L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12 Pharmacology

L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

About L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Mechanism of Action of L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Pharmacokinets of L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Onset of Action for L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Duration of Action for L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Half Life of L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Side Effects of L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Contra-indications of L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Special Precautions while taking L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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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 L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Interactions for L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Typical Dosage for L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Schedule of L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Storage Requirements for L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Effects of Missed Dosage of L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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Effects of Overdose of L-carnitine + Vit B1 + Vit B2 + Vit B3 + Vit B6 + Vit B12

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L-carnitine

About L-carnitine

Dietary supplement, Amino acid derivative, Antioxidant.

Mechanism of Action of L-carnitine

Carnitine is an essential co-factor of fatty acid metabolism in the heart, liver, and skeletal muscle. It is normally synthesised in the liver, brain, and kidneys in sufficient quantities to meet human requirements. It is an antioxidant. It protects neurons from damage caused by super oxide radicals.

Pharmacokinets of L-carnitine

Levocarnitine is absorbed slowly and incompletely from the small intestine. Distribution: It is distributed mainly in free form. Metabolism: It undergoes minimal metabolism. Excretion: It is excreted mainly in urine and small amount through faeces.

Onset of Action for L-carnitine

N/A

Duration of Action for L-carnitine

N/A

Half Life of L-carnitine

N/A

Side Effects of L-carnitine

1.Nausea
2.Vomiting
3.Diarrhoea
4.Abdominal cramps

Contra-indications of L-carnitine

N/A

Special Precautions while taking L-carnitine

1.Severe renal impairment
2.Diabetic patients

Pregnancy Related Information

N/A

Old Age Related Information

N/A

Breast Feeding Related Information

N/A

Children Related Information

N/A

Indications for L-carnitine

1.As antioxidant
2.Carnitine deficiency

Interactions for L-carnitine

N/A

Typical Dosage for L-carnitine

Oral
Adult: 100 - 200 mg/kg daily in 2 to 4 divided doses.
Children: 50 to 100 mg/kg daily in 2 to 4 divided doses
Parenteral (IV)
Adult: 50 to 100 mg/kg daily is given in 3 to 4 divided doses by slow intravenous injection over 2 to 3 minutes.

Schedule of L-carnitine

Storage Requirements for L-carnitine

N/A

Effects of Missed Dosage of L-carnitine

N/A

Effects of Overdose of L-carnitine

N/A

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

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 B3

About Vit B3

N/A

Mechanism of Action of Vit B3

Niacin refers to Nicotinic acid as well as Nicotinamide which exerts it`s action by influencing metabolic reactions. It is converted in to coenzymes Ncotinamide adenine dinucleotide (NAD) and it`s phosphate Ncotinamide adenine dinucleotide phosphate (NADP) involved in oxidation reduction reactions. These pyridine nucleotides act as hydrogen acceptors in the electron transport chain in tissue respiration, glycolysis, and fat synthesis. Nicotinic acid in high doses has vasodilator effects and also improves lipid profile; reduces serum cholesterol, raises HDL level, lowers VLDL, and LDL levels.

Pharmacokinets of Vit B3

Absorption: Well absorbed orally, Distribution: Widely distributed in the body, and also secreted in to breast milk, Modest amounts are stored in liver, Metabolism: Metabolized in to active metabolites in liver, Excretion: Extra drug is excreted through urine.

Onset of Action for Vit B3

N/A

Duration of Action for Vit B3

N/A

Half Life of Vit B3

N/A

Side Effects of Vit B3

1. Flushing
2. Activation of peptic ulcer
3. Nausea
4. Vomiting
5. Diarrhoea
6. Headache
7. Rashes
8. Pruritus
9. Hypotension
10. Arrhythmias
11. Hepatic impairment

Contra-indications of Vit B3

1. Hypersensitivity to the drug
2. Hepatic impairment
3. Peptic ulcer
4. Severe hypotension
5. Arterial haemorrhage

Special Precautions while taking Vit B3

1.History of liver disease
2.Gall bladder diseases
3.Gout
4.Coronary artery diseases
5.Diabetes mellitus
6.When use along with Statins reduces the dosage of Statins

Pregnancy Related Information

Use with caution

Old Age Related Information

Use with caution

Breast Feeding Related Information

Use with caution

Children Related Information

Use with caution

Indications for Vit B3

1. Pellagra
2. Niacin deficiency
3. Hartnup disease
4. Hyperlipidaemia (only nicotinic acid
5. Peripheral vascular diseases (only nicotinic acid)

Interactions for Vit B3

Aspirin: May decrease the metabolic clearance of nicotinic acid
Sympathetic blocking agent: May cause added vasodilation and hypotension
Isoniazid: may deplete levels of niacin and cause deficiency.

Typical Dosage for Vit B3

Oral:
Pellagra: 200 to 500mg daily in divided doses
Prophylactically: 20 to 50mg daily.
Dietary supplement: 10 to 20mg daily
Peripheral vascular diseases (only nicotinic acid): 100 to 150mg three to five times daily. Alternatively 1000 to 2000g once daily at bed time.
Hyperlipidaemia (only nicotinic acid): 1.5 to 6g daily in two to four divided doses with or after meals.
Hartnup disease: 50 to 200mg daily in divided doses.

Schedule of Vit B3

Storage Requirements for Vit B3

Store at controlled room temperature at a range of 15 to 30 degree C

Effects of Missed Dosage of Vit B3

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 B3

Provide supportive measures and symptomatic treatment

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

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.

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