ascorbic acid + biotin + colecalciferol; cholecalciferol + 10 other active ingredients: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
ascorbic acid + biotin + colecalciferol; cholecalciferol + 10 other active ingredients: clinical details
Prescribing considerations
- Reconcile all vitamin sources to reduce overdose risk.
- Assess hepatic and renal function, nutritional state, coagulation treatment and hypercalcaemia risk.
- Consider vitamin B12 assessment when deficiency is plausible; folate may partly mask haematological evidence.
- Account for vitamin degradation and admixture compatibility.
- Contains sodium and soya-derived phospholipid.
Contraindications and cautions
- Hypersensitivity to an active substance or excipient, including soya or peanut products
- Newborns, infants and children younger than 11 years
- Pre-existing hypervitaminosis
- Severe hypercalcaemia or hypercalciuria, or a disorder likely to cause either
- Concurrent vitamin A or retinoid treatment
Monitoring
- Clinical status and total vitamin exposure
- Vitamin concentrations, particularly vitamins A, D and E, when clinically indicated
- Liver function and bile acids
- Renal function and signs of vitamin accumulation or loss
- Coagulation where vitamin K or anticoagulant treatment is relevant
- Electrolytes and fluid balance during refeeding
- Laboratory-test interference from biotin and ascorbic acid
Clinical pharmacology
Intravenous administration makes the vitamins directly bioavailable. Water-soluble vitamins have limited storage and are mainly eliminated in urine; fat-soluble vitamins are stored principally in the liver and adipose tissue and clear more slowly.
Formulation and product differences
- Yellow-orange powder for solution for infusion containing 13 vitamins.
- Must be reconstituted and added to a compatible infusion or parenteral-nutrition admixture; not for direct injection.
- Contains glycine, sodium glycocholate and soyphosphatidylcholine.
- Single-use vial; the prepared product should be used immediately.
ascorbic acid + biotin + colecalciferol; cholecalciferol + 10 other active ingredients interactions
Review all medicines, supplements and parenteral-nutrition products because individual vitamins can alter treatment effects or laboratory results.
Vitamin A products and retinoids, including acitretin and bexarotene
Concurrent use is contraindicated because it increases vitamin A toxicity risk.
Coumarin anticoagulants, including warfarin and acenocoumarol
Vitamin K can reduce their anticoagulant effect; coagulation and INR require closer monitoring.
Enzyme-inducing antiseizure medicines
They may alter vitamin D, pyridoxine or folate status; folic acid may reduce seizure control with some agents.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.