Usage
This combination medication addresses nutritional deficiencies related to calcium, vitamin D3, and vitamin B12. It is prescribed to prevent or treat low blood calcium levels, especially in individuals with inadequate dietary calcium intake. Additionally, it contributes to bone health, mitigates osteoporosis risk, supports red blood cell formation, and enhances iron absorption.
Pharmacological Classification: Nutritional Supplement, Vitamin/Mineral Supplement.
Mechanism of Action: Replenishes deficient nutrients; calcium gluconate supplies calcium, vitamin D3 promotes calcium absorption, and cyanocobalamin aids hematopoiesis and iron absorption. Benzyl alcohol serves as a local anesthetic at the injection site and the other added ingredients act as preservatives.
Alternate Names
No officially recognized alternate names exist for this specific combination product. Individual components have alternate names (e.g., vitamin D3 as cholecalciferol, cyanocobalamin as vitamin B12). Brand names under which it’s marketed include Sigmacal Vit and Brackt.
How It Works
Pharmacodynamics: This combination provides the body with essential nutrients: calcium for nerve and muscle function, bone health, and blood clotting; vitamin D3 for calcium absorption and bone health; and vitamin B12 for red blood cell production and nerve function.
Pharmacokinetics:
- Absorption: Calcium gluconate absorption is influenced by vitamin D3 and dietary factors. Vitamin D3 is absorbed from the gut. Cyanocobalamin requires intrinsic factor for absorption in the small intestine.
- Metabolism: Vitamin D3 undergoes hepatic and renal metabolism to its active form, calcitriol. Cyanocobalamin is stored in the liver.
- Elimination: Calcium is excreted through urine and feces. Vitamin D3 metabolites are eliminated via bile and urine. Vitamin B12 undergoes enterohepatic circulation and renal excretion. Benzyl alcohol is metabolized in the liver and excreted by the kidneys.
Mode of Action: Calcium is crucial for numerous cellular processes. Vitamin D3 modulates gene expression related to calcium homeostasis. Cyanocobalamin is a cofactor in DNA synthesis and red blood cell formation.
Receptor Binding/Enzyme Inhibition/Neurotransmitter Modulation: Vitamin D3 binds to vitamin D receptors, regulating gene transcription. Cyanocobalamin acts as a cofactor for enzymes involved in DNA synthesis.
Dosage
Administered intramuscularly by a healthcare professional. Dosage is patient-specific, based on individual needs and deficiencies.
Standard Dosage
Not readily available in published literature and varies as per requirements.
Adults: Determined based on individual requirements and deficiency levels.
Children: Determined by a physician, considering the child’s age, weight, and deficiency status.
Special Cases: Dosage adjustments may be required for elderly patients, individuals with renal or hepatic impairment, or those with other underlying medical conditions.
Clinical Use Cases
Dosage is adjusted based on patient-specific needs and is determined by the healthcare provider.
- Intubation: Not typically indicated.
- Surgical Procedures: May be used pre- or post-operatively to address nutritional deficiencies.
- Mechanical Ventilation: Not typically indicated.
- Intensive Care Unit (ICU) Use: May be used to correct or prevent nutritional deficiencies.
- Emergency Situations: Not typically used.
Dosage Adjustments
Dose modifications are based on factors like renal and hepatic function, other medical conditions, and concomitant medications.
Side Effects
Common Side Effects: Generally well-tolerated. Injection site reactions (redness, swelling, pain) might occur.
Rare but Serious Side Effects: Hypercalcemia (high calcium levels) with symptoms including nausea, vomiting, confusion, weakness, fatigue, bone pain.
Long-Term Effects: No specific long-term adverse effects are associated with appropriate and monitored use.
Adverse Drug Reactions (ADR): Significant ADRs are rare. Allergic reactions (skin rash, itching, hives, facial swelling, difficulty breathing) may occur.
Contraindications
Hypercalcemia; hypervitaminosis D; hypersensitivity to any component.
Drug Interactions
Certain antibiotics (tetracyclines, quinolones); bisphosphonates; levothyroxine; digoxin; phosphate binders. Consult a comprehensive drug interaction database for detailed information.
Pregnancy and Breastfeeding
Can be used if deemed necessary by a physician. Caution is advised with doses of vitamin D exceeding the recommended allowance during pregnancy. Consult a doctor before use.
Drug Profile Summary
- Mechanism of Action: Replenishes calcium, vitamin D3, and vitamin B12.
- Side Effects: Generally well-tolerated; injection site reactions possible; rare cases of hypercalcemia.
- Contraindications: Hypercalcemia, hypervitaminosis D, hypersensitivity.
- Drug Interactions: Several interactions exist; consult a drug interaction resource.
- Pregnancy & Breastfeeding: Consult a doctor before use during pregnancy or breastfeeding.
- Dosage: Patient-specific, determined by a healthcare professional.
- Monitoring Parameters: Serum calcium, vitamin D, and vitamin B12 levels.
Popular Combinations
Information on specific popular combinations for this particular multi-ingredient formulation is not readily available. Its components are commonly found in other combinations targeting specific deficiency states.
Precautions
- General Precautions: Screen for allergies, metabolic disorders, and organ dysfunction before administering.
- Pregnant Women: Consult a doctor before use, caution advised with high vitamin D doses.
- Breastfeeding Mothers: Consult a doctor before use; potential risk of neonatal exposure.
- Children & Elderly: Pediatric and geriatric dosing should be tailored to the individual’s needs.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Benzyl Alcohol + Calcium Gluconate + Cyanocobalamin + Vitamin D3?
A: There’s no standard dosage. It’s determined by the treating physician based on individual patient needs, deficiency levels, and other factors such as age, weight, renal function, and coexisting medical conditions.
Q2: How is this combination administered?
A: It’s administered via intramuscular injection by a healthcare professional.
Q3: What are the main uses of this combination medication?
A: It is primarily used to prevent or treat deficiencies in calcium, vitamin D3, and vitamin B12.
Q4: What should I do if a patient experiences an allergic reaction?
A: Discontinue the medication immediately and provide appropriate medical care based on the severity of the reaction (e.g., antihistamines, corticosteroids, epinephrine).
Q5: Can this combination be used in patients with renal impairment?
A: It can be used with caution, and dosage adjustments might be necessary. Close monitoring of calcium levels is essential.
Q6: Are there any specific dietary recommendations when using this combination?
A: Encourage a balanced diet rich in calcium and vitamin D. Patients should avoid foods high in oxalates or phytates, which can interfere with calcium absorption.
Q7: Can this medication be used during pregnancy and breastfeeding?
A: It can be used if deemed necessary by a physician. During pregnancy, vitamin D doses exceeding recommendations should be used with caution. Breastfeeding women should consult their doctor before use.
Q8: What are the signs and symptoms of hypercalcemia to watch out for?
A: Nausea, vomiting, confusion, weakness, fatigue, bone pain, increased thirst and urination, and cardiac arrhythmias can be signs of hypercalcemia.
Q9: How should I monitor patients receiving this medication?
A: Regularly monitor serum calcium, phosphorus, vitamin D, and vitamin B12 levels, especially in patients with renal or hepatic impairment or those receiving long-term therapy. Adjust dosage as needed based on these levels.
