Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid Pharmacology

Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid

About Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
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Mechanism of Action of Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
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Pharmacokinets of Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
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Onset of Action for Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Duration of Action for Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Half Life of Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Side Effects of Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Contra-indications of Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Special Precautions while taking Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
Use with caution
Children Related Information
N/A
Indications for Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
Peripheral neuropathy, Vitamin deficiency
Interactions for Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Typical Dosage for Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
1 capsule/tablet per day
Schedule of Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Storage Requirements for Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
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Effects of Missed Dosage of Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A
Effects of Overdose of Vit B12 + Folic acid + Vit B6 + Alpha-lipoic acid
N/A

Vit B12

About Vit B12
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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.

Folic Acid

About Folic Acid
Dietary supplement, Folate derivative( B9 ), Water Soluble Vitamin.
Mechanism of Action of Folic Acid
Folic acid reduced by enzymes folate reductase and dihydrofolate reductase and forms dihydrofolic acid tetrahydrofolic acid respectively. Tetrahydrofolic acid acts as a coenzyme which mediates a number of one carbon transfer reactions by carrying a methyl group as an adduct. It involves a number of reactions such as 1).conversion of homocysteine to methionine. 2).synthesis of thymidylate which is an essential constituent of DNA from methylene-tetrahydrofolic acid. 3). Conversion of serine to glycine by tetrahydrofolic acid and forms methylene-tetrahydrofolic acid. 4).to introduce carbon units at position 2 and 8 during de novo purine synthesis requires formyl-tetrahydrofolic acid and methenyl-tetrahydrofolic acid.5).generation and utilization of "formate pool". 6).For mediating formino group transfer in histidine metabolism. Folic acid is required to maintain normal erythropoiesis and nucleoprotein synthesis.
Pharmacokinets of Folic Acid
Absorption: Well absorbed orally
Distribution: Widely distributed in the body and highest concentration is seen in liver. It appears in the CSF and breast milk
Metabolism: Metabolized in to N-methyl tetrahydrofolic acid in liver
Excretion: Extra drug is excreted unchanged in urine. A small portion of folate is lost by a combination of urinary and fecal excretion and oxidative cleavage of molecule.
Onset of Action for Folic Acid
Oral: 20 to 30minutes
I.V.: 5 minutes
I.M.:10 to 20minutes
Duration of Action for Folic Acid
Oral: 3 to 6 hours
I.V.:3 to 6minutes
I.M.:3 to 6hours
Half Life of Folic Acid
N/A
Side Effects of Folic Acid
N/A
Contra-indications of Folic Acid
N/A
Special Precautions while taking Folic Acid
1. In patients with undiagnosed anaemia; because it may mask pernicious anaemia
2. In pernicious anaemia and other megaloblastic where vitamin B12 is deficient
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 Folic Acid
1. Megaloblastic anaemia
2. Folic acid deficiency
3. Anaemias of pregnancy
4. Nutritional anaemia
5. Alcoholism
6. Tropical sprue
7. Non tropical sprue
Interactions for Folic Acid
1. Hypersensitivity reactions with injection form
2. Bronchospasm
Typical Dosage for Folic Acid
Oral: 5mg 1 to 4 times daily; depending up on the severity of deficiency.
Maintenance dosage: Half of the therapeutic dosage.
Children: 2.5 to 5mg 1 to 2 times daily.
Schedule of Folic Acid
C1 (Oral)
C (Parenteral)
Storage Requirements for Folic Acid
Store at controlled room temperature at a range of 15 to 25 degree C in a well closed container. Protect from excess heat, light and moisture.
Effects of Missed Dosage of Folic Acid
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 Folic Acid
Relatively non toxic. 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.

Alpha-Lipoic acid

About Alpha-Lipoic acid
Naturally occurring dithiol compound , antioxidant, Agent for neuropathies.
Mechanism of Action of Alpha-Lipoic acid
Alpha-lipoic acid and its reduced metabolite, Dihydrolipoic acid (DHLA), form a redox couple and may scavenge a wide range of reactive oxygen species. Alpha-lipoic acid has been found to decrease urinary isoprostanes, O-LDL and plasma protein carbonyls, markers of oxidative stress. Further, alpha-lipoic acid and its redox couple DHLA have been found to have antioxidant activity in aqueous, as well as in lipophilic regions, and in extra cellular and intracellular environments. Alpha-lipoic acid participates in the recycling of other important biologic antioxidants, such as vitamins E and C, Ubiquinone and glutathione.
Both alpha-lipoic acid and DHLA can scavenge hydroxyl radicals, the nitric oxide radical, peroxynitrite, hydrogen peroxide and hypochlorite. Alpha-lipoic acid may scavenge singlet oxygen, and DHLA may scavenge super oxide and peroxyl reactive oxygen species.
Pharmacokinets of Alpha-Lipoic acid
Absorption: Alpha-lipoic acid is absorbed from the small intestine. The natural R-entantiomer is more readily absorbed than the L-entantiomer and is the more active form.
Distribution:It is distributed to the liver via the portal circulation and to various tissues in the body via the systemic circulation. . Alpha-lipoic acid readily crosses the blood-brain barrier. It is found, after its distribution to the various body tissues, intracellularly, intramitochondrialy and extracellularly.Metabolism: Alpha-lipoic acid is metabolized to its reduced form, dihydrolipoic acid (DHLA), by mitochondrial lipoamide dehydrogenase enzyme. DHLA, together with lipoic acid, form a redox couple. It is also metabolized to lipoamide, which functions as the lipoic acid cofactor in the multienzyme complexes that catalyze the oxidative decarboxylations of pyruvate and alpha-ketoglutarate. Alpha-lipoic acid may be metabolized to dithiol octanoic acid, which can undergo catabolism.
Onset of Action for Alpha-Lipoic acid
N/A
Duration of Action for Alpha-Lipoic acid
N/A
Half Life of Alpha-Lipoic acid
N/A
Side Effects of Alpha-Lipoic acid
1.Nausea
2.Vomiting
Contra-indications of Alpha-Lipoic acid
1.Contraindicated during radiotherapy
Special Precautions while taking Alpha-Lipoic acid
Patient with diabetes and problems with glucose intolerance
Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
Use with caution
Children Related Information
N/A
Indications for Alpha-Lipoic acid
1.Diabetic neuropathy
2.It may help prevent the oxidation of LDL cholesterol and may be protective, generally, against oxidative stress and, specifically, against atherosclerosis, ischemia-reperfusion injury and various radiologic and chemical toxins.
3.It may also be useful in some inborn metabolic disorders
Interactions for Alpha-Lipoic acid
N/A
Typical Dosage for Alpha-Lipoic acid
Adult: up to 600 milligrams daily
Diabetic neuropathy: 300 milligrams daily taken in divided doses.
Schedule of Alpha-Lipoic acid
N/A
Storage Requirements for Alpha-Lipoic acid
Store at room temperature away from moisture and heat.Keep out of the reach of children. Keep the medicine from freezing. Do not refrigerate.
Effects of Missed Dosage of Alpha-Lipoic acid
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 Alpha-Lipoic acid
Give supportive measures and symptomatic treatment.

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