Askorbinsyra Pascoe (Ascorbic Acid 50 mg/ml)
Intravenous vitamin C solution for injection – prescription required
Quick Facts About Askorbinsyra Pascoe
Key Takeaways About Askorbinsyra Pascoe
- Injectable vitamin C for clinical use: Askorbinsyra Pascoe delivers ascorbic acid directly into the bloodstream, bypassing gastrointestinal absorption limitations and achieving plasma levels 30–70 times higher than oral supplements
- Prescription required: This medication must be prescribed by a physician and administered by or under the supervision of a healthcare professional in a clinical setting
- Key contraindication – G6PD deficiency: Patients with glucose-6-phosphate dehydrogenase deficiency must not receive high-dose IV vitamin C due to risk of hemolytic anemia
- Kidney stone risk: High-dose ascorbic acid increases urinary oxalate excretion, raising the risk of calcium oxalate kidney stones, particularly in predisposed individuals
- Laboratory test interference: IV ascorbic acid can cause falsely elevated or decreased readings on blood glucose monitors and other point-of-care tests – inform all healthcare providers about this treatment
What Is Askorbinsyra Pascoe and What Is It Used For?
Askorbinsyra Pascoe is a sterile, injectable solution containing ascorbic acid (vitamin C) at a concentration of 50 mg/ml. It is used to treat and prevent vitamin C deficiency (scurvy) in patients who cannot adequately absorb vitamin C through oral supplementation, such as those with malabsorption syndromes, critically ill patients, or individuals recovering from major surgery.
Ascorbic acid, commonly known as vitamin C, is an essential water-soluble vitamin that the human body cannot synthesize on its own. It must be obtained through diet or supplementation. While most people can meet their vitamin C requirements through oral intake of fruits and vegetables, certain clinical situations require parenteral (injectable) administration to rapidly restore adequate vitamin C levels in the body.
Askorbinsyra Pascoe is manufactured by Pascoe Naturmedizin and is specifically formulated for intravenous (IV) infusion or intramuscular (IM) injection. The solution contains 50 milligrams of ascorbic acid per milliliter, allowing healthcare providers to precisely dose the medication according to each patient's individual needs. The injectable route bypasses the gastrointestinal tract entirely, which is critical for patients whose absorption capacity is compromised.
When administered intravenously, ascorbic acid achieves plasma concentrations that are 30 to 70 times higher than what is possible with oral supplementation. This is because oral vitamin C absorption is limited by saturable intestinal transporters (primarily SVCT1), which cap absorption at approximately 200 mg per dose. The parenteral route eliminates this bottleneck, enabling rapid repletion of severely depleted stores.
Approved clinical indications
Askorbinsyra Pascoe is indicated for the following clinical situations:
- Treatment of scurvy: Clinical vitamin C deficiency manifesting with symptoms such as bleeding gums, petechiae, poor wound healing, and fatigue
- Prevention of vitamin C deficiency: In patients receiving total parenteral nutrition (TPN) or those unable to take oral supplements
- Malabsorption syndromes: Conditions such as Crohn's disease, short bowel syndrome, or post-bariatric surgery states where gastrointestinal absorption is significantly impaired
- Critical illness: Severely ill patients in intensive care settings where vitamin C levels are frequently depleted due to increased metabolic demand and oxidative stress
- Perioperative support: Before or after major surgical procedures where tissue repair and immune function require adequate vitamin C status
Ascorbic acid serves as a critical cofactor for numerous enzymatic reactions. It is essential for collagen synthesis (supporting wound healing and tissue integrity), carnitine biosynthesis (important for energy metabolism), and neurotransmitter production (including norepinephrine). As a potent antioxidant, it scavenges reactive oxygen species and regenerates other antioxidants such as vitamin E. It also enhances non-heme iron absorption from the gastrointestinal tract and supports immune function by stimulating white blood cell production and activity.
What Should You Know Before Taking Askorbinsyra Pascoe?
Before receiving Askorbinsyra Pascoe, your healthcare provider must assess your kidney function, screen for G6PD deficiency, and review your complete medication list. This injectable vitamin C product is contraindicated in several conditions and can interact with numerous drugs and laboratory tests.
While vitamin C is generally considered a safe nutrient at dietary doses, high-dose parenteral ascorbic acid carries specific risks that must be carefully evaluated before treatment. Your prescribing physician will consider your overall health status, existing medical conditions, and current medications to determine whether Askorbinsyra Pascoe is appropriate for you.
Contraindications
Askorbinsyra Pascoe must not be used in patients with the following conditions:
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency: High-dose IV ascorbic acid can trigger hemolytic anemia in patients with this enzyme deficiency, which affects approximately 400 million people worldwide, predominantly in regions of Africa, the Mediterranean, and Southeast Asia
- Hyperoxaluria: Ascorbic acid is metabolized to oxalate, and patients with hyperoxaluria are at significantly increased risk of calcium oxalate kidney stone formation and renal damage
- History of calcium oxalate kidney stones: The increased urinary oxalate from IV vitamin C can precipitate new stone formation in predisposed individuals
- Severe renal insufficiency: Patients with an estimated glomerular filtration rate (eGFR) below 30 ml/min/1.73 m² cannot adequately excrete the metabolic byproducts of ascorbic acid
- Known hypersensitivity: Allergy to ascorbic acid or any excipient in the formulation
- Iron storage disorders: Including hemochromatosis and thalassemia major, as vitamin C enhances iron absorption and can worsen iron overload
Warnings and Precautions
Several important warnings apply to the use of Askorbinsyra Pascoe:
- Kidney stone risk: Even in patients without a prior history of nephrolithiasis, high-dose IV ascorbic acid increases urinary oxalate excretion and may promote calcium oxalate crystal formation. Adequate hydration during and after infusion is essential to mitigate this risk
- Interference with glucose monitoring: Ascorbic acid can cause falsely elevated blood glucose readings on certain point-of-care glucometers that use glucose dehydrogenase pyrroloquinoline quinone (GDH-PQQ) technology. This is clinically significant for patients with diabetes who rely on accurate glucose monitoring. Laboratory-based glucose testing methods should be used during and for 24 hours following IV vitamin C infusion
- Osmolality considerations: High-dose infusions of hypertonic ascorbic acid solutions can cause phlebitis and venous irritation. Appropriate dilution and slow infusion rates are essential
- Sodium content: Some formulations of injectable ascorbic acid contain sodium as a buffering agent. This should be considered in patients on sodium-restricted diets or with conditions such as heart failure or hypertension
- Rebound scurvy: Abrupt discontinuation of high-dose vitamin C therapy can theoretically lead to rebound scurvy due to increased vitamin C catabolism. Gradual dose tapering is advisable when discontinuing prolonged high-dose therapy
Patients must be screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency before receiving high-dose intravenous ascorbic acid. Administration to G6PD-deficient individuals can cause severe hemolytic anemia, which may be life-threatening. G6PD testing is mandatory prior to initiating therapy, particularly in patients from populations with high prevalence of this condition.
Pregnancy and Breastfeeding
Ascorbic acid at recommended dietary allowance (RDA) levels (85 mg/day during pregnancy, 120 mg/day during lactation) is considered safe and necessary for both maternal and fetal health. However, the use of high-dose intravenous ascorbic acid during pregnancy has not been extensively studied in controlled clinical trials.
Animal studies have not demonstrated teratogenic effects at therapeutic doses. Nevertheless, the theoretical risk of neonatal rebound scurvy (where the newborn's vitamin C metabolism is up-regulated due to maternal high-dose exposure, leading to relative deficiency after birth) has been raised in the medical literature. For this reason, high-dose parenteral ascorbic acid should only be used during pregnancy when the expected clinical benefit clearly outweighs the potential risk, and under close medical supervision.
Ascorbic acid is excreted in breast milk, and infant exposure through breastfeeding after maternal IV vitamin C therapy should be considered. Breastfeeding mothers should consult their physician to weigh the benefits and risks before receiving treatment.
How Does Askorbinsyra Pascoe Interact with Other Drugs?
Askorbinsyra Pascoe can interact with several classes of medications, including anticoagulants, iron supplements, chemotherapy agents, and certain laboratory diagnostic tests. Always provide your healthcare provider with a complete list of all medications, supplements, and herbal products you are taking.
Drug interactions with injectable ascorbic acid are generally more clinically significant than with oral supplementation because of the much higher plasma concentrations achieved. The following interactions have been documented in the medical literature and should be carefully considered by prescribing physicians.
Major Interactions
| Drug / Class | Interaction | Clinical Significance |
|---|---|---|
| Warfarin / Anticoagulants | High-dose vitamin C may reduce anticoagulant effect by competing with vitamin K-dependent clotting factor synthesis | Monitor INR closely; dose adjustments may be needed |
| Deferoxamine (iron chelator) | Concurrent use may increase iron toxicity by mobilizing iron from tissue stores and increasing free iron in circulation | Avoid concurrent use; administer vitamin C only after deferoxamine has been infusing for at least 1 hour |
| Bortezomib (proteasome inhibitor) | In vitro studies suggest vitamin C may reduce the anti-tumor activity of bortezomib | Avoid concurrent high-dose vitamin C during bortezomib therapy |
| Glucose monitoring devices | Causes falsely elevated or decreased blood glucose readings depending on monitor technology | Use laboratory-based glucose testing; warn diabetic patients |
Minor Interactions
| Drug / Class | Interaction | Clinical Significance |
|---|---|---|
| Iron supplements | Vitamin C enhances non-heme iron absorption by reducing ferric iron (Fe3+) to ferrous iron (Fe2+) | Beneficial in iron deficiency; caution in iron overload states |
| Aluminum-containing antacids | Ascorbic acid may increase aluminum absorption from antacids | Separate administration; avoid in renal impairment |
| Aspirin / NSAIDs | Aspirin may decrease ascorbic acid levels; vitamin C may reduce GI side effects of aspirin | Generally not clinically significant at standard doses |
| Estrogen-containing contraceptives | High-dose vitamin C may increase estrogen levels slightly | Monitor for estrogen-related side effects; generally mild |
Beyond blood glucose monitoring, high-dose IV ascorbic acid can interfere with several laboratory tests: urinary glucose dipstick tests (false negatives), fecal occult blood tests (false negatives), serum creatinine measurements (false elevations with some assays), serum bilirubin measurements, and lactate dehydrogenase (LDH) levels. Inform the laboratory that the patient has received IV vitamin C to ensure appropriate test interpretation.
What Is the Correct Dosage of Askorbinsyra Pascoe?
The dosage of Askorbinsyra Pascoe depends on the clinical indication, severity of deficiency, and patient characteristics. Typical doses range from 100 mg to 1,000 mg daily for deficiency treatment. All dosing must be determined by a physician, and the medication must be administered by qualified healthcare personnel.
Askorbinsyra Pascoe contains 50 mg of ascorbic acid per milliliter. The solution must be diluted with a compatible intravenous fluid (such as 0.9% sodium chloride or 5% dextrose) before slow intravenous infusion. The infusion rate should generally not exceed 500 mg per 15 minutes to minimize the risk of osmotic effects and venous irritation. Intramuscular injection is an alternative route when IV access is not available, though absorption may be less predictable.
Adults
Treatment of Vitamin C Deficiency (Scurvy)
Dose: 200 mg to 500 mg daily for 1 to 2 weeks by IV infusion or IM injection
Maintenance: Transition to oral supplementation (100–200 mg daily) once clinical improvement is observed and oral absorption is adequate
Parenteral Nutrition Supplementation
Dose: 100 mg to 200 mg daily added to TPN solutions
Duration: Throughout the period of parenteral nutrition
Critical Illness / Perioperative Use
Dose: 200 mg to 1,000 mg daily by IV infusion, based on clinical assessment and measured plasma vitamin C levels
Note: Higher doses may be used under specialist guidance in intensive care settings, based on emerging evidence from clinical trials
Children
Pediatric Dosing
Treatment of deficiency: 100 mg to 300 mg daily by slow IV infusion, adjusted according to age, body weight, and severity of deficiency
Maintenance: Transition to age-appropriate oral supplementation as soon as feasible
Important: Pediatric use should be under specialist supervision. Ensure G6PD screening has been performed before administration.
Elderly
Geriatric Considerations
Dose: Standard adult doses apply, but renal function must be assessed before dosing
Caution: Elderly patients are more likely to have reduced renal function, increasing the risk of oxalate accumulation. eGFR should be calculated, and doses adjusted or withheld if renal function is significantly impaired (eGFR below 30 ml/min/1.73 m²)
Missed Dose
Since Askorbinsyra Pascoe is administered in clinical settings by healthcare professionals, missed doses are managed by the treating medical team. If a scheduled infusion is missed, it should be administered as soon as possible. There is no need to double the dose to compensate for a missed administration. The treating physician will adjust the treatment schedule as needed based on the patient's clinical response and vitamin C status.
Overdose
Ascorbic acid has a wide therapeutic index, and serious toxicity from overdose is uncommon due to the kidneys' ability to rapidly excrete excess vitamin C. However, very high doses (particularly above 10,000 mg in a single infusion) can lead to the following complications:
- Acute oxalate nephropathy: Massive doses can cause oxalate crystal deposition in the renal tubules, potentially leading to acute kidney injury
- Hemolysis: In patients with undiagnosed G6PD deficiency, even moderate-to-high doses can trigger hemolytic crisis
- Osmotic diuresis: Very high-dose infusions can cause significant fluid and electrolyte shifts
- Gastrointestinal disturbance: Nausea, vomiting, and abdominal cramping may occur
In the event of suspected overdose, treatment is supportive. Maintain adequate hydration to promote urinary excretion and prevent oxalate crystal deposition. Monitor renal function, serum electrolytes, and complete blood count. In severe cases, hemodialysis can effectively remove ascorbic acid from the circulation.
If you suspect an overdose of Askorbinsyra Pascoe, contact your local poison control center or emergency services immediately. Provide information about the dose administered, the time of administration, and any symptoms observed. Early intervention with aggressive hydration can prevent kidney damage from oxalate deposition.
What Are the Side Effects of Askorbinsyra Pascoe?
Like all medicines, Askorbinsyra Pascoe can cause side effects, although not everybody gets them. The most common side effects are local injection site reactions and mild gastrointestinal symptoms. Serious side effects such as hemolysis and kidney stones are rare but require immediate medical attention.
The side effect profile of injectable ascorbic acid is generally well characterized. Most adverse effects are dose-dependent and more likely to occur at higher doses. The side effects listed below are organized by frequency according to internationally accepted conventions used by the European Medicines Agency (EMA) and the World Health Organization (WHO).
Very Common (affects more than 1 in 10 patients)
- Pain, redness, or swelling at the injection or infusion site
- Transient warmth or tingling sensation during IV infusion
Common (affects 1 to 10 in 100 patients)
- Nausea
- Mild diarrhea or loose stools
- Abdominal discomfort or cramping
- Headache
- Fatigue or malaise
- Increased thirst and urination (due to osmotic effect)
Uncommon (affects 1 to 10 in 1,000 patients)
- Flushing or facial warmth
- Dizziness or lightheadedness
- Insomnia (particularly with late-day administration)
- Heartburn or dyspepsia
- Vomiting
- Phlebitis (inflammation of the vein at infusion site)
Rare (affects fewer than 1 in 1,000 patients)
- Calcium oxalate kidney stones (nephrolithiasis)
- Hemolytic anemia (primarily in G6PD-deficient patients)
- Anaphylactic or severe allergic reaction
- Acute oxalate nephropathy (with very high doses)
- Hypotension (with rapid infusion)
Contact your healthcare provider or emergency services immediately if you experience: sudden onset of dark or cola-colored urine (may indicate hemolysis), severe flank pain or blood in urine (may indicate kidney stones), difficulty breathing or throat swelling (may indicate anaphylaxis), or rapid heart rate with dizziness or fainting (may indicate hemodynamic instability).
The risk of side effects is influenced by several factors including dose, infusion rate, hydration status, and underlying medical conditions. Healthcare providers minimize risks by using appropriate dilution, controlling infusion rates, ensuring adequate patient hydration, and screening for contraindications before treatment.
How Should You Store Askorbinsyra Pascoe?
Askorbinsyra Pascoe should be stored below 25°C, protected from light, and kept in its original packaging until use. Once opened, the solution should be used immediately. Do not use the solution if it appears discolored (yellow or brown) or contains visible particles.
Proper storage of Askorbinsyra Pascoe is essential to maintain the potency and safety of the ascorbic acid solution. Vitamin C is inherently unstable and susceptible to oxidative degradation, particularly when exposed to light, heat, air, or alkaline conditions. Degraded ascorbic acid loses its therapeutic activity and may contain breakdown products that could be harmful.
- Temperature: Store below 25°C (77°F). Do not freeze. Avoid exposure to excessive heat or temperature fluctuations
- Light protection: Keep ampoules or vials in the original outer carton to protect from light. Ascorbic acid is photosensitive and degrades when exposed to ultraviolet or visible light
- After opening: Use the solution immediately after opening. Ascorbic acid solutions begin to oxidize rapidly upon exposure to air. Any unused solution should be discarded
- After dilution: Once diluted in an IV bag, the solution should be administered within 6 hours. Protect the diluted solution from light during infusion by using an opaque infusion line cover if available
- Visual inspection: Before use, inspect the solution visually. A fresh ascorbic acid solution should be clear and colorless to very slightly pale yellow. Discard if the solution is dark yellow, brown, or contains particulate matter
- Keep out of reach of children: Store all medications securely and out of the reach and sight of children
- Expiry date: Do not use Askorbinsyra Pascoe after the expiry date stated on the ampoule label and outer carton
Healthcare facilities should follow their institutional protocols for the storage and handling of injectable medications. Temperature monitoring of medication storage areas should be performed regularly to ensure compliance with storage requirements. Inventory management practices should ensure that stock is rotated (first-expiry, first-out) to prevent the use of expired product.
What Does Askorbinsyra Pascoe Contain?
The active ingredient is ascorbic acid (vitamin C) at 50 mg per milliliter. The solution also contains excipients such as sodium hydrogen carbonate as a pH adjuster and water for injection as the solvent.
Understanding the complete composition of Askorbinsyra Pascoe is important for identifying potential allergens or ingredients that may affect patients with specific dietary restrictions or medical conditions. The following outlines the known components of the formulation.
Active ingredient
- Ascorbic acid (vitamin C): 50 mg per ml – This is the pharmacologically active component responsible for the therapeutic effects. Ascorbic acid (chemical name: L-ascorbic acid, also known as (5R)-5-[(1S)-1,2-dihydroxyethyl]-3,4-dihydroxy-2(5H)-furanone) has a molecular weight of 176.12 g/mol
Excipients (inactive ingredients)
- Sodium hydrogen carbonate (sodium bicarbonate): Used as a buffering agent to adjust the pH of the solution to a physiologically tolerable range. This contributes a small amount of sodium to the formulation, which should be considered for patients on sodium-restricted diets
- Water for injection: The solvent in which the ascorbic acid is dissolved, meeting pharmacopoeial standards for sterility and purity
The solution is preservative-free, which is why it must be used immediately after opening. The absence of preservatives reduces the risk of preservative-related adverse effects but means that microbial contamination can occur if the solution is not handled aseptically. Healthcare providers must use proper aseptic technique when drawing up and preparing the solution for administration.
The pH of the solution is typically adjusted to approximately 6.0 to 7.0, which is close to physiological pH and helps minimize venous irritation during infusion. The osmolality of the undiluted solution may be hypertonic, which is why dilution with compatible IV fluids is recommended before intravenous infusion.
Frequently Asked Questions About Askorbinsyra Pascoe
The primary difference is the route of administration and the resulting blood levels. Oral vitamin C supplements are absorbed through the gastrointestinal tract, where absorption is limited by saturable intestinal transporters. Even at very high oral doses, plasma vitamin C concentration peaks at approximately 220 micromol/L. Askorbinsyra Pascoe, administered intravenously, bypasses this limitation entirely and can achieve plasma concentrations of 10,000 to 20,000 micromol/L or higher – roughly 30 to 70 times what oral dosing achieves. This makes it clinically necessary for patients who cannot absorb oral vitamin C adequately or who require rapid repletion of severely depleted stores.
No. Askorbinsyra Pascoe is a prescription medication that must be administered by or under the direct supervision of a qualified healthcare professional in a clinical setting. Intravenous administration requires proper venous access, sterile technique, appropriate monitoring equipment, and trained personnel to manage potential adverse reactions. Self-administration of IV medications carries serious risks including infection, air embolism, phlebitis, and unmonitored allergic reactions. If you believe you need injectable vitamin C therapy, consult your physician to arrange treatment in an appropriate clinical facility.
The duration depends on the dose being administered and the infusion rate. For standard deficiency treatment doses (200–500 mg), the infusion typically takes 15 to 30 minutes. For higher doses used in critical care settings, the infusion may last 1 to 3 hours. The infusion rate is carefully controlled to minimize venous irritation and osmotic effects. Your healthcare provider will determine the appropriate infusion duration based on your specific dose and clinical situation. Intramuscular injections are administered more quickly but are generally limited to smaller volumes.
Yes, this is a critically important interaction. Intravenous ascorbic acid can interfere with certain types of blood glucose monitoring devices, producing falsely elevated or falsely decreased readings. This is particularly dangerous for patients with diabetes who rely on accurate glucose readings to dose insulin. Glucose monitors that use the GDH-PQQ (glucose dehydrogenase pyrroloquinoline quinone) method are most susceptible to this interference. Patients receiving IV vitamin C should use laboratory-based glucose testing methods rather than point-of-care glucometers. This interference can persist for up to 24 hours after the infusion ends.
High-dose intravenous vitamin C has been investigated in clinical trials as an adjunctive therapy for various cancers. Some early-phase studies have shown potential benefits in terms of quality of life improvement and reduced chemotherapy-related side effects. However, as of 2026, there is no definitive evidence from large randomized controlled trials to support the use of IV vitamin C as a standalone cancer treatment. Major oncology guidelines (NCCN, ESMO) do not currently recommend high-dose IV vitamin C as standard cancer therapy. Askorbinsyra Pascoe is not indicated or approved for cancer treatment. Patients interested in IV vitamin C as part of cancer care should discuss this with their oncologist.
Before receiving Askorbinsyra Pascoe, inform your doctor about: any history of kidney stones or kidney disease; whether you have been tested for G6PD deficiency; all medications you are currently taking (including over-the-counter drugs, supplements, and herbal remedies); any known allergies to medications or food; whether you are pregnant, planning to become pregnant, or breastfeeding; any history of iron overload conditions; and whether you have diabetes (due to potential glucose monitoring interference). This information helps your doctor determine whether Askorbinsyra Pascoe is safe and appropriate for you.
References
All medical information in this article is based on peer-reviewed research, international clinical guidelines, and established pharmaceutical reference sources. The following sources were used in the preparation of this content:
- World Health Organization (WHO). Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023. Ascorbic acid listed as essential medicine for nutritional supplementation.
- European Medicines Agency (EMA). Summary of Product Characteristics (SmPC) Guidelines for Parenteral Vitamin Preparations. Amsterdam: EMA; 2024.
- Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017;9(11):1211. doi:10.3390/nu9111211
- Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 2010;5(7):e11414. doi:10.1371/journal.pone.0011414
- Lykkesfeldt J, Tveden-Nyborg P. The Pharmacokinetics of Vitamin C. Nutrients. 2019;11(10):2412. doi:10.3390/nu11102412
- Fowler AA 3rd, Truwit JD, Hite RD, et al. Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial. JAMA. 2019;322(13):1261–1270. doi:10.1001/jama.2019.11825
- British National Formulary (BNF). Ascorbic Acid Monograph. London: BMJ Group and Pharmaceutical Press; 2025.
- National Institutes of Health (NIH), Office of Dietary Supplements. Vitamin C – Fact Sheet for Health Professionals. Bethesda: NIH; Updated 2024.
- Riordan HD, Casciari JJ, González MJ, et al. A pilot clinical study of continuous intravenous ascorbate in terminal cancer patients. P R Health Sci J. 2005;24(4):269–276.
- Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;(1):CD000980. doi:10.1002/14651858.CD000980.pub4
Medical Editorial Team
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