Usage
This combination is prescribed for the management and treatment of nutritional deficiencies, especially during pregnancy, and for conditions such as:
- Folate deficiency anemia
- Vitamin B12 deficiency (and related conditions like pernicious anemia)
- Vitamin B6 deficiency (and associated disorders like peripheral neuropathy)
- Supporting cognitive function and brain health
- Maintaining cardiovascular health. It also may reduce the risk of age-related cognitive decline and lower blood triglyceride levels, and can help prevent neural tube defects in developing fetuses.
Pharmacological Classification: Nutritional supplement
Mechanism of Action: This combination addresses deficiencies by providing the necessary nutrients. DHA supports brain and eye development and reduces inflammation. Folic acid is essential for DNA/RNA synthesis and cell division. Methylcobalamin aids nerve function and red blood cell production. Pyridoxine is crucial for metabolism and neurotransmitter synthesis. Each component acts synergistically to promote overall health.
Alternate Names
- Vitamin B Complex with Docosahexaenoic Acid
- DHA with B Vitamins
- Folate, Methylcobalamin, Pyridoxine, and DHA combination
Brand Names: Examples include Cor-3 D Capsule, Enfolate Softgel Capsule, Rolifol-Dha Softgel Capsule, BFORCARIN, and Mynerve DHA. Many other brand names exist.
How It Works
Pharmacodynamics:
- Docosahexaenoic acid (DHA): Incorporated into cell membranes, particularly in the brain and retina, influencing cell behavior and reducing inflammation. Supports brain and eye development. Lowers triglycerides and raises good cholesterol levels.
- Folic acid: Converted into active forms aiding DNA/RNA production, amino acid metabolism, red blood cell creation, and lower homocysteine levels (a heart disease risk factor).
- Methylcobalamin: Aids in the synthesis of methionine from homocysteine, regulating homocysteine levels. Supports nerve function, red blood cell production, and DNA synthesis.
- Pyridoxine Hydrochloride: Converted to pyridoxal 5’-phosphate (PLP), a coenzyme for various metabolic reactions, including neurotransmitter synthesis and red blood cell function.
Pharmacokinetics:
- Absorption: Absorbed through the gastrointestinal tract. DHA absorption may be affected by the presence of food. Alcohol reduces the absorption of folic acid. Dairy products may also interfere with the absorption of this drug combination.
- Metabolism: Folic acid is metabolized in the liver. Methylcobalamin is stored in the liver. Pyridoxine is converted to its active form, PLP, in the liver. DHA is incorporated into cell membranes.
- Elimination: Folic acid is excreted primarily in the urine, with some biliary excretion. Methylcobalamin is primarily excreted in bile. Pyridoxine is excreted in the urine. DHA is slowly eliminated from the body.
Dosage
Dosage is determined by the patient’s specific needs and the severity of the deficiency. It is important to note that the following dosage information is a general guideline, and individualized dosing should be done by a physician. As with all medications, it is essential to follow your doctor’s advice on dosage. A typical dose might include one capsule or tablet daily. The dose should be individualized based upon the specific levels of DHA, folic acid, methylcobalamin, and pyridoxine required.
Standard Dosage
Adults: As directed by a physician.
Children: The dosage for children should be determined by a pediatrician. Children above the age of 12 years may take adult doses, but always consult a physician for guidance.
Special Cases: Dosage adjustments may be necessary in the following:
- Elderly Patients: Based on kidney function and other health conditions.
- Patients with Renal Impairment: Dose modification is required.
- Patients with Hepatic Dysfunction: Dose modification may be required.
- Patients with Comorbid Conditions such as diabetes, monitor blood glucose regularly.
Clinical Use Cases
Dosage for the clinical situations listed (Intubation, Surgical Procedures, Mechanical Ventilation, Intensive Care Unit (ICU) Use, and Emergency Situations) has not been found in the sources provided.
Dosage Adjustments
Dose modifications are based on renal/hepatic function and other individual patient factors.
Side Effects
Common Side Effects:
- Nausea
- Vomiting
- Diarrhea
- Anorexia (loss of appetite)
- Headache
- Weight loss
- Fatigue
- Bloating and flatulence
- Fishy aftertaste or burps
- Rash or itching
- Abdominal Discomfort
Rare but Serious Side Effects:
- Allergic reactions (rare, seek immediate medical attention if you experience an allergic reaction)
Long-Term Effects:
Limited information available.
Adverse Drug Reactions (ADR):
Clinically significant ADRs requiring immediate intervention are rare. Allergic reactions should be addressed promptly.
Contraindications
- Hypersensitivity to any of the components.
Drug Interactions
- Anticoagulants (e.g., warfarin, heparin)
- Antiplatelet agents (e.g., aspirin, clopidogrel)
- Medications affecting folate metabolism (e.g., methotrexate, phenytoin)
- Alcohol (reduces folic acid absorption and may worsen side effects)
- Dairy products and eggs (may affect absorption)
Pregnancy and Breastfeeding
Generally considered safe during pregnancy and lactation, particularly for promoting brain and eye development in the growing baby and for the prevention of neural tube defects. However, it is essential to consult a doctor before use. Folate is essential during pregnancy, but high doses may mask vitamin B12 deficiency. Pyridoxine and folic acid are excreted in breast milk.
Popular Combinations
This combination itself is a popular combination. Information on the popularity of this combination with other drugs has not been found in the provided sources.
Precautions
(See information above)
FAQs (Frequently Asked Questions)
(See below)
Q1: What is the recommended dosage for Docosahexanoic acid + Folic Acid + Methylcobalamin + Pyridoxine Hydrochloride?
A: The dosage varies depending on individual needs and should be determined by a physician. A typical dose might be one capsule or tablet daily.
Q2: Can this combination be taken during pregnancy?
A: It’s generally considered safe and even beneficial, especially for preventing neural tube defects. However, always consult a doctor before use during pregnancy or while breastfeeding.
Q3: What are the common side effects?
A: Common side effects are generally mild and include nausea, vomiting, diarrhea, stomach upset, headache, and a fishy aftertaste or burps.
Q4: Are there any drug interactions I should be aware of?
A: Yes, this medication may interact with certain other medications, such as anticoagulants, antiplatelet agents, medications affecting folate metabolism, antacids, antibiotics, and cholesterol-lowering agents.
Q5: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and take the next dose as scheduled. Never double the dose to catch up.
Q6: How should this medication be stored?
A: Store in a cool, dry place away from direct sunlight. Keep out of the reach of children.
Q7: Can I consume alcohol while taking this supplement?
A: It’s advisable to avoid or limit alcohol consumption as it can reduce the absorption of folic acid and may exacerbate side effects.
Q8: Are there any specific precautions for patients with kidney or liver disease?
A: Patients with kidney or liver disease should consult their doctor before taking this supplement as dose adjustments may be needed.
Q9: Is this combination safe for long-term use?
A: Long-term use should be under the guidance of a healthcare professional.
Q10: What are the signs of a vitamin B12 deficiency?
A: Signs of vitamin B12 deficiency can include fatigue, weakness, tingling or numbness in the hands and feet, pale skin, a smooth tongue, shortness of breath, dizziness, and heart palpitations.
