Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc Pharmacology

Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc

About Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Mechanism of Action of Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Pharmacokinets of Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Onset of Action for Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Duration of Action for Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Half Life of Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Side Effects of Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Contra-indications of Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Special Precautions while taking Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Interactions for Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Typical Dosage for Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Schedule of Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Storage Requirements for Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Effects of Missed Dosage of Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Effects of Overdose of Vit B1 + Vit B2 + Vit B6 + Vit B12 + Vitamin C + Zinc
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Vit B1

About Vit B1

Physiological functions: Thiamine pyrophosphate is a coenzyme and the active form of vitamin B. It functions as coenzyme in decarboxylation of a-keto acid and in Hexose Monophosphate shunt.
Deficiency symptoms: In severe vitamin B1 deficiency beriberi develops. It is of two types:
a) Wet beriberi
b) Dry beriberi
Wet beriberi: In this the symptoms are related to the cardiovascular system and they are palpitations, tachycardia, dyspnoea, ECG changes, oedema, and high output cardiac failure.
Dry beriberi: The symptoms and signs are related to the Nervous system. The main features are peripheral neuritis, hyperaesthesia (localized areas) or anaesthesia, there is gradual loss in muscle strength, wrist drop, poor memory, depression, lack of initiative and anorexia.
Mechanism of Action of Vit B1
Thiamine exerts it`s action by influencing carbohydrate metabolism. It combines with ATP to form thiamine pyrophosphate in the body. Thiamine pyrophosphate acts as a coenzyme for carbohydrate metabolism, decarboxylation of ketoacids, and hexose monophosphate shunt. It also have plays some role in neuromuscular transmission.
Pharmacokinets of Vit B1
Absorption: Well absorbed orally.
Distribution: Widely distributed in the body. It is also distributed in to breast milk.
Metabolism: Metabolized in the liver.
Excretion: Excess thiamine is excreted through urine.
Onset of Action for Vit B1
N/A
Duration of Action for Vit B1
N/A
Half Life of Vit B1
N/A
Side Effects of Vit B1
1. Angioedema
2. Cardiovascular collapse
3. Cyanosis
4. Restleessness
5. Nausea
6. Haemorrhage
7. Weakness
8. Allergic reactions
9. Tightness of throat
10. Feeling of warmth
11. Urticaria
12. Pruritus
13. Tenderness and induration following I. M. administration
Contra-indications of Vit B1
1. Hypersensitivity to the drug
Special Precautions while taking Vit B1
N/A
Pregnancy Related Information
Use with caution
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Vit B1
1. Thiamine deficiency
2. Dry beriberi
3. Wet beriberi
4. Wernicke`s encephalopathy
5. Hyperemesis gravidarum
6. Korsakoffs syndrome
7. Polyneuritis secondary to alcoholism
8. Multiple neurosis
9. Toxic and confusional states
10. Anorexia nervosa
11. Delirium
Interactions for Vit B1
N/A
Typical Dosage for Vit B1
Oral :
In mild deficiency: 10 to 25mg/day.
In severe deficiency: 200 to 300mg/day.
I.M, I.V.:
Beriberi:
Adults: 10 to 20mg I.M. depending up on the severity of the condition (Up to 100mg I.M. or I.V. for severe cases); thrice daily for two weeks followed by dietary correction and multivitamin supplement containing 5 to 30mg Thiamine/day in single or divided doses for 1 month.
Wernicke`s encephalopathy: 100mg I.V. followed by 50 to 100mg IM. or I.V./day.
"Wet beriberi with heart failure": 10 to 30mg I.V. for emergency treatment.

Schedule of Vit B1
C1 (Oral)
Storage Requirements for Vit B1
Store in a well closed container; in a cool place and protect from light.
Effects of Missed Dosage of Vit B1
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vit B1
Provide symptomatic treatment and supportive measures.

Vit B2

About Vit B2
N/A
Mechanism of Action of Vit B2
Riboflavin exerts it`s action by influencing metabolic reactions. Riboflavin functions in the forms of flavin adenine dinucleotide (FAD), and flavin mononucleotide (FMN) which are coenzymes for flavoproteins involved in many oxidation-reduction reactions. Both FMN and FAD play a vital metabolic role in numerous tissue respiration systems. Riboflavin also directly involves in maintaining erythrocyte integrity.
Pharmacokinets of Vit B2
Absorption: Well absorbed orally; bioavailability increases when administer along with food.
Distribution: Widely distributed in the tissues and limited amount is stored in the liver, spleen, kidneys, and heart. It crosses the placenta and also secreted in to the breast milk.
Metabolism: Phosphorylated in the intestine, liver and other tissues to FMN and metabolized in to FAD the liver.
Excretion: Larger doses are excreted unchanged in urine.
Onset of Action for Vit B2
N/A
Duration of Action for Vit B2
N/A
Half Life of Vit B2
66 to 84 minutes
Side Effects of Vit B2
1. Bright yellow urine with higher doses
Contra-indications of Vit B2
No known contraindications.
Special Precautions while taking Vit B2
N/A
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
May be used
Indications for Vit B2
1. Ariboflavinosis
2. Arteriosclerosis
3. Hypertension
4. Obesity
5. Diabetis
6. Cholepathy
7. Glossitis
8. Stomatitis
9. Dermatitis of trunk and extremities
10. Other riboflavin deficiency symptoms
Interactions for Vit B2
Oral contraceptive:Dose of Riboflavin may need to be increased
Propantheline Bromide:Delays absorption rate of Riboflavin
Typical Dosage for Vit B2
Oral:
Adults: 20 to 40mg three times daily or depending up on the severity.
Children: 20mg daily.
Riboflavin deficiency:
Adults and children over 12 years: 5 to 30mg/day depending up on the severity .
Children (below 12years): 3 to 10mg/day depending up on the severity.
Schedule of Vit B2
C1
Storage Requirements for Vit B2
Store in a well closed container; in a cool place and protect from light.
Effects of Missed Dosage of Vit B2
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose
Effects of Overdose of Vit B2
Provide symptomatic treatment and supportive measures.

Vit B6

About Vit B6
Physiological functions: It is involved as a coenzyme (Pyridoxal phosphate) in metabolism of tryptophan, in several metabolic transformations of amino acids including transamination, decarboxylation & racemization.
Deficiency symptoms: Peripheral neuritis, seizures, stomatitis, glossitis, anaemia, seborrhea like lesions.
Mechanism of Action of Vit B6
Vitamin B6 is a collective term for Pyridoxine, Pyridoxal, Pyridoxamine and their phosphorylated derivatives such as Pyridoxine phosphate, Pyridoxal phosphate and Pyridoxamine derivatives respectively. Vitamin B6 is essential for the metabolism of amino acid, glycogen and fatty acids, for nerve functions, for the formation of red blood cells and also helps the skin healthy. Vitamin B6 is also used for the synthesis of nucleic acid, Haemoglobin, Sphingomyelin, other Sphingolipids, Serotonin, Dopamine, Noradrenaline and GABA.
Pharmacokinets of Vit B6
Absorption: Vitamin B6 is readily absorbed after oral administration.
Distribution: It is mainly distributed in the body in protein bound form. It is stored primarily in the liver and to a lesser extent muscle and brain.
Metabolism: It is metabolised in the liver
Onset of Action for Vit B6
N/A
Duration of Action for Vit B6
N/A
Half Life of Vit B6
15-20 days
Side Effects of Vit B6
1. Neuropathy
2. Unstable gait
3. Drowsiness
4. Perioral numbness
5. Paresthesia
6. Numbness of feet
7. Somnolence
8. Sensory neuropathy
9. Ataxia
Contra-indications of Vit B6
1. Hypersensitivity to Vitamin B6
Special Precautions while taking Vit B6
N/A
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES: Contraindicated
Indications for Vit B6
1. Vitamin B6 deficiency including inadequate diet and drug induced causes
2. Neuropathy
3. Premenstrual syndrome
4. Hyperoxaluria type 1
5. Metabolic disorder
6. Isoniazid poisoning
Interactions for Vit B6
Cycloserine, Hydralazine, Isoniazide, Oral contraceptive, Penicillamine: Increase Pyridoxine requirement.
Levodopa: Pyridoxine reverses the therapeutic effect of Levodopa.
Phenobarbital, Phenytoin: Pyridoxine decreases serum level of these anticonvulsants.
Typical Dosage for Vit B6
Adult: 10 - 20 mg / day
Dietary deficiency: 2.5 -10 mg / day for effective therapeutic response is obtained.
Maintenance dose: 2 - 5 mg / day for several weeks.
Drug induced deficiency: 100 - 200 mg / day for 3 weeks.
Maintenance dose: 25 - 100 mg / day
Neuropathy: 50 - 200 mg /day
Premenstrual syndrome: 40 - 500 mg / day
Hyperoxaluria type 1: 25 - 300 mg / day
Metabolic disorder: 100-500 mg /day.
Isoniazid poisoning: Initial dose: 1 - 4 g as IV administration, then 1 g IM every 30 minute until Pyridoxine dose is equal to the Isoniazid dose has been given.
Schedule of Vit B6
N/A
Storage Requirements for Vit B6
Store it at 15 - 30 degree C. Protect from moisture and heat.
Effects of Missed Dosage of Vit B6
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vit B6
Give supportive measures and symptomatic treatment. The signs of Pyridoxine overdose can be resolved by discontinuation (withdrawal) of Pyridoxine.

Vit B12

About Vit B12
N/A
Mechanism of Action of Vit B12
Vitamin B12 is an essential constituent for growth, cell reproduction, hematopoiesis, and nucleoprotein and myelin synthesis. Vitamin B12 is converted in to coenzyme B12 in the tissues which is essential for conversion of methyl-malonate to succinate and synthesis of methionine from homocystine. It is also associated with fat and carbohydrate metabolism and protein synthesis. Cells characterized by rapid division such as epithelial cells, bone marrow, and myeloid cells appear to have greatest requirement of Cyanocobalamin.
Pharmacokinets of Vit B12
Absorption: Absorbed irregularly after oral administration and absorption depends on Ca and intrinsic factor. It is also administered subcutaneously and intramuscularly.
Distribution: Distributed in to liver, bone marrow, and other tissues. It crosses the placenta and appears in breast milk.
Metabolism: It is metabolized in liver.
Excretion: In normal dosage it is reabsorbed from bile and a minute portion is excreted through urine but the extra drug is excreted through urine.
Onset of Action for Vit B12
N/A
Duration of Action for Vit B12
N/A
Half Life of Vit B12
N/A
Side Effects of Vit B12
1. Anaphylaxis
2. Anaphylactoid reactions
3. Pain and burning sensation at injection site
4. Itching
5. Urticaria
6. Transient diarrhea
7. Peripheral vascular thrombosis
8. Pulmonary oedema
Contra-indications of Vit B12
1. Hypersensitivity to the drug
2. Leber`s disease
Special Precautions while taking Vit B12
1. Anemic patients with coexisting cardiac, pulmonary and hypertensive diseases.
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
NEONATES : Use with caution
Indications for Vit B12
1. Vitamin B12 deficiency
2. Pernicious Anaemia
3. Peripheral neuropathy (diabetic, alcoholic, and drug induced)
Interactions for Vit B12
N/A
Typical Dosage for Vit B12
I.M., S.C.:
Pernicious Anaemia: 100mcg daily for 1 week followed by the same dose given on alternate days for 7 doses and then every 3 to 4days for another 3 weeks. This regimen should be followed by 100mcg monthly for life. Concurrently administer folic acid if required.
Vitamin B12 deficiency other than pernicious Anaemia: 30mcg daily for 5 to 10days depending up on the severity of the condition.
Maintenance dosage: 100 to 200mcg once monthly.
Children: 100mcg I.M. or S.C. over the course of 2 or more weeks.
Maintenance dosage: 60mcg monthly I.M. or S.C.
Schilling test flushing dose:
Adults and Children: 1000mcg I.M. in single dose
Recommended RDA (recommended dietary allowance) for Vitamin B12:
Infants up to 6months of age: 0.3mcg.
Children age 6 months to 1 year: 0.5mcg.
Children age 1 to 3: 0.7mcg.
Children age 4 to 6: 1mcg.
Children age 7 to 10: 1.4mcg.
Children age 11 to adult: 2mcg..
Pregnant women: 2.2mcg.
Breast feeding women: 2.6mcg.
Schedule of Vit B12
C
Storage Requirements for Vit B12
Store at room temperature range of 15 to 30 degree C.in a light resistant well closed container in a dry place.
Effects of Missed Dosage of Vit B12
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vit B12
Not applicable. Even in large doses Vitamin B12 isn`t usually toxic.

Vitamin C

About Vitamin C
Water soluble vitamin, antioxidant.
Mechanism of Action of Vitamin C
Vitamin C exerts it`s action by influencing the biologic oxidations and reductions used in cellular respirations. It directly stimulates collagen synthesis and maintains intracellular connective tissue. It involves in various metabolic reactions such as 1).Hydroxylation of praline and lysine residues of protocollagen which is essential for formation and stabilization of collagen triple helix, 2).hydroxylation of carnitine, 3).Conversion of folic acid to folinic acid, 4).biosynthesis of adrenal steroids, catecholamines, oxytocin, and ADH, 5).Metabolism of cyclic nucleotides and prostaglandins. Vitamin C is important in resistance to infections.
Pharmacokinets of Vitamin C
Absorption: Well absorbed orally.
Distribution: Widely distributed both extracellularly and intracellularly, It crosses the placenta and also distributed in to the breast milk.
Metabolism: Metabolized in the liver; partly oxidized in to active dehydroascorbic acid and inactive metabolites.
Excretion: Inactive metabolites and extra drug is excreted through urine.
Onset of Action for Vitamin C
N/A
Duration of Action for Vitamin C
N/A
Half Life of Vitamin C
N/A
Side Effects of Vitamin C
1. Discomfort at injection site
2. Acid urine
3. Renal calculi
4. Oxaluria
Contra-indications of Vitamin C
No known contraindications
Special Precautions while taking Vitamin C
1. Renal impairment
2. Ingestion of large doses during pregnancy has resulted in scurvy in neonates
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Vitamin C
1. Scurvy
2. Prophylaxis and treatment of vitamin C deficiency
3. As an antioxidant to maintain natural colour and flavour of food items
4. For acidification of urine
5. Capillary fragility
6. Dental caries

Interactions for Vitamin C
Oral contraceptives and estrogens: Vitamin C increases serum levels of oestrogen resulting in adverse reactions .
Warfarin: The anticoagulant effects of warfarin is reduced.
Lab Tests: Large doses (>500 mg) of vitamin C may cause false negative urine glucose determinations. May result in false negative amine dependent stool occult blood tests.
Typical Dosage for Vitamin C
Oral:
Adults: 50 to 1000mg/day depending up on the requirement.
Pregnancy and lactation: 100 to 150mg/day
Children: 30 to 100mg/day.
Scurvy:
Oral:
Adults: 1000mg twice daily to thrice daily.
Children: 300mg to 1000mg daily.
Sub clinical scurvy:
Oral, S.C., I.M., or I.V.: 100 to 250mg once daily or twice daily depending up on the severity of the condition. Then give a maintenance dosage of 50mg/day.
Children: 100 to 300mg depending up on the severity. Then give a maintenance dose of 35mg/day.

Schedule of Vitamin C
C1 (Oral)
C (Parenteral)
Storage Requirements for Vitamin C
Store in a cool dry area in a well closed container. Protects from moisture, light and direct heat.
Effects of Missed Dosage of Vitamin C
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vitamin C
Discontinue the therapy and provide symptomatic and supportive measures.

Zinc

About Zinc
Trance metal, Dietary mineral, Nutritional supplement,Treatment of zinc deficiency,in wound healing.
Mechanism of Action of Zinc
Zinc acts as a cofactor for more than 70 different enzymes. Zinc dependent enzymes are involved in the metabolism of carbohydrates, lipids, and proteins. Zinc facilitates wound healing, normal growth rates, normal skin hydration and maintains senses of taste and smell. It provides normal growth and tissue repair. It also helps in development of cell mediated immunity.
Pharmacokinets of Zinc
Absorption: Poorly absorbed orally, Distribution: Zinc is distributed mainly in to skeletal muscle, skin, bone, pancreas, kidney, liver, retina, prostate, RBC, and WBC. Excretion: Excreted mainly through intestine; only 2% loss in the urine.
Onset of Action for Zinc
N/A
Duration of Action for Zinc
N/A
Half Life of Zinc
N/A
Side Effects of Zinc
1. Nausea
2. Vomiting
3. Abdominal distress
4. Gastric ulceration
5. Rashes
Contra-indications of Zinc
N/A
Special Precautions while taking Zinc
1.Don`t exceed prescribed dose
2.Renal failure
3.Biliary obstruction

Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
N/A
Children Related Information
N/A
Indications for Zinc
1. Zinc deficiency
2. Acne vulgaris
3. Chronic skin ulcers
4. Adjunct to antimicrobials
5. Delayed wound healing
6. Alopecia
Interactions for Zinc
Fluoroquinolones, Tetracyclines: Decreased GI absorption and serum levels of some fluoroquinolone.
Pencillamine: Reduced absorption of zinc.
Iron: Reduced absorption of iron and vice versa.

Typical Dosage for Zinc
Adults: 25 to 50mg zinc daily or 1 to 2 tablets daily.
Children: 5mg/kg 1 to 3 times daily.
Schedule of Zinc
N/A
Storage Requirements for Zinc
Store at a temperature below 30 degree C
Effects of Missed Dosage of Zinc
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Zinc
Provide symptomatic treatment and supportive measures

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