Vit B12 + Vit B3 + Folic acid Pharmacology

Vit B12 + Vit B3 + Folic acid

About Vit B12 + Vit B3 + Folic acid
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Mechanism of Action of Vit B12 + Vit B3 + Folic acid
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Pharmacokinets of Vit B12 + Vit B3 + Folic acid
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Onset of Action for Vit B12 + Vit B3 + Folic acid
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Duration of Action for Vit B12 + Vit B3 + Folic acid
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Half Life of Vit B12 + Vit B3 + Folic acid
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Side Effects of Vit B12 + Vit B3 + Folic acid
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Contra-indications of Vit B12 + Vit B3 + Folic acid
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Special Precautions while taking Vit B12 + Vit B3 + Folic acid
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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 B12 + Vit B3 + Folic acid
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Interactions for Vit B12 + Vit B3 + Folic acid
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Typical Dosage for Vit B12 + Vit B3 + Folic acid
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Schedule of Vit B12 + Vit B3 + Folic acid
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Storage Requirements for Vit B12 + Vit B3 + Folic acid
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Effects of Missed Dosage of Vit B12 + Vit B3 + Folic acid
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Effects of Overdose of Vit B12 + Vit B3 + Folic acid
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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.

Vit B3

About Vit B3
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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
C1
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

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.

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