Here is an excellent .pdf file on Vit C intravenous protocols:
http://www.doctoryourself.com/RiordanIVC.pdfSome Highlights from this website:
Quote:
Precautions and side effects:
1. In our 25 years of clinical experience giving over 40,000 onsite IVC treatments, the side-effects
of high-dose IVC are rare. However, there are precautions and potential side-effects to consider.
2. The danger of diabetics on insulin incorrectly interpreting their glucometer finger stick has already
been mentioned. Diabetics wishing to know their blood sugar must have blood drawn from a vein
and run in the laboratory using the hexokinase glucose determination method.
3. Tumor necrosis or tumorlysis syndrome has been reported in one patient after high-dose IVC. For
this reason, the protocol always begins with a small 15 gram dose (see Administration below).
4. Acute oxalate nephropathy (kidney stones) was reported in one patient with renal insufficiency
who received a 60 gram IVC. Adequate renal function, hydration, and urine voiding capacity must
be documented prior to starting high-dose IVC therapy. In our experience, however, the incidence
of calcium oxalate stones during or following IVC is negligible.
5. Hemolysis has been reported in patients with G6PD deficiency when given high-dose IVC. The
G6PD level should be assessed before beginning IVC. (At our Center, G6PD readings have yieldedadverse effects.)
6. IV site irritation may occur at the infusion site when given in a vein and not a port. This can be
caused by an infusion rate exceeding 1.0 gram/minute. The protocol suggests adding magnesium to
reduce the incidence of vein irritation and spasm.
7. Due to the chelating effect of IVC, some patients may complain of shakiness due to low calcium
or magnesium. An additional 1.0 mL of MgCl added to the IVC solution will usually resolve this.
If severe, it can be treated with an IV push of 10 mL’s of calcium gluconate, 1.0 mL per minute.
Eating before the IVC infusion is recommended to help reduce blood sugar fluctuations.
8. Given the amount of fluid used as a vehicle for the IVC, any condition that could be adversely
affected by fluid or sodium overload (the IV ascorbate is buffered with sodium hydroxide and
bicarbonate) is a relative contraindication; i.e. congestive heart failure, ascites, edema, etc.
9. There have been some reports of iron overload with vitamin C therapy. We have treated one
patient with hemochromatosis with high-dose IVC with no adverse effects or significant changes in
the iron status.
10. As with any I.V. infusion, infiltration at the site is possible. This is usually not a problem with
ports. Our nursing staff has found that using #23 Butterfly needles with a shallow insertion is very
reliable with rare infiltrations (depending upon the status of the patient’s veins!)
11. IVC should only be given by slow intravenous drip at a rate of 0.5 grams per minute. (Rates up to
1.0 gram/minute are generally tolerable, but close observation is warranted. Patients can develop
nausea, shakes, and chills.) It should never be given as an IV push, as the osmolality at high doses
may cause sclerosing of peripheral veins, nor should it be given intramuscularly or subcutaneously.
12. Table 1 lists the calculated osmolality of various amounts of fluid volume. Our experience has
found that an osmolality of less than 1200 mOsm/kg H2O is tolerated by most patients. A low
infusion rate (0.5 grams IVC per minute) also reduces the tonicity, although up to 1.0 grams per
minute can be used in order to achieve higher post IVC saturation levels. (Pre and post serum
osmolality measurements are advisable at this dose.)
13. We presently use a sodium ascorbate solution, MEGA-C-PLUS®, 500 mg/mL, pH range 5.5-7.0
from Merit Pharmaceuticals, Los Angeles, CA, 90065.
Administration of IVC:
1. Having taken all precautions listed above and having obtained informed consent from the patient,
the administering physician begins with a series of three consecutive IVC infusions at the 15, 25,
and 50 gram dosages followed by post IVC plasma vitamin C levels in order to determine the
oxidative burden for that patient so that subsequent IVCs can be optimally dosed.
2. The Riordan IVC Protocol dosing schedule depicted above has served as a “safe start” for cancer
patients new to IVC. For the past 25 years The Center for the Improvement of Human Functioning
International in Wichita, Kansas, has administered over 40,000 onsite IVC infusions according to
this protocol. Zero fatalities and rare side effects attest to its remarkable safety.
3. The initial three infusions are monitored with post IVC infusion plasma vitamin C levels. As noted in the Treatment Rationale section above, research and experience has shown that a therapeutic goal of 350-400 mg/dL is most efficacious. (No increased toxicity for post IVC plasma vitamin C levels up to 780 mg/dL has been observed, but no additional clinical benefit has been gained.)
4. The first post IVC plasma level following the 15 gram IVC has been shown to be clinically instructive: levels below 100 mg/dL correlate with higher levels of existent oxidative stress, presumably from higher tumor burden, chemo/radiation damage, hidden infection, or other oxidative insult, such as smoking.
5. Following the first three IVCs, the patient can be scheduled to continue either a 25 or 50 gram IVC dose (doctor’s discretion) twice a week until the post IVC plasma level results are available from the lab.
6. If the initial 50 gram post IVC level did not reach the therapeutic range of 350-400 mg/dL, another post IVC vitamin C level should be obtained after the next scheduled 50 gram IVC. If the therapeutic range is achieved, the patient is continued on a 50 gram twice a week IVC schedule with monthly post IVC determinations to assure continued efficacy.
7. If the therapeutic range is still not achieved, the IVC dosage is increased to 75 grams of vitamin C per infusion for four infusions, at which time a subsequent post IVC plasma level is obtained.
8. If the patient remains in a sub-therapeutic range, the IVC dosage is increased to the 100 gram level
9. If after four infusions the post IVC dosage remains sub-therapeutic, the patient may have an occult infection, may be secretly smoking, or may have tumor progression. While these possibilities are being addressed, the clinician can elect to increase the 100 gram IVC frequency to three times per week.
10. Higher infusion doses beyond 100 grams are not recommended without serum osmolality testing before and after infusions in order to properly adjust the infusion rate to maintain a near physiologic osmolality range.
11. If higher dosages are not tolerated, or there is tumor progression in spite of achieving the therapeutic range, lower dosages can still augment the biological benefits of IVC, including enhanced immune response, reduction in pain, increased appetite, and a greater sense of well-being.
12. Very small patients, such as children, and very large obese patients need special dosing. Small patients < 110 lbs. with small tumor burdens and without infection may only require 25 gram vitamin C infusions 2x/week to maintain therapeutic range. Large patients > 220 lbs. or patients with large tumor burdens or infection are more likely to require 100 grams IVC infusions 3x/week. Post IVC plasma levels serve as an excellent clinical guide to this special dosing.13. In our experience, the majority of cancer patients require 50 gram IVC infusions 2-3x/week to maintain therapeutic IVC plasma levels. All patients reaching therapeutic range should still be monitored monthly with post IVC plasma levels to ensure that these levels are maintained long term.
14. We advise patients to orally supplement with at least 4 grams of vitamin C daily, especially on the days when no infusions are given, to help prevent a possible vitamin C “rebound effect.” Oral alpha lipoic acid is also recommended on a case by case basis.