Vitamin C 500 mg Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Vitamin C 500 mg against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Vitamin C 500 mg is a dietary supplement by Exchange Select with 2 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 412 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin C, Sodium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Vitamin C 500 mg by Exchange Select
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AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Vitamin C 500 mg by Exchange Select
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains 2 active ingredients: sodium and vitamin C. Sodium is an electrolyte your body needs in small amounts for nerve and muscle function, but this product adds supplemental sodium on top of what you get from food.
Vitamin C (ascorbic acid) is a water-soluble vitamin that supports immune function and collagen formation, and it acts as an antioxidant in the body. The rest of the tablet is made up of inactive ingredients like sorbitol, sucrose, flavoring, colorants, and binding agents.
Does it work?
Moderate evidence
Vitamin C is rated Effective for preventing or treating vitamin C deficiency, and Possibly Effective for anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced respiratory infections. Sodium doesn't have a primary wellness purpose in a supplement like this—your dietary intake is normally plenty.
The product's effectiveness for any specific condition depends on which active ingredient matters to you; if you're taking it for vitamin C support, it can work, but the sodium content is a drawback for many people.
How safe is it?
Well-documented data
Vitamin C at 500 mg per tablet is generally well tolerated; most side effects appear only at doses above 2 grams daily and include stomach cramps, diarrhea, heartburn, nausea, and headache. Kidney stone risk is higher if you're prone to them.
Sodium in supplements is a caution: your body needs some from food, but excess sodium is linked to high blood pressure and heart strain, and it can worsen kidney disease. Normal dietary sodium is fine; avoid adding supplemental sodium without talking to your doctor first.
For pregnancy and breastfeeding, vitamin C is rated Likely Safe at normal amounts, and sodium is also rated Likely Safe; however, both carry a Possibly Unsafe rating under certain circumstances, so talk with your doctor or pharmacist if you're pregnant or nursing.
Meds to double-check
Moderate interaction found
Check with your pharmacist before taking this if you're on: blood pressure medications (sodium can reduce their effectiveness), lithium (mood stabilizer—sodium changes how your body clears it), corticosteroids, warfarin or other blood thinners (vitamin C at higher doses may reduce effectiveness), birth control or hormone therapy (vitamin C can raise estrogen levels), levothyroxine (thyroid hormone—vitamin C may increase absorption), chemotherapy drugs, HIV medications like indinavir, or antipsychotics like fluphenazine. Severity ranges from Moderate across all these categories.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
If you need vitamin C support and have no blood pressure, lithium, warfarin, or hormone therapy concerns, this product can work. Anyone on blood pressure meds, lithium, thyroid hormone, HIV medications, or blood thinners should check their exact drugs with the search tool before using it.
The sodium content is a real drawback if you're watching your intake for heart or kidney health—ask your pharmacist if a sodium-free vitamin C makes more sense for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2017.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Vitamin C 500 mg, straight from the product label.
| Brand | Exchange Select |
|---|---|
| Barcode (UPC) | 614299405523 |
| Net contents | 100 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Aug 22, 2017 |
| DSLD ID | 76766 |
| Product type | Vitamin |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Vitamin C 500 mg by Exchange Select, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 5 Calorie(s) | -- |
| Total Carbohydrates | 1 Gram(s) | 1% |
| Sodium | 35 mg | 1% |
| Vitamin C | 500 mg | 833% |
Other ingredients: Sorbitol, Sodium Ascorbate, Sucrose, Ascorbic Acid, Stearic Acid, Magnesium Stearate, Aspartame, Lactose, natural Flavor blend powder, natural Orange juice powder, natural Orange flavor, Natural Lemon/Lime flavor, FD&C Yellow No. 6 Lake, natural Tropical Fruit flavor, Natural and Artificial Watermelon flavor, FD&C Red No. 40 Lake, FD&C Yellow no. 5 lake - Tartrazine, FD&C Blue No. 1 Lake, May contain
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Precautions
Safety sealed. Do not use if printed seal under cap is cut, torn, or missing.
Contains: Milk derivative (lactose), Soy.
Do not swallow whole.
Keep out of the reach of children.
Warning: Pregnant or nursing women, individuals taking medication(s) or persons who have a health condition should consult their physician before using this product.
General Statements
Chewable natural & artificial assorted fruit flavors
Immune health ~ Helps support & maintain a healthy immune system
Quality value
Vitamin C, one of the antioxidant essentials, supports the immune system and helps protect the body’s cells from potential oxidative damage.
Chewable tablets are ideal for individuals who may have difficulty swallowing solid tablets.
"Satisfaction guaranteed or your money back."
FDA Statement of Identity
Dietary Supplement
Formula
Contains: Milk derivative (lactose), Soy.
Contains FD&C Yellow No. 5 Lake – Tartrazine as a color additive.
Suggested/Recommended/Usage/Directions
Directions: Adults - Chew one tablet daily with food as a dietary supplement.
Storage
Store at 15(0) - 30(0) C (59(0) - 86(0) F).
Formulation
No gluten ~ No trans fat
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General
136896 518371 USA646857
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Vitamin C 500 mg by Exchange Select label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Vitamin C 500 mg by Exchange Select
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Sodium
Interacts with205 drugs
Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...
Sodium monograph & interactionsVitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsOther (inactive) ingredients: Sorbitol, Sodium Ascorbate, Sucrose, Ascorbic Acid, Stearic Acid, Magnesium Stearate, Aspartame, Lactose, Natural Flavor blend powder, Natural Orange juice powder, Natural Orange flavor, Natural Lemon/Lime flavor, FD&C Yellow No. 6 Lake, Natural Tropical Fruit flavor, Natural and Artificial Watermelon flavor, FD&C Red No. 40 Lake, FD&C Yellow no. 5 lake - Tartrazine, FD&C Blue No. 1 Lake, May contain. These complete the product’s ingredient list but are not active constituents.
Vitamin C 500 mg by Exchange Select Drug Interactions
HelloPharmacist Interaction Report
Exchange Select Vitamin C 500 mg contains two active ingredients—sodium and vitamin C—and both have documented interactions with medications.
The most serious concern is sodium's effect on blood pressure control: if you take blood pressure medications, a high sodium intake (including from supplements) can reduce how well they work, requiring higher doses to keep your blood pressure in check. This is a Moderate-severity interaction.
Read the full breakdown — every affected drug type, severity by severity
Sodium also interacts with lithium (a mood stabilizer), where high intake raises the risk of lithium toxicity by changing how your kidneys clear it. It can similarly increase sodium levels dangerously if you're on corticosteroids, didanosine (an HIV medicine), sodium phosphates, tolvaptan, or other sodium-containing drugs—all Moderate severity.
Vitamin C at this dose (500 mg) carries Moderate interactions with estrogens (birth control and hormone therapy), chemotherapy drugs like alkylating agents and antitumor antibiotics, warfarin (a blood thinner), and several others including levothyroxine (thyroid hormone), indinavir (HIV), aluminum-containing products, and fluphenazine (an antipsychotic). High-dose vitamin C can also reduce warfarin absorption, which matters if you're on blood thinners.
Altogether, these interactions span 410 individual medications. Check your exact prescriptions with the medication search tool on this page before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Vitamin C 500 mg?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Vitamin C 500 mg interact with 412 drugs. Click any drug to see the details.
2 of the 2 ingredients in Vitamin C 500 mg interact with drugs. Each result below shows which ingredient is responsible. Vitamin C Sodium
Azelastine Hydrochloride, Fluticasone PropionateDymista
How Azelastine Hydrochloride, Fluticasone Propionate interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Azelastine Hydrochloride, Fluticasone Propionate interactionAzilsartanEdarbi
How Azilsartan interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Azilsartan interactionAzilsartan, ChlorthalidoneEdarbyclor
How Azilsartan, Chlorthalidone interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Azilsartan, Chlorthalidone interactionBazedoxifene Acetate, Conjugated EstrogensDuavee
How Bazedoxifene Acetate, Conjugated Estrogens interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CEstrogens Moderate
Interaction Summary
Vitamin C might increase blood levels of estrogens.
Read the full Vitamin C + Bazedoxifene Acetate, Conjugated Estrogens interactionBeclometasone DipropionateBecotide
How Beclometasone Dipropionate interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Beclometasone Dipropionate interactionBeclomethasoneBeclovent, Vanceril
How Beclomethasone interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Beclomethasone interactionBeclomethasone DipropionateQNASL, Qvar
How Beclomethasone Dipropionate interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Beclomethasone Dipropionate interactionBenazeprilLotensin
How Benazepril interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Benazepril interactionBenazepril, HydrochlorothiazideLotensin HCT
How Benazepril, Hydrochlorothiazide interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Benazepril, Hydrochlorothiazide interactionBendamustineBelrapzo, Treanda, Vivimusta
How Bendamustine interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Bendamustine interactionBendamustine HydrochlorideBendeka
How Bendamustine Hydrochloride interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Bendamustine Hydrochloride interactionBendroflumethiazideAprinox, Naturetin, Neo-NaClex
How Bendroflumethiazide interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bendroflumethiazide interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bendroflumethiazide, Nadolol interactionBendroflumethiazide, Rauwolfia SerpentinaRauzide
How Bendroflumethiazide, Rauwolfia Serpentina interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bendroflumethiazide, Rauwolfia Serpentina interactionBenzthiazideExna
How Benzthiazide interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Benzthiazide interactionBetamethasoneCelestone, Diprolene AF, Diprosone
How Betamethasone interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Betamethasone interactionBetamethasone DipropionateSernivo
How Betamethasone Dipropionate interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Betamethasone Dipropionate interactionBetamethasone Dipropionate, CalcipotrieneEnstilar, Wynzora
How Betamethasone Dipropionate, Calcipotriene interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Betamethasone Dipropionate, Calcipotriene interactionBetamethasone ValerateLuxiq
How Betamethasone Valerate interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Betamethasone Valerate interactionBetaxololBetoptic, Kerlone
How Betaxolol interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Betaxolol interactionBisoprololZebeta
How Bisoprolol interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bisoprolol interactionBisoprolol, HydrochlorothiazideZiac
How Bisoprolol, Hydrochlorothiazide interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bisoprolol, Hydrochlorothiazide interactionBleomycinBlenoxane
How Bleomycin interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
Read the full Vitamin C + Bleomycin interactionBosentanTracleer
How Bosentan interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bosentan interactionBudesonideEntocort EC, Eohilia, Pulmicort, Tarpeyo, Uceris
How Budesonide interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumCorticosteroids Moderate
Interaction Summary
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Read the full Sodium + Budesonide interactionBumetanideBurinex
How Bumetanide interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bumetanide interactionBumetanide (iv)Bumex
How Bumetanide (iv) interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bumetanide (iv) interactionBumetanide (oral)Bumex
How Bumetanide (oral) interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Bumetanide (oral) interactionBusulfanBusulfex, Myleran
How Busulfan interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Busulfan interactionCandesartan CilexetilAmias, Atacand
How Candesartan Cilexetil interacts with Vitamin C 500 mg — through 1 ingredient. Tap an ingredient for the detail:
SodiumAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
Read the full Sodium + Candesartan Cilexetil interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Vitamin C 500 mg with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Sodium
Antihypertensive Drugs
Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.
Corticosteroids
Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.
Didanosine (Videx)
Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.
Lithium
Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.
Sodium Phosphates
Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.
Sodium-Containing Drugs
Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.
Tolvaptan (Samsca)
Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.
Brand information
Manufacturer and brand details for Vitamin C 500 mg, from the product label.
Exchange Select
See all Exchange Select products- Name
- International Vitamin Corporation
- City
- Freehold
- State
- NJ
- ZipCode
- 07728
- Phone Number
- 1-866-927-5470
Vitamin C 500 mg by Exchange Select: Common Questions
Does Vitamin C 500 mg by Exchange Select interact with any medications?
How can one product interact with so many drugs?
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Will vitamin C at 500 mg cause side effects?
Is this safe during pregnancy?
Does vitamin C from this product actually work?
Can I take this with my thyroid medication?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Vitamin C 500 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sodium
Interacts with 205 drugsSodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...
Read the full Sodium monograph → Herb & supplement monographVitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph →Sources & How We Checked
Vitamin C 500 mg's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 89 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Sodium 38 references
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- Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
- Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
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- Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
- Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
- Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
- D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
- Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
- Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
- Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
- Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
- Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
- Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
- Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
- O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
- Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
- Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
- Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
- Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
- He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
- Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
- Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
- Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
- Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
- Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
- Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
- Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
- Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
- Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
- Filippini T, Malavolti M, Whelton PK, Vinceti M. Sodium intake and risk of hypertension: A systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022;24(5):133-144. PubMed
- Wang DD, Li Y, Nguyen XT, et al. Dietary sodium and potassium intake and risk of non-fatal cardiovascular diseases: The million veteran program. Nutrients 2022;14(5):1121. PubMed
- Kwak JH, Park CH, Eun CS, et al. The associations of dietary intake of high sodium and low zinc with gastric cancer mortality: A prospective cohort study in Korea. Nutr Cancer 2022;74(10):3501-3508. PubMed
- George S, Maiti R, Mishra BR, Jena M, Mohapatra D. Effect of regulated add-on sodium chloride intake on stabilization of serum lithium concentration in bipolar disorder: A randomized controlled trial. Bipolar Disord 2023;25(1):66-75. PubMed
- Zhou TL, Schütten MTJ, Kroon AA, et al. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2023;12(1):e026578. PubMed
Vitamin C 51 references
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- Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
- Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
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- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
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- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
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- Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
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- Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC