Intravenous Vitamin Research Articles

Role of intravenous vitamin C on outcomes in hospitalized patients with moderate or severe COVID-19: a real life data of Turkish patients.

We aimed to examine the efficacy of intravenous vitamin C (IV-VC) in the treatment of hospitalized patients with moderate or severe COVID-19. We conducted a single-center and retrospective study including patients with COVID-19 diagnosis who were hospitalized. Patients were categorized into three groups as those who received low-dose (LDVC group, 2g/day, n = 183) or high-dose IV-VC (HDVC group, 25g/day, n = 41) and who did not receive IV-VC (control group, n = 46). 270 patients aged 19-97years were enrolled. The median length of stay (LOS) was significantly high (9days) in patients treated with high-dose VC when compared to patients treated with low-dose VC and control patients (6 vs 5days, respectively). Need for intensive care unit (ICU) transfer was found to be significantly low in patients treated with low-dose VC (25.7%); contrarily, control patients had significantly higher rates of ICU transfer (67.4%), when compared to patients treated with high-dose VC (39%). Mortality of the LDVC group was significantly lower than that of the HDVC group (11.5 vs 29.3%). However, mortality rates were similar between the control and HDVC groups (21.7 vs 29.3%). According to the multivariate stepwise logistic regression mortality analysis, percent of change (∆%)-BUN was the most significant variable (p < 0.001), the second significant variable was ∆%-AST (p = 0.002), the third significant variable was respiratory distress (p = 0.002), and the fourth significant variable was the IV-VC groups (p = 0.017). The mortality risk of those in the LDVC group was 10.2 times low compared to the control group. Similarly, the risk of mortality in the HDVC group was 6.5 times lower than that of the control group. Especially low and continious doses of IV-VC suggest fewer days of in-hospital LOS and survival benefit in hospitalized patients with moderate and severe COVID-19. Logistic regression analysis revealed that high-dose VC supplementation also had a mortality-reducing effect.

Oxalate nephropathy from high-dose intravenous vitamin C in a patient with multiple myeloma.

Oxalate nephropathy from high-dose intravenous vitamin C in a patient with multiple myeloma.

Effect of perioperative single dose intravenous vitamin C on pain after total hip arthroplasty

IntroductionVitamin c can relieve the pain after other diseases, but there are no studies on whether vitamin C can relieve the pain after hip replacement. The purpose of this paper is to study whether vitamin C can relieve the pain after total hip replacement.PurposeIn this prospective, double-blind, placebo-controlled, randomized trial, 100 patients receiving THA at our hospital were randomly assigned to vitamin c or control groups. During the operation, the vitamin C group will receive intravenous injection of 3 g vitamin C, and the control group will receive 3 g placebo. If the patient has postoperative pain, 10 ml subcutaneous injection of morphine will be required as a rescue analgesic. The primary outcome was the amount of postoperative injection of morphine as a rescue analgesic and expression of inflammatory factors, and the secondary outcome was postoperative pain and hip recovery as assessed by visual analog scale (VAS).ResultsThe dosage of subcutaneous injection of morphine was significantly reduced in vitamin C group. VAS pain scores at rest and exercise were lower in the vitamin C group 24 h after surgery, and hip motion was better 24 h after surgery, but there was no significant difference between the two groups 24 h after surgery.Nonetheless, the overall changes in morphine usage and VAS scores did not surpass the established minimal clinically important differences (10 mg for morphine consumption; 1.5 at rest and 1.8 during movement for VAS scores).ConclusionAdding intravenous vitamin c to multimodal analgesia significantly improved morphine consumption, VAS pain score, and functional recovery. However, it is recommended that single intravenous administration of vitamin C during the perioperative period may achieve better pain relief for patients after THA.

Tranexamic acid with vitamin K mixture decreases bleeding of total hip arthroplasty in a Jordanian population

Background: Bleeding of total hip arthroplasty has severe consequences on postoperative recovery. 75–90% of early bleeding after surgery and during surgery is caused by operative technical issues. tranexamic acid decreases bleeding of arthroplasty. vitamin k has late and dose sensitive effect in clotting. Methods: This retrospective investigation included subjects of middle age and of both genders scheduled for primary hip replacement at Queen Alia hospital, Jordanian Royal medical services, between March 2022 and June 2023. Subjects were classified into two groups. Group I subject were administered intravenous mixture of Tranexamic acid 10 mg/kg with vitamin K1 of 10 mg 5 min pre-skin incision followed by an infusion of Tranexamic acid 1 mg/kg/h and vitamin K1 0.2 mg/kg/h, until skin closure. Group II subjects were administered only intravenous vitamin K1 of 10 mg, 5 min pre- skin incision followed by infusion of 0.2 mg/kg/h until skin closure. Hemoglobin, packed cell volume, platelet count, prothrombin time, partial thromboplastin time and fibrinogen were tested. Bleeding and blood transfusion were remarked. Results: Group I demonstrated a remarkable less modifications in blood tests and less bleeding than group II. Group II demonstrated less bleeding after surgery. The average Hb in group I demonstrated a remarkable less reduction after surgery compared to group II. (p&lt;0.005). No blood transfusion after surgery was needed in group I. Nine (15%) patients in group II needed one unit of blood transfusion during surgery. Conclusion: Intravenous administration of Tranexamic acid with vitamin K mixture in total hip arthroplasty decreased bleeding during and after surgery and decreased the requirement for blood transfusion.

Effects of High-Dose Intravenous Vitamin C on Colorectal Cancer Recurrence: The Retrospective Study by Medical Records for 23 Years

Background: Among the complementary and alternative therapies used to treat cancer, studies have reported since the late 1960s that the intravenous administration of high-dose vitamin C had an anticancer effect. As the incidence of colorectal cancer has recently increased, interest in treating and preventing its recurrence has also increased. Therefore, this study investigated whether the intravenous administration of high-dose vitamin C to patients with colorectal cancer who received chemotherapy after radical resection would reduce recurrence rates.Methods: One hundred eighty patients who were diagnosed with colorectal cancer and received chemotherapy after surgery at a university hospital in Busan for a total of 23 years from January 2000 to March 2023 were retrospectively studied. Of them, 30 were administered high-dose (1 g/kg) intravenous vitamin C injections twice weekly for more than 5 weeks in addition to standard treatments, while the remaining 150 patients who received only standard treatments were assigned to the control group. In both groups, a thorough examination was performed every year after surgery. The chi-squared test was performed to compare 5-year recurrence rates.Results: The control group had higher recurrence and mortality rates than the experimental group; however, the differences were not statistically significant. The recurrence rate was 28.1% in the stage 2 and 3 control groups, non-significantly higher than that in the experimental group (18.8%; P&gt;0.05).Conclusions: There was no statistically significant difference in recurrence among patients with colorectal cancer who received chemotherapy, although the 5-year recurrence rate was decreased in the experimental versus control group.

When B12 therapy fails: two case reports of intravenous vitamin B12 resistance in pernicious anemia

When B12 therapy fails: two case reports of intravenous vitamin B12 resistance in pernicious anemia

Early intravenous high-dose vitamin C in postcardiac arrest shock (VICEPAC): study protocol for a randomised, single-blind, open-label, multicentre, controlled trial

IntroductionThe high incidence of morbidity and mortality associated with the post-cardiac arrest (CA) period highlights the need for novel therapeutic interventions to improve the outcome of out-of-hospital cardiac arrest (OHCA)...

Effects of Music Therapy on Patients with Cancer Receiving Outpatient Treatment

Patients with cancer often experience anxiety when waiting for diagnostic test results, before receiving treatment, or when informed of a recurrence. Therefore, appropriate interventions are required at each of these stages. This study determines the effects of music therapy with preferred music on anxiety, blood pressure, pulse, and the satisfaction of patients with cancer when receiving outpatient intravenous therapy in a long-term care facility. This quasi-experimental non-equivalent control-group and non-synchronized study was conducted in the outpatient injection room of a long-term care facility in South Korea. This study included 57 patients (divided into experimental and control groups) with female reproductive system/breast or digestive system cancer who received short-term intravenous vitamin C on an outpatient basis. The participants chose from a music selection table for each genre, which was based on the prior research, under the supervision of a professor experienced in music therapy. The participants selected 20 songs to listen to for 1 h while receiving intravenous therapy. The participants were surveyed for state anxiety and satisfaction to confirm the effects of music therapy, and their systolic and diastolic blood pressure and pulse were measured. The state anxiety (U=282, p=.046) and satisfaction (U=262, p=.016) scores of the experimental and control groups revealed significant differences. There were no significant differences in systolic blood pressure (U=311, p=.13), diastolic blood pressure (t=1.88, p=.065), and pulse (t=-0.5, p=.61) between the experimental and control groups. Music therapy is an effective intervention for reducing anxiety and improving satisfaction in patients with cancer when receiving short-term outpatient treatment. However, to generalize these results, a larger sample size of participants is needed with similar types of cancer.

Feasibility of intravenous vitamin C supplementation in allogeneic hematopoietic cell transplant recipients.

Intravenous vitamin C was administered following hematopoietic stem cell transplant to mitigate nonrelapse mortality (NRM) in a Phase II clinical trial. Patients with advanced hematologic malignancies received IV vitamin C, 50mg/kg/day, in three divided doses on days 1-14 after HSCT, followed by 500mg bid oral until 6 months. All patients enrolled (55) were deficient in vitamin C at day 0 and had restoration to normal levels. Vitamin C recipients had a trend for lower nonrelapse mortality (NRM, 11%vs. 25%, p-value=0.07) compared with propensity score-matched historical controls. A similar trend toward improved survival was observed (82%vs. 62% p=0.06), with no attributable grade 3 and 4 toxicities to vitamin C. In patients undergoing allogeneic HSCT, repletion of vitamin C is feasible and may reduce NRM and improve overall survival. Randomized trials in large uniform cohorts of patients are needed to confirm the utility of this easily available and inexpensive therapy.

Does intravenous vitamin C reduce mortality in patients with sepsis?

Does intravenous vitamin C reduce mortality in patients with sepsis?

Novel intervention based on an individualized bundle of care to decrease infection in kidney transplant recipients.

Infection remains a relevant complication after kidney transplantation (KT). A well-established strategy in modern medicine is the application of bundles of evidence-based practice in clinical settings. The objective of this study is to explore the application of a personalized bundle of measures aimed to reduce the incidence of infection in the first 12 months after KT. A single-center prospective cohort of 148 patients undergoing KT between February 2018 and September 2019 that received an individualized infection prevention strategy was compared to a preintervention cohort (n = 159). The bundle comprised a review of the patient's immunization history, infection risk by country of origin, screening for latent tuberculosis infection (LTBI), antimicrobial prophylaxis, and immunological assessment. Individualized recommendations were accordingly provided at a scheduled visit at day +30 after transplantation. The intervention cohort showed a higher compliance rate with the recommended vaccine schedule, screening for geographically restricted infections and LTBI, and intravenous immunoglobulin and vitamin D supplementation (p values <.001). The 1-year incidence rate of infection was lower in the intervention cohort (42.6% vs. 57.9%; p value =.037), as was the rate of infection-related hospitalization (17.6% vs. 32.1%; p value =.003) and the incidence of severe bacterial infection. There were no differences in graft rejection or mortality rates between groups. A multifaceted intervention, including a bundle of evidence-based practices, enhanced compliance with recommended preventive measures and was correlated with a reduction in the 12-month incidence of infection after KT.

High-Dose Intravenous Vitamin C Combined with Docetaxel in Men with Metastatic Castration-Resistant Prostate Cancer: A Randomized Placebo-Controlled Phase II Trial.

This is the first randomized, placebo-controlled, double-blind trial to evaluate HDIVC in cancer treatment. The addition of HDIVC to docetaxel in patients with mCRPC does not improve PSA response, toxicity, or other clinical outcomes compared with docetaxel alone. The routine use of HDIVC in mCRPC treatment is not supported outside of clinical trials.

Delayed Symptoms of Rodenticide Poisoning in a 16-Year-Old: A Case Report

Anticoagulant rodenticides, a key tool in pest control since the 1940s, have undergone significant evolution to overcome resistance and improve efficacy. However, resistance in rodent populations led to the development of second-generation anticoagulants such as Brodifacoum and Difenacoum, which are more potent but pose increased risks to non-target species, including humans. This case report describes the management of a 16-year-old Iranian male who deliberately ingested a super warfarin rodenticide, resulting in severe coagulopathy and delayed clinical presentation. Despite the initial absence of overt symptoms, the patient’s condition required immediate intervention with intravenous vitamin K and blood products, demonstrating the complexity of diagnosing and managing rodenticide poisoning. Recovery was achieved with comprehensive medical and psychological interventions, demonstrating the need for high clinical suspicion and prompt treatment in similar cases. This report highlights the ongoing public health challenges posed by highly potent rodenticides and the critical need for awareness and preparedness among healthcare providers to effectively manage such emergencies.

Safety of High-Dose Vitamin C in Non-Intensive Care Hospitalized Patients with COVID-19: An Open-Label Clinical Study.

Background: Vitamin C has been used as an antioxidant and has been proven effective in boosting immunity in different diseases, including coronavirus disease (COVID-19). An increasing awareness was directed to the role of intravenous vitamin C in COVID-19. Methods: In this study, we aimed to assess the safety of high-dose intravenous vitamin C added to the conventional regimens for patients with different stages of COVID-19. An open-label clinical trial was conducted on patients with COVID-19. One hundred four patients underwent high-dose intravenous administration of vitamin C (in addition to conventional therapy), precisely 10 g in 250 cc of saline solution in slow infusion (60 drops/min) for three consecutive days. At the same time, 42 patients took the standard-of-care therapy. Results: This study showed the safety of high-dose intravenous administration of vitamin C. No adverse reactions were found. When we evaluated the renal function indices and estimated the glomerular filtration rate (eGRF, calculated with the CKD-EPI Creatinine Equation) as the main side effect and contraindication related to chronic renal failure, no statistically significant differences between the two groups were found. High-dose vitamin C treatment was not associated with a statistically significant reduction in mortality and admission to the intensive care unit, even if the result was bound to the statistical significance. On the contrary, age was independently associated with admission to the intensive care unit and in-hospital mortality as well as noninvasive ventilation (N.I.V.) and continuous positive airway pressure (CPAP) (OR 2.17, 95% CI 1.41-3.35; OR 7.50, 95% CI 1.97-28.54; OR 8.84, 95% CI 2.62-29.88, respectively). When considering the length of hospital stay, treatment with high-dose vitamin C predicts shorter hospitalization (OR -4.95 CI -0.21--9.69). Conclusions: Our findings showed that an intravenous high dose of vitamin C is configured as a safe and promising therapy for patients with moderate to severe COVID-19.

Correlation of Vitamin C with Risk Factors of Coronary Artery Disease to Measure the Disease Prognosis to Prepare a Diagnostic Strategy

Abstract BACKGROUND: Reports depicted insufficient plasma Vitamin C levels and significant associations to both acute and chronic inflammation. Recently, use of intravenous Vitamin C has gained visibility for its effectiveness in coronavirus-19 treatment. There were no studies available currently to detect the clinical correlation between plasma Vitamin C with risk factors of coronary artery disease (CAD). The present aim of the study is to estimate the Vitamin C levels in CAD patients as well as to correlate with clinical and laboratory variables to assess the severity of CAD and also to formulate a diagnostic strategy. METHODS: A prospective comparative study was conducted in 100 diagnosed cases of CAD and estimate plasma Vitamin C levels and compared with healthy individuals. Spearman correlation analysis was performed between Vitamin C levels and risk factors of CAD. RESULTS: Maximum CAD cases were in the age group of 60–70 years. The mean age was 58.54 ± 11.60 years in the CAD patients. Among risk factors, 54% of patients had hypertension, 54% of patients had diabetes mellitus, and 27% of patients had dyslipidemia. There significant association noted between diabetes and type of CAD (P = 0.015). Among CAD cases, 70% of patients had ST-elevation myocardial infarction (STEMI), 11% of patients had a non-ST-elevation myocardial infarction (NSTEMI), 17% of patients had unstable angina (USA), and only 2% of patients had central sleep apnoea (CSA). Angiogram diagnosis shows that 34% of patients had single-vessel disease (SVD), 28% of patients had double-vessel disease (DVD), 8% of patients had triple-vessel disease (TVD), 2% of patients had left main coronary artery (LMCA) disease, 13% patients had mild CAD, and 15% patients had normal epicardial coronaries. The range of plasma Vitamin C concentrations level was from 33.25 to 92.5 μmol/L in CAD patients. The mean plasma Vitamin C concentration levels in CAD patients were lower than in healthy individuals (66.96 ± 13.6 vs. 71.33 ± 10.8 μmol/L). There was no statistically significant difference between CAD and non-CAD for plasma Vitamin C concentration levels (P = 0.085). The mean Vitamin C level was higher in DVD (70.6 ± 10.9) than the TVD, LM (71.6 ± 5.82), SVD (68.49 ± 12.4), mild CAD (65.55 ± 13.1), and TVD (62.92 ± 8.9). There was no statistically significant difference in plasma Vitamin C levels in the coronary angiogram (CAG) diagnosis for CAD cases (P = 0.103). The mean plasma Vitamin C levels were higher in NSTEMI (72.98 ± 10.8) than the STEMI (69.5 ± 12.5), USA (63.6 ± 15.2), and CSA (58.45 ± 3.5) μmol/L. There was no statistically significant difference in plasma Vitamin C levels in the type of CAD (P = 0.135). A negative correlation is noted between Vitamin C and low-density lipoprotein (LDL) cholesterol (r = −0.32, P = 0.02). Similarly, there is a negative correlation between Vitamin C and TGL (r = −0.28, P = 0.0067), whereas there is a positive correlation between Vitamin C and high-density lipoprotein (HDL) (r = 0.27, P = 0.0025). CONCLUSION: The mean of Vitamin C concentration levels was lower in CAD patients than in healthy individuals. There is a significant negative correlation between Vitamin C and LDL and between Vitamin-C and TGL. A positive correlation was observed between Vitamin-C and HDL. Vitamin C along with HDL was markedly decreased in CAD and may be the cause. Hence, the combination of Vitamin C, LDL, and HDL can be considered prognostic detectors to know the CAD at its early stages.

Antiviral Mechanisms of Vitamin C

&lt;p class="MsoNormal"&gt;&lt;span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;"&gt;There isn't a COVID-19 vaccination or particular antiviral drug available yet. In order to preserve lives and stop the disease's spread, a readily available, efficient, and secure therapy is desperately needed. Acute respiratory distress syndrome plays a major role in COVID-19 death rates. The characteristic of acute respiratory distress syndrome is markedly elevated oxidative stress brought on by a fast release of free radicals and cytokines (cytokine storm), which can result in organ failure, cellular damage, and even death. We describe a case where the patient responded well to early administration of high dose intravenous vitamin C in addition to other nutrients and drugs.&lt;/span&gt;&lt;/p&gt;

RENAL PROTECTIVE EFFECT AND CLINICAL ANALYSIS OF VITAMIN B 6 IN PATIENTS WITH SEPSIS.

Objective: To investigate the protective effect and possible mechanisms of vitamin B 6 against renal injury in patients with sepsis. Methods: A total of 128 patients with sepsis who met the entry criteria in multiple centers were randomly divided into experimental (intravenous vitamin B 6 therapy) and control (intravenous 0.9% sodium chloride therapy) groups based on usual care. Clinical data, the inflammatory response indicators interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor (TNF-α), and endothelin-1 (ET-1), the oxidative stress response indicators superoxide dismutase, glutathione and malondialdehyde, and renal function (assessed by blood urea nitrogen, serum creatinine, and renal resistance index monitored by ultrasound) were compared between the two groups. Results: After 7 d of treatment, the IL-6, IL-8, TNF-α, and ET-1 levels in the experimental group were significantly lower than those in the control group, the oxidative stress response indicators were significantly improved in the experimental group and the blood urea nitrogen, serum creatinine, and renal resistance index values in the experimental group were significantly lower than those in the control group ( P < 0.05). There was no statistical difference between the two groups in the rate of renal replacement therapy and 28 d mortality ( P > 0.05). However, the intensive care unit length of stay and the total hospitalization expenses in the experimental group were significantly lower than those in the control group ( P < 0.05). Conclusion: The administration of vitamin B 6 in the treatment of patients with sepsis attenuates renal injury, and the mechanism may be related to pyridoxine decreasing the levels of inflammatory mediators and their regulation by redox stress.

Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Sepsis Associated with Acute Necrotizing Soft Tissue Infections: The NASTI-HAT Case Series

Abstract Necrotizing soft tissue infections (NSTIs) are surgical emergencies often presenting with concomitant sepsis. The use of intravenous hydrocortisone, vitamin C (ascorbic acid), and thiamine (HAT) has been proposed as beneficial in treating sepsis. To our knowledge, no study has focused exclusively on its use in NSTIs. This study aimed to evaluate use of HAT among patients with NSTIs and included patients from a single Midwestern regional burn center. Patients diagnosed with sepsis or septic shock secondary to an NSTI were randomized and received either intravenous HAT or placebo. The primary outcome was hospital survival. Secondary outcomes included vasopressor therapy duration, renal replacement therapy need, intensive care unit length of stay, serum procalcitonin and sequential organ failure assessment (SOFA) change in the first 72 h, number of wound-related surgeries, and wound classification at hospital discharge. While our study started as a randomized controlled trial, due to low enrollment it was transitioned to a case series. Of the 10 patients enrolled, half received HAT therapy. No significant difference was found between the treatment and placebo groups. Future larger, multicenter studies may help better elucidate the role of intravenous HAT therapy in patients with NSTIs.

The effects of vitamin C supplementation in the critically ill patients outcomes: A systematic review and meta-analysis of randomized controlled trials.

Vitamin C has significant anti-inflammatory effects and is particularly important for critically ill patients. However due to inconsistent research findings in critically ill patients in meta-analysis. Therefore, the primary objective of this meta-analysis is to investigate the effects of isolated intravenous supplementation of vitamin C in adults with critical illness by comprehensively incorporating articles from randomized controlled trials. Articles included searching through PubMed, Embase, Medline, Cochrane Library, and Web of Science up to April 28, 2023, for articles on vitamin C and the critically ill. We calculated pooled standard relative risk (RR), mean difference (MD), and 95% confidence intervals (CIs). And the protocol for the review has been registered on PROSPERO (CRD42023425193). There are 2047 critically ill included in 19 articles. Compared with placebo, patients who underwent intravenous vitamin C (IVVC) have reduced duration of vasopressor used (SMD 0.26; CI 0.01-0.51; I2 = 87.0%, P = .044), mechanical ventilation (SMD -0.29; CI -0.55 to -0.03; I2 = 36.8%, P = .031). However, the administration of IVVC had no statistical difference in 28-d mortality (RR 0.95; CI 0.80-1.11; I2 = 12.2%, P = .337), mortality (RR 0.79; CI 0.55-1.12; I2 = 0%, P = .188), fluid intake (SMD -0.02; CI -0.25 to 0.20; I2 = 0%, P = .838), urine output (SMD 0.23; CI -0.03 to 0.49; I2 = 0%, P = .084), ICU days (SMD 0.10; CI -0.03 to 0.22; I2 = 0%, P = .127), hospital stay (SMD 0.10; CI -0.12 to 0.32; I2 = 0%, P = .375), and pneumonia (RR 0.85; CI 0.50-1.44; I2 = 0%, P = .552). This study comprehensively and systematically evaluated IVVC supplementation in the critically ill through a meta-analysis of RCT. There is no difference except for patients who had reduced duration of vasopressor use and mechanical ventilation by the administration of IVVC. Of course. More scientific and rigorous conclusions can be drawn from multi-center RCT research in the future.

Intravenous Vitamin C in Cancer Care: Evidence Review and Practical Guidance for Integrative Oncology Practitioners

Intravenous vitamin C (IVC) is a common therapy used by naturopathic doctors and other licensed integrative practitioners. With several proposed mechanisms of action related to cancer care, it is often used in integrative oncology settings. Despite its common use, there are no published evidence-based resources on the efficacy, safety, and procedural considerations for the use of IVC in practice. The objectives of this review are to summarize the evidence on high-dose IVC in supportive cancer care and to provide a resource of practical clinical guidance for IVC application. In cancer care, IVC is most commonly used at doses high enough to achieve a potential cancer cell cytotoxicity. This review focuses on IVC at doses of ≥15 g which we have defined as high-dose. To date, there are 23 published clinical trials evaluating the use of high-dose IVC in cancer support. Based on data from these clinical studies, IVC used concurrently with oxidative therapies, such as chemotherapy and radiotherapy, seems to produce the greatest likelihood for improvements in quality of life and additive anti-tumour effects compared with IVC as monotherapy or with non-oxidative therapies. IVC has shown promise in improving quality of life in patients with breast cancer and advanced pancreatic and ovarian cancers. Limited evidence suggests survival and/or tumour response may be improved with the inclusion of IVC in patients with advanced pancreatic cancer, non-small cell lung cancer, and RAS-mutated colorectal cancer. IVC does not offer curative potential, and further research is needed to explore its effectiveness relevant to mortality outcomes. Practical guidance including assessment, monitoring, dosing, safety, and communication with other healthcare providers is discussed.