Description

This is a sterile, lyophilized powder for injection/infusion which contains nine water-soluble and three fat soluble vitamins. Mixed micelles is used as a solubilizing agent. It is presented as a lyophilized, orange-yellow, sterile powder that is to be reconstituted with 5ml of Water for injections or other parenteral fluids, (e.g. as 0.9% Sodium chloride or 5% Glucose solution), prior to administration by parenteral route.

This is indicated as a daily multivitamin maintenance dosage for adults and children aged 11 years and above receiving parenteral nutrition. It is also indicated in other situations where administration by the intravenous route is required. Such situations include surgery, extensive burns, fractures and other trauma, severe infectious diseases and comatose states, which may provoke a "stress" situation with profound alterations in the body's metabolic demands and consequent tissue depletion of nutrients.

Patients receiving drugs that bind to a1-acid glycoprotein should be closely monitored for increases in response to these drugs, e.g. propranolol, prazosin and quinidine. Folic acid may increase the metabolism of some antiepileptics, such as phenobartbitol, phenytoin and primidone. Pyridoxine can reduce the effect of levo-dopa. Bleomycin can be inactivated by ascorbic acid and riboflavin.

This is contraindicated in patients with pre-existing hypervitaminosis or known hypersensitivity to any of the active ingredients. This product should not be injected to patients with pre-existing intolerance to thiamine. Similarly, this product should not be administered to patients with impaired hepatic function. This preparation should not be administered to those suffering from hyperparathyroidism due to hypercalcaemic complications.

Anaphylactic reactions have been reported following large intravenous doses of Thiamine. Urticaria and rash have also been associated with this preparation. There have been very rare reports of anaphylactic reactions following IV injection/infusion with this preparation over 1-4 minutes.

The use of this preparation has not been studied in human during pregnancy. This should be given to a pregnant woman only if clearly needed. The use of this product in lactating women is not recommended.

Anaphylactic reactions may occur in allergic subjects who are susceptible to Thiamine (Vitamin B1) and nicotinamide components of this product. Mild allergic reactions such as sneezing or mild asthma are warning signs that further injection/infusion may give rise to anaphylactic shock. Due to glychocolic acid content, repeated and prolonged administration in patients with jaundice of hepatic origin or severe biochemical evidence of cholestatis requires careful monitoring of liver function. Also in the case of impaired kidney function, fat-soluble vitamin levels should be carefully monitored.

Accumulation of Vitamin A and Vitamin D may be occured with prolonged administration of high doses.