Usage
- This combination is prescribed as a nutritional supplement primarily to support nerve health, particularly in conditions like diabetic neuropathy. It is also used to address deficiencies in any of its individual components. It can be used for conditions like neuropathic pain, anemia, homocysteinemia, cardiovascular disease risk reduction, and promoting bone health. It may also be prescribed to improve brain and nerve health, and lower homocysteine levels in the blood.
- Pharmacological Classification: This is a combination of vitamins and antioxidants.
Alternate Names
- This combination is marketed under various brand names like ZENCOBAL D3, Dalfomin OD Tablet, Mucobal Plus Tablet, and Oramylin-D Tablet.
- Some formulations may use alternative names for ingredients, such as Vitamin B1 for Thiamine Mononitrate, Vitamin B6 for Pyridoxine Hydrochloride, and Vitamin B12 for Methylcobalamin.
How It Works
- Pharmacodynamics: The components exert their effects through a combination of antioxidant activity, neurotransmitter synthesis support, nerve function support, and metabolic regulation. ALA neutralizes harmful free radicals and regenerates other antioxidants. Folic acid helps produce red blood cells and DNA. Methylcobalamin aids nerve function, DNA/red blood cell production, and metabolizes homocysteine. Pyridoxine converts food into energy and metabolizes fats and protein. Vitamin D3 regulates calcium absorption and supports healthy bone mineralization. Thiamine is crucial for converting food into energy, cellular growth, and nerve function.
- Pharmacokinetics: Absorption, distribution, metabolism, and excretion vary among the components. B vitamins are generally water-soluble and excreted renally, while lipoic acid is metabolized and eliminated both renally and hepatically.
Dosage
Standard Dosage
Adults:
- One capsule or tablet daily is the typical dosage. The dose can range from 200 to 1800 mg daily, administered orally or intravenously.
- The duration of treatment is typically 8–12 weeks. However, treatment can last up to 4 years.
Children:
- This combination is generally considered safe for children over six years of age under medical supervision. The dosage should be determined by a pediatrician based on weight and health conditions.
Special Cases:
- Elderly Patients: Dosage should be carefully evaluated and adjusted based on organ function and overall health.
- Patients with Renal Impairment: Dose modification may be needed for patients with kidney diseases.
- Patients with Hepatic Dysfunction: Caution and dose adjustments may be needed in patients with liver disease due to altered metabolism.
- Patients with Comorbid Conditions: Dosage should be individualized based on the specific comorbidities.
Clinical Use Cases
- Dosage for specific medical settings like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations should be determined by the attending physician.
Dosage Adjustments
- Dose modification may be needed in patients with renal or hepatic impairment, malabsorption syndrome, or other conditions affecting vitamin absorption or metabolism.
Side Effects
Common Side Effects
- Nausea
- Vomiting
- Diarrhea
- Headache
- Dizziness
- Skin rash
- Itching
- Abdominal cramps
Rare but Serious Side Effects
- Severe allergic reactions (anaphylaxis)
- Multiorgan failure (rare and potentially fatal)
Long-Term Effects
- Excessive intake of certain vitamins can lead to toxicity.
Contraindications
- Hypersensitivity to any of the components.
- Leber’s hereditary optic neuropathy (specifically for Alpha Lipoic Acid).
- Existing hypervitaminosis.
Drug Interactions
- Alpha Lipoic Acid can interact with diabetes medications.
- High doses of Pyridoxine can interfere with some anticonvulsants.
- Other potential interactions include: altretamine, cisplatin, arsenic trioxide, phenytoin, phenobarbital, primidone, carbamazepine, valproate, chloramphenicol, trimethoprim, levodopa, fluorouracil, sulfasalazine, cholestyramine, metformin, glipizide, glibenclamide, levothyroxine, warfarin, heparin, and alcohol.
Pregnancy and Breastfeeding
- Generally considered safe for use during pregnancy and breastfeeding when used under a doctor’s supervision.
- Alpha Lipoic Acid has been used safely during pregnancy in doses up to 600 mg daily for up to 4 weeks. Limited safety data exists for longer durations or higher dosages.
- It is unknown whether Alpha Lipoic Acid is excreted into breast milk.
- Adequate folic acid is important for preventing neural tube defects in developing fetuses.
Drug Profile Summary
- Mechanism of Action: See “How It Works” above.
- Side Effects: See “Side Effects” above.
- Contraindications: See “Contraindications” above.
- Drug Interactions: See “Drug Interactions” above.
- Pregnancy & Breastfeeding: Consult a healthcare professional before use during pregnancy or while breastfeeding.
- Dosage: See “Dosage” above.
- Monitoring Parameters: Periodic monitoring of nerve function and vitamin/mineral levels might be necessary.
Popular Combinations
Information not available in the current sources.
Precautions
- General Precautions: Pre-screening for allergies, metabolic disorders, and organ dysfunction. Monitoring blood glucose regularly for patients with diabetes. Avoid in alcoholics, thiamine deficiency, thyroid disease, and 2 weeks prior to surgery.
- Pregnant Women: Consult a doctor before use.
- Breastfeeding Mothers: Consult a doctor before use.
- Children & Elderly: Dosage adjustments may be necessary.
- Lifestyle Considerations: Limit alcohol consumption. Monitor blood glucose regularly and follow prescribed dietary and exercise plans if you have diabetes.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Alpha Lipoic Acid + Folic Acid + Methylcobalamin + Pyridoxine Hydrochloride + Thiamine mononitrate + Vitamin D3?
A: The typical adult dosage is one capsule or tablet daily, but dosages can range from 200 to 1800 mg daily. Pediatric dosages should be determined by a pediatrician. Specific doses and duration of treatment should always be determined by a healthcare provider.
Q2: What are the primary uses of this combination?
A: This combination is used to manage vitamin deficiencies, particularly B vitamins, and support nerve health, especially in conditions like diabetic neuropathy.
Q3: Are there any significant drug interactions I should be aware of?
A: Yes, this combination can interact with various medications, including diabetes medications and anticonvulsants. Consult a healthcare professional about potential drug interactions based on individual medication regimens.
Q4: What are the common side effects?
A: Common side effects can include nausea, vomiting, diarrhea, headache, skin rashes, and allergic reactions.
Q5: Is this combination safe during pregnancy and breastfeeding?
A: Consult a healthcare professional before use during pregnancy or breastfeeding. Folic acid is generally recommended during pregnancy for neural tube development, but the safety of the combination product as a whole must be assessed individually.
Q6: Can this combination be used in patients with liver or kidney disease?
A: Use with caution in patients with pre-existing conditions, especially liver disease. Patients with kidney or liver disease may require dosage adjustments. Consult with a nephrologist or hepatologist, respectively.
Q7: Are there any specific lifestyle recommendations while taking this combination?
A: Maintain a balanced diet, engage in regular physical activity, and monitor blood sugar levels if you have diabetes.
Q8: Are there vegetarian/vegan options available for this combination?
A: Yes, vegetarian and vegan-friendly versions are often available. Check product labels or consult a pharmacist for specific formulations.
Q9: What should I do if I miss a dose?
A: If you miss a dose, take the next dose at the scheduled time. Do not double the dose to catch up.
Q10: What should I do if I experience side effects?
A: Consult your doctor if you experience any side effects, particularly if they are severe or persistent. Most side effects are mild and resolve on their own, but some may require medical attention.