Cyanocobalamin + D-Panthenol + Niacinamide + Vitamin B2 + Vitamin B6

Usage

This combination of B vitamins is prescribed for preventing and treating deficiencies in these essential nutrients. These deficiencies can arise from various factors, including inadequate dietary intake, malabsorption, or increased metabolic demands (e.g., pregnancy, lactation, hyperthyroidism). Specific conditions this combination addresses include:

• Vitamin B12 deficiency anemia (pernicious anemia)
• Wernicke-Korsakoff syndrome (thiamine deficiency)
• Pellagra (niacin deficiency)
• Ariboflavinosis (riboflavin deficiency)
• Peripheral neuropathy (often associated with B vitamin deficiencies)

Pharmacological Classification: Vitamins, Nutritional Supplements.

Mechanism of Action: This drug acts by replenishing depleted B vitamin stores. Each B vitamin plays a unique and crucial role in cellular function, particularly energy production, DNA synthesis, nerve function, and red blood cell formation. D-Panthenol is a provitamin of B5, which is vital for metabolic processes.

Alternate Names

• Vitamin B Complex

How It Works

Pharmacodynamics: Each B vitamin in this combination exerts specific effects on the body:

• Cyanocobalamin (B12): Essential for DNA synthesis, red blood cell formation, and nerve function.
• D-Panthenol (Provitamin B5): Converted to pantothenic acid, which is crucial for fatty acid metabolism and maintaining healthy skin.
• Niacinamide (B3): Plays a role in energy production and metabolism, supports neurological function, and reduces inflammation.
• Riboflavin (B2): Acts as a precursor to coenzymes involved in energy production and metabolism.
• Vitamin B6 (Pyridoxine): Aids in neurotransmitter synthesis, red blood cell formation.

Pharmacokinetics:

• Absorption: Primarily absorbed in the gastrointestinal tract. Vitamin B12 requires intrinsic factor for absorption.
• Metabolism: B vitamins are metabolized in the liver.
• Elimination: Primarily through renal excretion.

Mode of Action: These vitamins act as coenzymes in various metabolic pathways. For example, vitamin B12 is essential for the conversion of homocysteine to methionine.

Dosage

Dosing depends on the specific formulation and the patient’s individual needs. Always refer to the manufacturer’s instructions for the prescribed product.

Standard Dosage

Adults: Dosages vary widely depending on the formulation and the specific deficiency being treated. A common regimen might involve one tablet or capsule daily, or as directed by a physician.

Children: Pediatric dosing is based on the child’s age, weight, and specific needs. Consult pediatric dosing guidelines and consider liquid formulations for easier administration.

Special Cases:

• Elderly Patients: Consider age-related changes in renal function and adjust dose accordingly.
• Patients with Renal Impairment: Dosage adjustments may be necessary.
• Patients with Hepatic Dysfunction: Monitor liver function and consider dosage modifications.
• Patients with Comorbid Conditions: Consider individual patient needs and any potential interactions.

Clinical Use Cases

• Intubation/Surgical Procedures/Mechanical Ventilation/ICU Use: Parenteral administration (IV or IM) may be preferred in these settings. Dosage depends on individual requirements.
• Emergency Situations: In acute Wernicke’s encephalopathy, high doses of thiamine are given intravenously.

Side Effects

Common Side Effects:

• Nausea
• Vomiting
• Diarrhea
• Headache
• Dizziness
• Itching

Rare but Serious Side Effects:

• Allergic reactions (rash, hives, swelling, difficulty breathing)
• Flushing
• Jaundice
• Numbness or weakness in the limbs

Contraindications

• Hypersensitivity to any of the components.
• Leber’s hereditary optic neuropathy (for cyanocobalamin).

Drug Interactions

• Antibiotics (e.g., tetracycline): May impair absorption of certain B vitamins.
• Anticonvulsants: May reduce vitamin B6 levels.
• Proton Pump Inhibitors: May interfere with vitamin B12 absorption.
• Levodopa: Vitamin B6 can reduce the effectiveness of levodopa.
• Alcohol: May inhibit absorption and utilization of certain B vitamins.

Pregnancy and Breastfeeding

This combination is generally considered safe during pregnancy and breastfeeding when used as directed. Adequate vitamin B intake is essential for fetal development and maternal health. However, always consult a physician before taking any medication during pregnancy or while breastfeeding.

Drug Profile Summary

• Mechanism of Action: Replenishes essential B vitamins.
• Side Effects: Generally well-tolerated, but nausea, diarrhea, and headache may occur.
• Contraindications: Hypersensitivity to any component.
• Drug Interactions: May interact with certain antibiotics, anticonvulsants, and other medications.
• Pregnancy & Breastfeeding: Generally safe when used as directed. Consult a physician before use.
• Dosage: Varies depending on the formulation and patient needs.
• Monitoring Parameters: Serum B vitamin levels, complete blood count, as needed.

Popular Combinations

Often combined with other vitamins and minerals in multivitamin formulations. Specific therapeutic combinations are determined based on the individual’s needs.

Precautions

• Assess patient’s nutritional status and medical history.
• Screen for allergies.
• Monitor for potential drug interactions.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Cyanocobalamin + D-Panthenol + Niacinamide + Vitamin B2 + Vitamin B6?

A: Dosage varies widely based on the individual product formulation and the patient’s specific needs. Always refer to the prescribing information.

Q2: What are the common side effects?

A: Common side effects include nausea, vomiting, diarrhea, headache, and itching.

Q3: Are there any contraindications to using this combination?

A: Yes, contraindications include known hypersensitivity to any of the components and Leber’s hereditary optic neuropathy (for cyanocobalamin).

Q4: Can this combination be used during pregnancy and breastfeeding?

A: Generally considered safe when used as directed, but consult a physician before use.

Q5: What are the signs of vitamin B12 deficiency?

A: Signs of B12 deficiency include megaloblastic anemia, fatigue, weakness, neurological symptoms (numbness, tingling), and cognitive impairment.

Q6: What foods are good sources of B vitamins?

A: Good sources of B vitamins include meat, poultry, fish, eggs, dairy products, leafy green vegetables, and legumes.

Q7: How are B vitamin deficiencies diagnosed?

A: Diagnosis typically involves blood tests to measure serum levels of specific B vitamins. A complete blood count (CBC) may also be performed.

Q8: What is the difference between oral and injectable forms of this combination?

A: Oral forms are generally used for less severe deficiencies, while injectable forms are preferred for acute deficiencies or when malabsorption is a concern.

Q9: Can this combination interfere with other medications?

A: Yes, this combination can interact with certain medications, such as antibiotics, anticonvulsants, and proton pump inhibitors.