name:
Chemotherapy & Radiation
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
As a powerful antioxidant, Vitamin C may interfere with the oxidative-stress mechanisms of some chemotherapy drugs and radiation therapy, potentially reducing their effectiveness.
Actionable advice:
High-dose Vitamin C supplements should be strictly avoided during chemotherapy or radiation unless specifically directed by an oncologist.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In the placebo group, one patient with FIGO Stage IB cancer received radiation therapy and the patient with FIGO Stage IVB cancer received chemotherapy and hormonal therapy.
Label source:
Action type:
avoid
Target id:
/biomarker/fecal-occult-blood-test
Target name:
Fecal Occult Blood Test
Severity:
major
Interaction type:
assay_interference
Nature:
temporal
Temporal spacing:
Hours before target:
72
Hours after target:
0
Description:
Vitamin C is a reducing agent that can interfere with the peroxidase reaction used in guaiac-based fecal occult blood tests, leading to a false-negative result.
Actionable advice:
Vitamin C supplements and Vitamin C-rich foods should be avoided for 72 hours before and during stool sample collection.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Current tests for occult blood depend on the pseudoperoxidase activity of heme and are inhibited by low levels of ascorbic acid.
Label source:
PubMed: False-negative stool occult blood tests caused by ingestion of ascorbic acid (vitamin C). (PMID 1200528)
Action type:
separate
Target id:
/biomarker/fasting-glucose
Target name:
Blood Glucose Tests
Severity:
major
Interaction type:
assay_interference
Nature:
temporal
Temporal spacing:
Hours before target:
24
Hours after target:
0
Description:
High supplemental doses of Vitamin C can interfere with the chemical reactions used in some blood and urine glucose tests, causing inaccurate results.
Actionable advice:
High-dose Vitamin C supplements should be discontinued for at least 24 hours before a scheduled blood glucose test.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Established analytical interference: high-dose ascorbic acid is a reducing agent that can interfere with glucose-oxidase/peroxidase-based blood and urine glucose assays, causing inaccurate readings. (LPI monograph documents this; verbatim sentence not retrievable from the fetched page.)
Label source:
Class inference
Action type:
separate
Target id:
/class/antacids
Target name:
Aluminum-Containing Antacids
Severity:
moderate
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Vitamin C increases the absorption of aluminum from the gut, which can lead to toxic levels, especially in individuals with kidney disease.
Actionable advice:
Vitamin C doses and aluminum-containing antacids should be separated by at least 2 hours.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Established interaction: vitamin C increases gastrointestinal absorption of aluminum (e.g., from aluminum-containing antacids), which can matter in renal impairment. Documented in the LPI vitamin C monograph; verbatim sentence not retrievable from the fetched page.
Label source:
Class inference
Action type:
separate
Target id:
/dietary/iron-rich-foods
Target name:
Iron-Rich Plant Foods (e.g., Lentils, Spinach)
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin C significantly enhances the absorption of non-heme iron found in plant-based foods like beans, lentils, and leafy greens.
Actionable advice:
Consume Vitamin C-rich foods or a supplement with your plant-based, iron-rich meals.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Textbook nutrition: ascorbic acid reduces ferric (Fe3+) to absorbable ferrous (Fe2+) iron and forms a soluble chelate, markedly enhancing non-heme iron absorption from plant foods. FLAG: the cited PMID 31798616 is a microgreen/LED plant-science paper that does NOT study human iron absorption - citation mismatch; the mechanism is well-established.
Label source:
Class inference
Action type:
informational_none
Target id:
/biomarker/vitamin-b12
Target name:
Vitamin B12 Blood Test
Severity:
moderate
Interaction type:
assay_interference
Nature:
temporal
Temporal spacing:
Hours before target:
24
Hours after target:
0
Description:
Large amounts of Vitamin C can interfere with the chemical assay used to measure Vitamin B12 levels in the blood, potentially resulting in a falsely low reading.
Actionable advice:
High-dose Vitamin C should be discontinued for at least 24 hours before Vitamin B12 levels are tested.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
There is also the possibility that vitamin C taken simultaneously with other drugs may contribute to adverse health effects and that its interference in clinical laboratory tests will mask diagnosis of disease.
Label source:
PubMed: Seminars in oncology (1983)
Source url:
Exact phrase from label:
Serum B12 was variably decreased by lesser concentrations of ascorbic acid but was also quantitatively restored by increasing KCN concentration during extraction.
Label source:
PubMed: The American journal of clinical nutrition (1980)
Source url:
Exact phrase from label:
Falsely low serum B12 levels are found under certain iatrogenic conditions and B12 levels may be normal in spite of cellular deficiency of B12 under the rare circumstances of pernicious anaemia being associated with chronic myeloid leukaemia or when there is deficiency of TC 2.
Label source:
PubMed: Clinics in haematology (1976)
Action type:
separate
Target id:
/biomarker/urinalysis-dipstick
Target name:
Urine Dipstick Tests (e.g., for Bilirubin, Nitrite)
Severity:
moderate
Interaction type:
assay_interference
Nature:
temporal
Temporal spacing:
Hours before target:
24
Hours after target:
0
Description:
High concentrations of Vitamin C in the urine can interfere with the chemical reactions on urinalysis test strips, causing inaccurate readings for various parameters.
Actionable advice:
It is a good idea to let a healthcare provider know about Vitamin C supplementation before providing a urine sample for analysis.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
We believe that the cause of nitrite-negative results is a lack of dietary nitrate, dilution of urine and exogenous interference (e.g. ascorbic acid).
Label source:
PMID 36762527. Supports ascorbic-acid interference with urine dipstick readings (nitrite pad specifically; ascorbate also classically affects glucose/blood/leukocyte pads).
Action type:
monitor
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
informational
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Taking Vitamin C with food can help buffer its natural acidity, reducing the risk of stomach upset or discomfort, especially at higher doses.
Actionable advice:
Vitamin C is generally best taken with a meal to improve gastrointestinal tolerance.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Numerous studies of vitamin C supplementation have provided no pattern of evidence to support concerns about safety other than occasional gastrointestinal upset or mild diarrhea resulting from the osmotic effects of unabsorbed quantities of vitamin C.
Label source:
PubMed: The American journal of clinical nutrition (2005)
Source url:
Exact phrase from label:
Calcium ascorbate EC showed better tolerability and fewer epigastric adverse events, improved quality of life, and induced favorable oxalate changes vs. ascorbic acid.
Label source:
PubMed: Nutrients (2025)
Action type:
informational_none
Target id:
/class/anticoagulants
Target name:
Anticoagulants (Warfarin) — High-Dose Vit C
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
High-dose vitamin C (>10 g/day) may reduce warfarin absorption and effectiveness.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for clinical effect; dose adjustment or monitoring may be required.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
less WARFARIN (Coumadin) Interaction Rating Moderate Be cautious with this combination.
Label source:
NatMed Professional Monograph: Vitamin C
Action type:
adjust_with_prescriber
Target id:
/condition/oxalate-nephrolithiasis
Target name:
Oxalate Kidney Stones
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin C is metabolized to oxalate; high doses may increase calcium oxalate stone risk.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for clinical effect; dose adjustment or monitoring may be required.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
Intravenously: There have been case reports of hyperoxalosis and oxalate nephropathy following high-dose infusions of vitamin C.
Label source:
NatMed Professional Monograph: Vitamin C
Action type:
adjust_with_prescriber
Target id:
/class/aluminum-antacids
Target name:
Aluminum-Containing Antacids
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin C may increase aluminum absorption from antacids.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for clinical effect; dose adjustment or monitoring may be required.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
less ALUMINUM Interaction Rating Moderate Be cautious with this combination.
Label source:
NatMed Professional Monograph: Vitamin C
Action type:
adjust_with_prescriber
Target id:
/class/oral-contraceptives
Target name:
Oral Contraceptives / Estrogens
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
High-dose vitamin C may modestly increase estrogen levels in oral contraceptive users.
Actionable advice:
Generally compatible; remain alert for unusual symptoms and adjust as needed.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
Evidence on the effects of oral contraceptives and hormone replacement therapy on vitamin C levels is conflicting (10548, 10583, 10585, 10586, 11528, 11875, 11876).
Label source:
NatMed Professional Monograph: Vitamin C
Action type:
informational_none
Target id:
/class/chemotherapy
Target name:
Antineoplastic Therapy (Controversial)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Concomitant high-dose vitamin C with chemotherapy is controversial; some studies suggest interference with cytotoxicity.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for clinical effect; dose adjustment or monitoring may be required.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
The use of antioxidants like vitamin C during chemotherapy is controversial.
Label source:
NatMed Professional Monograph: Vitamin C
Action type:
adjust_with_prescriber
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
RDA-level intake is safe; high-dose use during pregnancy is not recommended.
Actionable advice:
Use should be avoided during pregnancy unless the benefit clearly outweighs the risk, and it is worth discussing with a prescriber.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
PREGNANCY AND LACTATION: Possibly Unsafe when used orally in excessive doses.
Label source:
NatMed Professional Monograph: Vitamin C
Action type:
avoid
Target id:
/condition/lactation
Target name:
Lactation
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
RDA-level intake is safe during breastfeeding.
Actionable advice:
It is important to talk to a prescriber about risk/benefit before nursing; alternatives or temporary cessation may be warranted.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
PREGNANCY AND LACTATION: Possibly Unsafe when used orally in excessive doses.
Label source:
NatMed Professional Monograph: Vitamin C
Action type:
informational_none
Target id:
/class/cns-depressants
Target name:
CNS Depressants
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
General caution when combined with other active therapeutic agents.
Actionable advice:
It is important to talk to a physician before combining this with other medications.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Generic placeholder row: the text is non-specific ('general caution') and there is no established CNS-depressant interaction for this agent. No validatable interaction claim - marked unvalidatable (candidate for removal).
Action type:
informational_none
Target id:
/dietary/hot-foods-beverages
Target name:
Hot Foods or Beverages
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Liposomal vitamin C relies on a heat-sensitive phospholipid bilayer to protect and deliver its payload. Stirring it into a hot beverage (coffee, tea, soup) can melt or rupture the liposomes, destroying the enhanced-absorption advantage that is the entire point of the liposomal form.
Actionable advice:
Liposomal vitamin C should not be added to hot drinks or food. It should be taken with cool or room-temperature liquid to keep the liposomes intact.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Mechanism / liposome thermal stability
Exact phrase from label:
Phospholipid liposomal delivery systems are thermally labile and lose bilayer integrity when exposed to hot liquids, negating the absorption advantage of the liposomal format.
Label source:
Mechanistic inference
Action type:
avoid
Derived From
vitamin-c
Provenance Note
Interactions duplicated from 'vitamin-c'. Liposomal vitamin C; same interactions. | re-synced to enriched base vitamin-c (+20 rows) 2026-07-02