Adults: Injection One vial (10 ml) daily. Oral 1-2 Capsule daily.
Decreased GI tract absorption with neomycin, aminosalicylic acid, H2-blockers and colchicine. Reduced serum concentrations with oral contraceptives. Reduced effects in anaemia with parenteral chloramphenicol.
Folic acid may mask the symptoms of pernicious anemia in that hematologic remission may occur while neurologic manifestations remain progressive. Administering folic acid may obscure pernicious anemia. Recommended doses are insufficient to correct severe vitamin deficiency states and may be insufficient in patients with markedly increased vitamin requirements. In patients receiving total parenteral nutrition (TPN), routine supplementation with both fat-soluble and water-soluble vitamins is recommended to prevent deficiency states and to obviate the need to speculate on individual vitamin status. Daily vitamin requirements must be calculated to avoid over dosage and toxic effects, especially with regards to vitamins A & D and particularly in pediatric patients. In patients for whom total parenteral nutrition is continued for prolonged periods (months or years), periodic monitoring of blood vitamin levels should be considered. To prevent excessive excretion of water-soluble vitamins and for reasons of safety, daily dosage should be administered over a number of hours.
Vitamin B: Plays a role in the synthesis and maintenance of coenzyme A. Necessary for lipid metabolism, carbohydrate metabolism, tissue respiration, glycogenolysis, inhibition of very low-density lipoprotein (VLDL) synthesis. May increaase chylomicron triglyceride removal from plasma. Vitamin B12 (cyanocobalamin): Required for the maintenance of normal erthropoiesis, nucleprotein and myelin synthesis, cell reproduction and normal growth; intrinsic factor, a glycoprotein secreted by the gastric mucosa, is required for active absorption of Vitamin B12 from the GI tract. Necessary for normal tissue respiration; plays a role in activation of pyridoxine and conversion of tryptophan to niacin. Vitamin C is necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in conversion of folic acid to folinic acid.
Oral Children age 11 years and above: 1-2 Capsule daily. Injection Children age 11 years and above: One vial (10 ml) daily. Children below 11 years of age: Children weighing less than 10 kg should be given 1 ml of the dissolved mixture per kg body weight /day. Children weighing 10 kg or more should be given 10 ml (one vial) of the dissolved mixture /day.
Supplement for intravenous nutrition in order to meet the daily requirements of the water-soluble vitamins in infants, adults and children.
Pregnancy Category Note
The unwanted effects of nutrient solutions are a rise in the body temperature, shivering, chills and nausea and vomiting. Adverse reactions that may be expected based on experience with other water-soluble vitamin compounds administered intravenously include: allergic reactions, including anaphylaxis; dermatological reactions including flushing, erythema and pruritus and CNS reactions including headache, dizziness and agitation etc.
Hypersensitivity to any of the ingredients of the preparation.
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