Usage
This combination is primarily prescribed for conditions requiring both nutritional supplementation and antibacterial action. It is specifically aimed at addressing deficiencies in calcium, B vitamins, and folic acid while simultaneously treating infections susceptible to oxytetracycline.
Pharmacological Classifications: This combination product falls into multiple categories including:
- Vitamins: Folic Acid, Methylcobalamin, Thiamine (B1), Vitamin B2 (Riboflavin), Vitamin B3 (Niacin), Vitamin B6 (Pyridoxine)
- Mineral Supplement: Calcium
- Antibiotic: Oxytetracycline (Tetracycline antibiotic)
Mechanism of Action:
This preparation acts through the combined effects of its components:
- Calcium: Supports bone health, nerve function, and muscle contraction.
- Folic Acid: Crucial for DNA synthesis, cell division, red blood cell formation, and neural tube development during pregnancy.
- Methylcobalamin (Vitamin B12): Essential for nerve function, DNA synthesis, and red blood cell formation.
- Oxytetracycline: Inhibits bacterial protein synthesis, thus exerting a broad-spectrum antibacterial effect.
- Thiamine (Vitamin B1): Supports carbohydrate metabolism and nerve function.
- Vitamin B2 (Riboflavin): Plays a role in energy production and cellular function.
- Vitamin B3 (Niacin): Involved in energy metabolism, DNA repair, and cell signaling.
- Vitamin B6 (Pyridoxine): Contributes to protein metabolism, neurotransmitter synthesis, and red blood cell formation.
Alternate Names
There is no internationally recognized non-proprietary name for this specific combination. Each component has its own established names. Brand names vary depending on the manufacturer and region. One example found was Terramycin SF Capsule, but others may exist.
How It Works
Pharmacodynamics: The effects on the body are the sum of each component’s individual actions, as described above. Oxytetracycline’s antibacterial effect is the most prominent pharmacological action. The other components work to correct nutritional deficiencies and support metabolic processes.
Pharmacokinetics: Absorption, metabolism, and elimination characteristics will vary for each component.
- Oxytetracycline: Absorbed orally, concentrated in liver and kidneys, excreted primarily in urine and feces.
- B Vitamins: Generally well-absorbed orally, undergo metabolic processing, and are excreted in urine.
- Calcium: Absorption is influenced by vitamin D and other dietary factors; excess calcium is excreted primarily in urine.
- Folic Acid: Absorbed in the small intestine.
Mode of Action (Cellular/Molecular):
- Oxytetracycline: Binds to the 30S ribosomal subunit in bacteria, inhibiting protein synthesis.
- B Vitamins: Act as coenzymes in various metabolic reactions.
- Folic Acid: Converted to tetrahydrofolic acid, which is essential for one-carbon transfer reactions in DNA synthesis.
Receptor Binding, Enzyme Inhibition, Neurotransmitter Modulation: This information pertains specifically to each individual component. For example, vitamin B6 is a cofactor for enzymes involved in neurotransmitter synthesis.
Elimination Pathways: As previously mentioned, elimination varies for each component. Oxytetracycline is excreted through renal and hepatic routes. B vitamins are primarily excreted renally. Calcium is primarily excreted renally, with some fecal loss.
Dosage
Due to the complexity of this combination and the inclusion of oxytetracycline, a prescription antibiotic, dosage must be determined and monitored by a physician based on the individual patient’s needs and the infection being treated. Self-medication with this combination is strongly discouraged.
Standard Dosage
Not applicable to this specific combination. Dosages must be individualized by a physician.
Adults: Dosage will be tailored to the specific needs of the patient and the infection being treated.
Children: Dosage must be determined by a physician considering the child’s age, weight, and the specific clinical context.
Clinical Use Cases
This combination, given the inclusion of oxytetracycline, would not typically be used in settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations unless there’s a specific coexisting infection susceptible to oxytetracycline and concurrent nutritional deficiencies. The preference would be to address these issues separately with more targeted agents.
Dosage Adjustments
Dose modification is essential based on patient-specific factors like renal/hepatic function, metabolic disorders, and potential drug interactions.
Side Effects
Common Side Effects
Common side effects can include nausea, vomiting, diarrhea, and other gastrointestinal disturbances related to oxytetracycline.
Rare but Serious Side Effects
Rare but serious side effects can include hypersensitivity reactions, hepatotoxicity, and effects on bone development (especially with long-term tetracycline use).
Long-Term Effects
Long-term use of tetracyclines can cause tooth discoloration and affect bone growth in children.
Adverse Drug Reactions (ADR)
ADRs include severe allergic reactions, Clostridium difficile infection, and photosensitivity.
Contraindications
Contraindications include hypersensitivity to any component, severe renal or hepatic impairment, and pregnancy (especially for oxytetracycline, which is categorized as Pregnancy Category D).
Drug Interactions
Oxytetracycline interacts with antacids, iron supplements, and other drugs affecting gut motility. It can also reduce the effectiveness of oral contraceptives. The individual vitamins and minerals may have specific interactions. For example, Vitamin B6 may interfere with the efficacy of certain anticonvulsants.
Pregnancy and Breastfeeding
Oxytetracycline is contraindicated during pregnancy. The other vitamins and minerals are generally considered safe during pregnancy at recommended doses, but physician guidance is still necessary. Oxytetracycline can be passed into breast milk and might affect bone development in the nursing infant.
Drug Profile Summary
- Mechanism of Action: Combines nutritional supplementation (calcium, B vitamins, folic acid) with the antibiotic action of oxytetracycline.
- Side Effects: GI upset, hypersensitivity reactions, hepatotoxicity (rare), tooth discoloration (long-term use).
- Contraindications: Hypersensitivity, severe renal/hepatic impairment, pregnancy.
- Drug Interactions: Antacids, iron supplements, oral contraceptives, some anticonvulsants.
- Pregnancy & Breastfeeding: Oxytetracycline is contraindicated. Other components generally safe but should be used under medical supervision.
- Dosage: Individually determined by a physician.
- Monitoring Parameters: Renal function, liver function tests, signs of superinfection.
Popular Combinations
It is unusual to see this particular combination used widely in practice. Clinicians tend to prescribe targeted therapies for specific conditions.
Precautions
Standard precautions include screening for allergies and organ dysfunction. Specific precautions apply to pregnant/breastfeeding women and patients with renal/hepatic impairment.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium + Folic Acid + Methylcobalamin + Oxytetracycline + Thiamine + Vitamin B2 + Vitamin B3 + Vitamin B6?
A: There is no standard recommended dosage. Dosage must be individualized by a physician based on the patient’s specific condition and the infection being treated.
Q2: Can this combination be used during pregnancy?
A: No, oxytetracycline is contraindicated during pregnancy.
Q3: What are the main side effects?
A: Common side effects include gastrointestinal disturbances such as nausea, vomiting, and diarrhea.
Q4: What are the key drug interactions to be aware of?
A: Oxytetracycline interacts with antacids, iron supplements, and can reduce the effectiveness of oral contraceptives.
Q5: Are there any long-term risks associated with this combination?
A: Long-term use of tetracyclines can lead to tooth discoloration and affect bone development, especially in children.
Q6: Can this combination be used in children?
A: Use in children requires careful consideration by a physician, and the dosage must be adjusted based on the child’s age and weight.
Q7: What should patients be monitored for during treatment?
A: Patients should be monitored for signs of superinfection, renal function, and liver function.
Q8: What are the primary indications for this combination?
A: This combination is indicated when a patient has a bacterial infection susceptible to oxytetracycline alongside deficiencies in calcium, folic acid, and/or B vitamins.
Q9: Why is it essential to avoid self-medication with this combination?
A: Self-medication with antibiotics like oxytetracycline can lead to antibiotic resistance, adverse drug reactions, and potentially mask underlying conditions requiring different treatments. It is crucial to consult with a physician for proper diagnosis and treatment.
