vitamin b + Vitamin C: clinical use

Prescribing considerations

• Reserve for clinically significant depletion, malabsorption or other licensed settings requiring intravenous replacement.
• Administer only intravenously after dilution; have facilities for managing anaphylaxis immediately available.
• Consider the product’s sodium content in patients requiring sodium restriction.
• Do not mix with medicines or fluids other than those documented as compatible.

Contraindications and cautions

• Hypersensitivity to any active substance or excipient.
• Use particular caution after sneezing, mild asthma or another suspected reaction to previous parenteral thiamine.

Monitoring

• Observe closely during and shortly after administration for early hypersensitivity symptoms, hypotension and infusion-site reactions.
• Assess clinical response and the underlying cause of depletion or malabsorption.
• Visually inspect each ampoule for particles before administration.

Clinical pharmacology

A water-soluble combination containing thiamine, riboflavin, pyridoxine, nicotinamide and ascorbic acid. These compounds support coenzyme-dependent energy, amino-acid and redox pathways; product-specific pharmacokinetic data are not supplied in the SmPC.

Formulation and product differences

• Supplied as paired amber-glass ampoules forming a concentrate for intravenous infusion.
• Ampoule 1 contains thiamine, riboflavin and pyridoxine; ampoule 2 contains ascorbic acid, nicotinamide and glucose.
• Equal volumes from both ampoules are combined and diluted before use.
• The formulation contains sodium and is intended for single use.