Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid Pharmacology

Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

About Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Mechanism of Action of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Pharmacokinets of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Onset of Action for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Duration of Action for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Half Life of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Side Effects of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Contra-indications of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Special Precautions while taking Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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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 Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Interactions for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Typical Dosage for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Schedule of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Storage Requirements for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Effects of Missed Dosage of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Effects of Overdose of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid

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Thyroxine

About Thyroxine

Thyroid hormone, Replacement or supplemental therapy in hypothyroidism.

Mechanism of Action of Thyroxine

Thyroid hormones; Thyroxine (T4) and Triiodothyronine (T3) exert the therapeutic action by regulating protein synthesis. T4 and T3 enter the cells and combine with nuclear receptor. T3 receptor complex binds to specific DNA sequence called "thyroid hormone response elements" present in the regulatory region of specific genes and causes derepression of gene transcription or direct activation of gene transcription. Thus causes expression of predetermined genetically coded pattern of protein synthesis. It causes induction of adenylyl cyclase and proliferation of ?-adrenoceptors and a better coupling of these two. It regulate growth, development, improves carbohydrate utilization and BMR.

Pharmacokinets of Thyroxine

Absorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form, Metabolism: Metabolized primarily in liver by deiodination, glucuronide and sulfate conjugation. Also metabolized in salivary glands and kidneys. Excretion: Excreted through faeces and urine.

Onset of Action for Thyroxine

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Duration of Action for Thyroxine

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Half Life of Thyroxine

T4: 6 to 7days
T3: 1 to 2 days

Side Effects of Thyroxine

1. Tachycardia
2. Arrhythmia
3. Increased BP
4. Hyperglycaemia
5. Tremor
6. Palpitation
7. Angina
8. Cardiac arrest
9. Osteoporosis
10. Thyrotoxicosis
11. Headache
12. Weakness
13. Weight loss
14. Allergic reactions
15. Diarrhoea
16. Vomiting
17. Sweating
18. Restlessness
19. Insomnia
20. Heat intolerance
21. Fever
22. Menstrual irregularities

Contra-indications of Thyroxine

1. Hypersensitivity
2. Thyrotoxicosis
3. Cardiac disease
4. Acute myocardial infarction
5. Adrenal insufficiency

Special Precautions while taking Thyroxine

1. Angina pectoris
2. Coronary artery diseases
3. Hypertension
4. Ischaemia
5. Renal impairment
6. ECG changes
7. In adrenal insufficiency give corticosteroid therapy prior to Thyroxine therapy

Pregnancy Related Information

Use with caution

Old Age Related Information

Use with in caution

Breast Feeding Related Information

Use with caution

Children Related Information

Use with caution

Indications for Thyroxine

1. Cretinism
2. Hypothyroidism
3. Myxoedema
4. Nontoxic goiter
5. Benign functioning thyroid nodule
6. Temporary regression of papillary carcinoma of thyroid

Interactions for Thyroxine

N/A

Typical Dosage for Thyroxine

Oral: Starts with 50 to 100mcg. Increased by increments of 25 to 50mcg at intervals of 3 to 4 weeks; as required by the patient.
Maximum daily dose: 0.15 to 0.3mg
Children: 25 to 150 mcg/day depending up on the requirement of the patient. Increased by increments of 25mcg every 2 to 4 weeks.
Juvenile myxoedema:
Children over 1year: Initially 2. to 5mcg/kg/day

Schedule of Thyroxine

Storage Requirements for Thyroxine

Store in a refrigerator

Effects of Missed Dosage of Thyroxine

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 Thyroxine

Treatment is supportive and symptomatic. Remove drug from the body by gastric lavage and induced emesis. Administer activated charcoal to reduce absorption. If patient is in a coma state inflate cuff on endotrachaeal tube to prevent aspiration. Assist and support respiration if required. Take appropriate measures to control heart failure and control fever, hypoglycaemia and fluid loss. Propranolol or any other beta blocker may be used to correct increased sympathetic activity.

Vitamin E

About Vitamin E

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Mechanism of Action of Vitamin E

Vitamin E acts as an antioxidant and protecting unsaturated lipids in the cell membrane, coenzyme Q, vitamin A, vitamin C etc. from free radical oxidation damage and generation of toxic peroxidation products. It also decreases platelet aggregation.

Pharmacokinets of Vitamin E

Absorption: Absorbed through lymph with the help of bile. Only 20 to 60% of vitamin from dietary sources is absorbed. As dose increases the fraction absorbed decreases.
Distribution: Widely distributed in a protein bound form and stored in adipose tissue.
Metabolism: Metabolized in liver by glucuronide conjugation.
Excretion: Excreted mainly through bile and also excreted through urine.

Onset of Action for Vitamin E

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Duration of Action for Vitamin E

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Half Life of Vitamin E

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Side Effects of Vitamin E

1. Fatigue
2. Weakness
3. Headache
4. Nausea
5. Diarrhoea
6. Blurred vision
7. Flatulence

Contra-indications of Vitamin E

1. Hypersensitivity to the drug
2. Should not administer intravenously

Special Precautions while taking Vitamin E

1. Hepatic impairment
2. Gall bladder disease
3. Along with estrogens

Pregnancy Related Information

May be used

Old Age Related Information

N/A

Breast Feeding Related Information

May be used

Children Related Information

N/A

Indications for Vitamin E

1. Vitamin E deficiency
2. Intermittent claudication
3. Nocturnal muscle cramps
4. Coronary artery disease
5. Fibrocystic breast disease
6. Cystic fibrosis
7. In premature infants exposed to high concentration of oxygen
8. As antioxidant

Interactions for Vitamin E

Oral anticoagulants : Hypoprothrombinemic effect may be increased with possibility of bleeding.

Typical Dosage for Vitamin E

Oral:
Vitamin E deficiency:
Adults: 40 to 50mg/day or 60 to 75i.u. daily based on the severity of deficiency.
Children: 1 unit/kg/day.
Premature neonates: 5units daily.
Full term neonates: 5 units per liter of formula.
Intermittent claudication: 400mg/day for 12 to 18 weeks.
Nocturnal muscle cramps: 400mg/day for 8 to 12 weeks.
Coronary artery disease: 100 to 200mg/day for at least 2 years.
Fibrocystic breast disease: 600mg/day for at least 2years.
Cystic fibrosis: 100 to 200mg/day.
Children above 1 year: 100mg/day.
Children below 1year: 50mg/day.

Schedule of Vitamin E

Storage Requirements for Vitamin E

Store in a well closed container in a cool dry place. Protect from light.

Effects of Missed Dosage of Vitamin E

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 E

Provide supportive measures and symptomatic treatment.

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Special Precautions while taking

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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

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Typical Dosage for

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Vit B2

About Vit B2

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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

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Duration of Action for Vit B2

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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 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

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Duration of Action for Vit B6

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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

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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.

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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Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid is a generic medicine name and there are several brands available for it. Some of the brands for thyroxine + vitamin e + vit b1 + vit b2 + vit b6 + folic acid might be better known than thyroxine + vitamin e + vit b1 + vit b2 + vit b6 + folic acid itself. If the pharmacy that's willing to deliver medicines to your home doesn't have thyroxine + vitamin e + vit b1 + vit b2 + vit b6 + folic acid in stock, you can ask for one of the branded alternatives for thyroxine + vitamin e + vit b1 + vit b2 + vit b6 + folic acid.