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Testing is recommended before initiating therapy Kidney stones: High-dose vitamin C metabolizes to oxalate, which can increase kidney stone risk in susceptible patients Interference with lab tests: High-dose vitamin C can interfere with certain blood glucose meters and occult blood tests Iron absorption: Vitamin C significantly enhances dietary iron absorption caution in patients with iron overload Common Side Effects Injection site pain, bruising, or swelling Mild flushing or warmth Nausea Headache Unusual taste in the mouth Mild fatigue Temporary increase in urination (vitamin C is water-soluble) Seek Medical Attention For Signs of allergic reaction: rash, swelling, difficulty breathing Severe flank or back pain (possible kidney stone) Signs of hemolysis: dark urine, jaundice, severe fatigue Severe injection site reaction or infection Drug Interactions High-dose vitamin C may reduce the effectiveness of certain chemotherapy agents Vitamin C can enhance iron absorption from supplements May affect warfarin anticoagulation (rare)

Persistent nausea lasting beyond the first few weeks at a stable dose

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