Alpha Lipoic Acid + Benfotiamine + Calcium Carbonate + Chromium + Folic Acid + Methylcobalamin + Myo-Inositol + Pyridoxine Hydrochloride + Selenium + Vitamin D3

Usage

This combination is generally prescribed as a nutritional supplement to address deficiencies and support overall health, especially nerve and metabolic function. It’s commonly used for conditions like:

• Diabetic Neuropathy: Management of nerve damage associated with diabetes.
• Vitamin Deficiencies: Replenishing specific vitamins and minerals.
• Metabolic Support: Improving blood sugar control and insulin sensitivity.
• Peripheral Neuropathy: Managing nerve pain not associated with diabetes.

Pharmacological Classification: This isn’t a single drug but a combination of vitamins, minerals, and antioxidants, thus lacking a single pharmacological class. Each component has its own classification.

Mechanism of Action: The components work synergistically:

• Alpha Lipoic Acid: Antioxidant, improves nerve function and blood sugar control.
• Benfotiamine: Fat-soluble form of vitamin B1 (thiamine), essential for nerve function and carbohydrate metabolism.
• Calcium Carbonate: Provides calcium for bone health.
• Chromium: Enhances insulin action, improves blood sugar regulation.
• Folic Acid: Crucial for DNA synthesis, red blood cell formation, and nerve function.
• Methylcobalamin: Active form of vitamin B12, supports nerve function, red blood cell production, and DNA synthesis.
• Myo-Inositol: Aids cell signaling, insulin sensitivity, and nerve function.
• Pyridoxine Hydrochloride (Vitamin B6): Essential for nerve function, red blood cell formation, and various metabolic processes.
• Selenium: Antioxidant, supports immune function.
• Vitamin D3: Promotes calcium absorption, bone health, and immune function.

Alternate Names

This combination has no single official alternate name. It is often identified by its individual components or marketed under various brand names. Some examples of brand names include (but are not limited to): Rejunex CD3, Sarfast-CD3, Cobacyn CD3.

How It Works

Pharmacodynamics: The combined effects improve nerve function, metabolic processes, and overall health by correcting nutritional deficiencies and protecting against oxidative stress.

Pharmacokinetics:

• Absorption: Each component has its own absorption profile. Benfotiamine, as a fat-soluble form of thiamine, enhances thiamine absorption. Vitamin D3 also requires fat for absorption.
• Metabolism: The components are metabolized via various pathways, some involving hepatic enzymes.
• Elimination: Elimination pathways vary – renal or hepatic excretion.

Mode of Action: At the cellular level, these components contribute to energy production, nerve conduction, DNA/RNA synthesis, antioxidant defense, calcium homeostasis, and insulin signaling.

Receptor Binding/Enzyme Inhibition/Neurotransmitter Modulation: Chromium potentiates insulin receptor activity. Pyridoxine is a cofactor in numerous enzymatic reactions, including neurotransmitter synthesis. Methylcobalamin is involved in myelin synthesis and nerve function. Alpha-lipoic acid acts as a potent antioxidant.

Elimination Pathways: This varies for each component. Some are excreted renally, while others undergo hepatic metabolism.

Dosage

Dosage is individualized based on the patient’s needs and condition.

Standard Dosage

Adults: A common dosage is one tablet/capsule daily, usually taken after meals. However, it’s crucial to follow the doctor’s specific recommendations.

Children: Safety and efficacy in children haven’t been firmly established, and this combination isn’t typically recommended for children. In some cases, doctors may prescribe certain components individually based on specific needs, adjusting the dosage based on age or weight.

Special Cases:

• Elderly Patients: Dosage adjustments may be needed based on organ function.
• Patients with Renal Impairment: Dose modifications are essential based on creatinine clearance.
• Patients with Hepatic Dysfunction: Adjustments might be necessary due to impaired metabolism.
• Patients with Comorbid Conditions: Dosage should be carefully considered in patients with diabetes, kidney stones, hypercalcemia, or other conditions.

Clinical Use Cases:

The combination isn’t typically used in acute medical settings like intubation, surgical procedures, mechanical ventilation, ICU, or emergency situations. It is primarily used for the long-term management of chronic conditions like diabetic neuropathy or nutritional deficiencies.

Dosage Adjustments: Dosage modifications are based on individual patient factors like renal/hepatic function, metabolic disorders, or genetic polymorphisms.

Side Effects

Common Side Effects:

Nausea, vomiting, diarrhea, stomach upset, headache, dizziness, skin rash, itching, flushing.

Rare but Serious Side Effects: Allergic reactions (e.g., hives, shortness of breath, swelling).

Long-Term Effects: Potential for vitamin D or calcium toxicity with prolonged high doses, especially in patients with impaired renal function.

Adverse Drug Reactions (ADR): Severe allergic reactions, though rare, necessitate immediate intervention.

Contraindications

• Hypersensitivity to any component.
• Leber’s hereditary optic neuropathy.
• Hypercalcemia or vitamin D toxicity.
• Kidney stones or severe renal impairment.
• Certain metabolic disorders.

Drug Interactions

• Antidiabetic medications (e.g., metformin).
• Anticonvulsants (e.g., phenytoin, carbamazepine).
• Thyroid hormones (e.g., levothyroxine).
• Anticoagulants (e.g., warfarin).
• Antibiotics (e.g., tetracycline).
• Bisphosphonates (e.g., alendronate).
• Other multivitamins or supplements.

Alcohol may worsen side effects like dizziness.

Pregnancy and Breastfeeding

While considered generally safe, it is essential to consult a doctor before using this combination during pregnancy or breastfeeding.

Drug Profile Summary (Refer to sections above for details)

Popular Combinations: Often prescribed as a standalone supplement.

Precautions (Refer to previous sections for details)

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage?

A: Dosage is individualized, commonly one tablet/capsule daily after meals, but strictly adhere to the doctor’s recommendation.

Q2: Can it be used during pregnancy/breastfeeding?

A: Consult a doctor before use during pregnancy or breastfeeding.

Q3: What are the common side effects?

A: Nausea, vomiting, diarrhea, stomach upset, headache, dizziness, skin rash, itching.

Q4: Are there any serious side effects?

A: Rare but serious side effects include allergic reactions.

Q5: What are the contraindications?

A: Hypersensitivity, Leber’s hereditary optic neuropathy, hypercalcemia, kidney stones, certain metabolic disorders.

Q6: Does it interact with other medications?

A: Yes, interactions are possible with several medications, including antidiabetics, anticonvulsants, thyroid hormones, and anticoagulants. Always inform your doctor about all other medications you are taking.

Q7: Can it be used in children?

A: Safety and efficacy in children haven’t been established. It is not typically recommended for pediatric use.

Q8: What should I do if I miss a dose?

A: Do not take a double dose. Take the next dose as scheduled.

Q9: Can I drive after taking this medication?

A: It may cause dizziness or drowsiness. Avoid driving or operating machinery if you experience such symptoms.

Q10: Should any monitoring parameters be observed during prolonged use?

A: Long-term use may require monitoring of calcium and vitamin D levels to prevent toxicity. Regular monitoring of kidney function and blood glucose levels may also be advisable, especially in patients with diabetes.