Multivitamins + Other preparations - instructions for use, doses, side effects, contraindications

Vitamins, minerals and microelements reduce the consequences of poor nutrition, the effect of harmful environmental factors, stress effects, activate the body's defenses in long and severe illnesses.

The complex of biologically active substances of ginseng (saponin glycosides - ginsenosides, eleutherosides, peptides, essential oils, styrene, vitamins and minerals) possess adaptogenic, stimulating and detoxifying action. Regulates the work of endocrine glands, promotes the normalization of blood pressure, the concentration of cholesterol and glucose in the blood.

The combination is effective in complex treatment against a background of general weakening of the body's functions, overstrain and a feeling of fatigue, during the reconvalescence after the transferred diseases.

Retinol stimulates epithelization, is necessary for the growth of bones and cartilage, the synthesis of rhodopsin.

Ergocalciferol - stimulation of absorption of Ca²⁺ and phosphorus from the small intestine (an essential element for absorption, utilization of Ca²⁺, calcification process). Regulation of phosphorus-calcium metabolism (along with PTH and calcitonin), stimulation of calcium mobilization from the bone. Binding of active metabolites to receptors, initiation of synthesis of calcium-binding protein, enhancement of reabsorption in distal tubules of the kidneys, increase in the capture of bone tissue, maintenance of normal Ca concentration²⁺ in the extracellular fluid.

Tocopherol has antioxidant activity, stimulates the synthesis of heme and proteins, processes of tissue respiration and proliferation.

Thiamine (vitamin B₁) as thiamine pyrophosphate catalyzes carbohydrate metabolism, affects the functioning of the nervous system.

Calcium pantothenate - for the synthesis of coenzyme acetylation.

Riboflavin (vitamin B₂) activates tissue respiration; pyridoxine - exchange of amino acids, histamine, neurotransmitters.

Nicotinamide - in the processes of tissue respiration, carbohydrate and fat metabolism.

Ascorbic acid - inhibition of lipid peroxidation; regulation of the transport of hydrogen ions in biochemical reactions.It is an electron donor in the reactions of hydroxylation of proline and lysine in the collagen molecule, carnitine biosynthesis, dopamine hydroxylation (with the formation of norepinephrine) with the participation of dopamine-.beta.-hydroxylase, tyrosine metabolism and amide group addition to peptide hormones (which increases their stability).

Pyridoxine (vitamin B₆) in the body is phosphorylated into pyridoxal-5-phosphate-coenzyme reactions of decarboxylation, transamination and deamination of amino acids. Replenishes vitamin B deficiency₆: participates in the exchange of tryptophan, methionine, cysteine, glutamic acid, glycine, γ-aminobutyric acid, histamine, serotonin and others; ensures the normal functioning of the central and peripheral nervous system. Normalizes lipid metabolism.

Folic acid provides a normal course of amino acid, nucleic acid, choline metabolism, is necessary for normal hematopoiesis.

Cyanocobalamin (vitamin B₁₂) is involved in the process of hematopoiesis, myelin synthesis

Pharmacokinetics:

Pharmacokinetics of the drug corresponds to that shown for vitamins, plant components and minerals that are included in the composition.

Retinol: atSucks in the duodenum and ileum require the presence of bile acids, protein lipases and fat. Biotransformation in the liver. Linkage to plasma proteins <5% (65% - with increased consumption). Elimination with feces, excess - kidneys. It accumulates in the liver, kidneys and lungs.

Ergocalciferol - absorption in the small intestine in the presence of bile. The connection with plasma proteins is a specific α-globulin (for transport). Depot: liver, fat depots. Biotransformation (sequential in 2 stages) in the liver and kidneys. Half-life~ 19-48 h, deposits in adipose tissue - for a long time. Elimination by the kidneys and with feces.

Vitamin E (tocopherol): when taken orally, the absorption is 50%; in the process of absorption forms a complex with lipoproteins (intracellular carriers of tocopherol). Absorption requires the presence of bile acids. Associated with alpha₁- and beta-lipoproteins, in part - with serum albumin. If there is a violation of protein metabolism, transport is difficult. Maximum concentrationis achieved after 4 hours. It is deposited in the adrenal glands, pituitary gland, testes, adipose and muscle tissue, erythrocytes, liver. More than 90% is excreted with bile, 6% - with kidneys.

Thiamine: aAbsorption full (in the duodenum), alcohol hampers the absorption of vitamin B₁. The connection with plasma proteins is low. Biotransformation (phosphorylation) in the liver; active metabolite - thiamine pyrophosphate (cocarboxylase). Elimination by the kidneys (metabolites and unchanged) and with feces.

Calcium pantothenate: well absorbed in the digestive tract. It is distributed in various tissues of the body (mainly as coenzyme A). The highest concentrations are in the liver, adrenal gland, heart and kidneys. It is not metabolized. Elimination - kidneys (70% unchanged) and with feces (30%).

Riboflavin: absorption rapid (in the duodenum). Relationship with plasma proteins 60%. Biotransformation in the liver. Half-life66-84 min. Elimination of the kidneys in the form of metabolites, in high doses - in unchanged form.

Nicotinamide: Absorption is fast and complete 60-70% of the dose taken internally. Low fat foods increase bioavailability. Biotransformation in the liver. Half-life45 min. Elimination by the kidneys (in the form of a metabolite, to a lesser extent - unchanged).

Ascorbic acid - absorbed in the duodenum, in part - in the ileum (suction decreases with increasing dose). Absorption of 20-50% (when taking a dose exceeding 200 mg).Stocks in the body are about 1.5 g. Depot: leukocytes, platelets, endocrine glands, liver, ocular epithelium, lungs, kidneys, intestinal wall, heart, muscles. Connection with plasma proteins - 25%. Biotransformation in the liver. Elimination by the kidneys (in the form of metabolites).

Pyridoxine: metabolized in the liver with the formation of pharmacologically active metabolites (pyridoxalphosphate and pyridoxamino phosphate). Distribution is predominantly in the muscles, liver and CNS. Penetrates through the placenta and into the mother's milk. It is excreted by the kidneys (with intravenous injection with bile - 2%).

Folic acid: the connection with plasma proteins is high. Deposited in the liver, where the biotransformation takes place (the active form is tetrahydrofolic acid). Maximum concentration30-60 min. Elimination by the kidneys (unchanged appearance, metabolites). Removed during hemodialysis.

Cyanocobalamin: absorption occurs in the distal ileum after binding to the internal factor in the presence of calcium ions and at pH> 5.4. Exposed to hepatic intestinal recirculation. The connection with plasma proteins (transcobalamins) is very high. The main reserves are in the liver (90%), in part - in the kidneys.Biotransformation in the liver. The half-life is 6 days. Elimination with feces. When the drug is prescribed in an amount exceeding the daily requirement, it is displayed mainly unchanged.

Indications:

Prolonged physical and mental stress.

Chronic fatigue syndrome.

The use of antibiotics.

Hypovitaminosis.

Improve metabolism and general condition in the elderly.

Asthenic conditions of various origin, decreased immunity (slow the progression of HIV infection), chronic fatigue syndrome.

Memory disorder (a minimal positive effect is found, further, longer-term studies are needed), headaches, dizziness and tinnitus (especially in the elderly) that result from cerebrovascular disorders. The positive effect in prescribing to people on a balanced diet was not detected.

Unfavorable environmental conditions.

The recovery period after severe diseases, during and after treatment with chemotherapeutic drugs.

Preventing infections in the elderly - the results are contradictory, further research is needed.

ICD-10

III.D80-D89.D84.9 Immunodeficiency, unspecified

IV.E50-E64 Other types of malnutrition

IV.E50-E64.E59 Almentary insufficiency of selenium

IV.E50-E64.E61.7 Insufficiency of many cells

XIV.N80-N98.N95.1 Menopause and menopause in women

XVIII.R50-R69.R53 Malaise and fatigue

XX.Y90-Y98.Y97 Factors associated with environmental pollution

XXI.Z40-Z54.Z54 Condition of recovery

XXI.Z70-Z76.Z72.0 Tobacco use

XXI.Z70-Z76.Z72.1 Alcohol consumption

XXI.Z70-Z76.Z73.0 Overwork

XXI.Z70-Z76.Z73.2 Insufficient rest and relaxation

XXI.Z70-Z76.Z73.3 Stress condition, not elsewhere classified

Contraindications:

Hypersensitivity
Sleep disorders
Increased nervous excitability
Children up to 3 years old
Hypervitaminosis A and D

Carefully:

Diseases of the liver
Stomach ulcer and duodenal ulcer
Diabetes

Pregnancy and lactation:

Category FDA not determined. Do not use when pregnant and breast-feeding.

Dosing and Administration:

1 tablet with meals once a day as directed by a doctor.

Side effects:

Allergic reactions.

Thiamine: sweating, tachycardia.

Riboflavin: impaired renal function, impaired vision.

Pyridoxine: hypersecretion of hydrochloric acid

Cyanocobalamin: state of excitement, pain in the heart, tachycardia.

Nicotinamide: at long appointment in high doses - development of fatty dystrophy of a liver.

Vitamin E (tocopherol): diarrhea, epigastric pain.

Calcium pantothenate: nausea, vomiting, heartburn.

Ascorbic acid: headache, fatigue, insomnia. Spasms of the stomach, nausea and vomiting. Hyperoxaluria and the formation of kidney stones from calcium oxalate. Feeling hot.

Overdose:

If the above dose of the drug is exceeded, the symptoms of retinol hypervitaminosis are clinically significant.

Symptoms of overdose: severe headache, dizziness, facial flushing, nausea, vomiting, decreasing heart rate, vision impairment possible.

Treatment: washing the stomach, ingestion of activated carbon.

Interaction:

It is not recommended simultaneous intake of other vitamin and tonic drugs.

The effect reduces diphenin, colestramine, toxicity - vitamin A. Biotransformation rate is increased by barbiturates.

Vitamin B₆ reduces the severity of the action of levodopa.

If you need to take other medications in combination with multivitamins, there should be an interval of about 2 hours between taking.

Retinol: while simultaneous application with neomycin, a decrease in the absorption of retinol is possible.

Thiamine: ethanol sharply reduces the absorption of thiamine (concentration in the blood can decrease by 30%). Long-term treatment with anticonvulsant drugs can lead to a thiamine deficiency. Thiamine completely disintegrates in solutions containing sulfites. Thiamine is unstable in alkaline and neutral solutions; the appointment with carbonates, citrates, barbiturates, copper preparations is not recommended.

Riboflavin: when used simultaneously with m-holinoblokatorami, absorption and bioavailability of riboflavin increases (due to a decrease in intestinal motility).

With simultaneous use with thyroid hormones, metabolism of riboflavin is accelerated.

With simultaneous use decreases the activity of doxycycline, tetracycline, oxytetracycline, erythromycin and lincomycin.

Riboflavin is not compatible with streptomycin.

With simultaneous use, side effects are reduced and preventedchloramphenicol (violation of hemopoiesis, optic neuritis).

With simultaneous application chlorpromazine, amitriptyline due to blockade of flavinokinase, the incorporation of riboflavin into flavinadenine mononucleotide and flavinadenine dinucleotide is disrupted and its excretion in the urine is increased.

Tocopherol: when used simultaneously with tocopherol, the effects of warfarin and dicumarol may change.

There are reports of a decrease in the effectiveness of simultaneous treatment with iron in children.

With simultaneous application of tocopherol with cyclosporin, the absorption of cyclosporin increases.

Pyridoxine: the physiological function of vitamins B₁ and B₆is the potentiation of the actions of each other, manifested in a positive effect on the nervous, muscular and cardiovascular systems.

With simultaneous use with hormonal contraceptives, an increase in the concentration of pyridoxine in the blood plasma is possible.

With simultaneous use, potentiates the action of diuretics.

When combined with levodopa, the effects of levodopa are reduced or completely inhibited.

With simultaneous use with isonicotinhydrazide, penicillamine, cycloserine, a decrease in the effectiveness of pyridoxine is possible.

With simultaneous use with phenytoin, phenobarbital, the concentrations in the blood plasma of phenytoin and phenobarbital may decrease.

Cyanocobalamin: when used simultaneously with hormonal contraceptives for oral administration, a decrease in the concentration of cyanocobalamin in the blood plasma is possible. With simultaneous use with anticonvulsants, the absorption of cyanocobalamin from the intestine is reduced. When used simultaneously with neomycin, aminosalicylic acid, colchicine, cimetidine, biguanides, ranitidine, potassium preparations, the absorption of cyanocobalamin from the intestine decreases. When parenteral application chloramphenicol can reduce the hematopoietic effect of cyanocobalamin in anemia.

Nicotinamide: with alcohol - skin rashes and itching are possible.

Folic acid: With simultaneous use with oral contraceptives, a decrease in the concentration of folic acid in the blood plasma is possible.

With simultaneous application with sulfasalazine, a decrease in the absorption of folic acid is possible.

With simultaneous use, it is possible to reduce the concentration in the blood plasma of phenytoin, phenobarbital, primidone and decrease their anticonvulsant activity.

Calcium pantothenate: increases the cardiotonic effect of cardiac glycosides, reduces the toxic effect of streptomycin and other antituberculous drugs.

Ascorbic acid: when applied simultaneously with barbiturates, primidone, excretion of ascorbic acid with urine increases.

With the simultaneous use of oral contraceptives, the concentration of ascorbic acid in the blood plasma decreases.

When used simultaneously with iron preparations ascorbic acid, thanks to its reducing properties, converts trivalent iron into bivalent iron, which improves its absorption.

Ascorbic acid in high doses can reduce the pH of the urine, which, when used at the same time, reduces the tubular reabsorption of amphetamine and tricyclic antidepressants. With simultaneous application acetylsalicylic acid reduces absorption of ascorbic acid by about a third. With simultaneous use with warfarin, the effects of warfarin may be reduced. With simultaneous application ascorbic acid increases the excretion of iron in patients receiving deferoxamine.

With simultaneous use with tetracycline, the excretion of ascorbic acid with urine increases. Vitamin C enhances the effect and side effects of antimicrobial agents from the group of sulfonamides (including the appearance of crystals in the urine). It is possible to increase the concentration of ethinyl estradiol in blood plasma when it is used simultaneously in oral contraceptives.

Special instructions:

Impact on the ability to drive vehicles and manage mechanisms not found.

Instructions

Multivitamins + Other drugs (Multivitamins + Other medicines)