NEUROBION PLUS TABLET

Manufacturer : MCO-MERCK LIMITED
Composition : METHYLCOBALAMIN-750MCG+PYRIDOXINE (VITB6)-1.5MG+NICOTINAMIDE-45MG
Dose Form : TABLET
Description : NEUROBION PLUS TAB
Route Of Administration : ORAL
Pack : 10
In stock
SKU
NEU0100
₹94.82
Manufacturer : MCO-MERCK LIMITED
Composition : METHYLCOBALAMIN-750MCG+PYRIDOXINE (VITB6)-1.5MG+NICOTINAMIDE-45MG
Dose Form : TABLET
Description : NEUROBION PLUS TAB
Route Of Administration : ORAL
Pack : 10

Drug Ingredient Information

METHYLCOBALAMIN-750MCG+PYRIDOXINE (VITB6)-1.5MG+NICOTINAMIDE-45MG

METHYLCOBALAMIN

Information for patients
Drug Information Vitamin B12, is used to treat vitamin B12 deficiency, cyanide poisoning, and hereditary deficiency of transcobalamin II.[3] It is also given as part of the schilling test for detecting pernicious anemia.[3] For cyanide poisoning, large amount may be given intravenously, and sometimes in combination with sodium thiosulfate.[4] The mechanism of action is straightforward: the hydroxycobalamin hydroxide ligand is displaced by the toxic cyanide ion, and the resulting harmless B12 complex is excreted in urine. In the United States, the Food and Drug Administration approved (in 2006) the use of hydroxocobalamin for acute treatment of cyanide poisoning.[5] High vitamin B12 level in elderly individuals may protect against brain atrophy or shrinkage, associated with Alzheimer's disease and impaired cognitive function.[6] High-dose administration of Vitamin B12 has been additionally validated to stimulate the activity of the body's TH1 suppressor T-Cells, which then down-regulates the over-production of the allagen antibody 1gE in allergic individuals.
Drug Alert
Alert no data available
Before Consuming the Medicine
Avoid Drug no data available
Drug Special Care Vitamin B12 supplements in theory should be avoided in people sensitive or allergic to cobalamin, cobalt, or any other product ingredients. However, direct allergy to a vitamin or nutrient is extremely rare, and if reported, other causes should be sought.
Drug Drug Interactions Aminosalicylic acid (para-aminosalicylic acid, PAS, Paser): Aminosalicylic acid can reduce oral vitamin B12 absorption, possibly by as much as 55%, as part of a general malabsorption syndrome. Megaloblastic changes, and occasional cases of symptomatic anemia have occurred, usually after doses of 8 to 12 g/day for several months. Vitamin B12 levels should be monitored in people taking aminosalicylic acid for more than one month. Antibiotics: An increased bacterial load can bind significant amounts of vitamin B12 in the gut, preventing its absorption. In people with bacterial overgrowth of the small bowel, antibiotics such as metronidazole (Flagyl) can actually improve vitamin B12 status. The effects of most antibiotics on gastrointestinal bacteria are unlikely to have clinically significant effects on vitamin B12 levels. Hormonal contraception: The data regarding the effects of oral contraceptives on vitamin B12serum levels are conflicting. Some studies have found reduced serum levels in oral contraceptive users, but others have found no effect despite use of oral contraceptives for up to 6 months. When oral contraceptive use is stopped, normalization of vitamin B12 levels usually occurs. Lower vitamin B12serum levels seen with oral contraceptives probably are not clinically significant. Chloramphenicol (Chloromycetin): Limited case reports suggest that chloramphenicol can delay or interrupt the reticulocyte response to supplemental vitamin B12 in some patients. Blood counts should be monitored closely if this combination cannot be avoided. Cobalt irradiation: Cobalt irradiation of the small bowel can decrease gastrointestinal (GI) absorption of vitamin B12. Colchicine: Colchicine in doses of 1.9 to 3.9 mg/day can disrupt normal intestinal mucosal function, leading to malabsorption of several nutrients, including vitamin B12. Lower doses do not seem to have a significant effect on vitamin B12 absorption after 3 years of colchicine therapy. The significance of this interaction is unclear. Vitamin B12 levels should be monitored in people taking large doses of colchicine for prolonged periods. Colestipol (Colestid), cholestyramine (Questran): These resins used for sequestering bile acids to decrease cholesterol, can decrease gastrointestinal (GI) absorption of vitamin B12. It is unlikely this interaction will deplete body stores of vitamin B12 unless there are other factors contributing to deficiency. In a group of children treated with cholestyramine for up to 2.5 years, there was not any change in serum vitamin B12 levels. Routine supplements are not necessary. H2-receptor antagonists: include cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac). Reduced secretion of gastric acid and pepsin produced by H2 blockers can reduce absorption of protein-bound (dietary) vitamin B12, but not of supplemental vitamin B12. Gastric acid is needed to release vitamin B12 from protein for absorption. Clinically significant vitamin B12 deficiency and megaloblastic anemia are unlikely, unless H2 blocker therapy is prolonged (2 years or more), or the person's diet is poor. It is also more likely if the person is rendered achlorhydric(with complete absence of gastric acid secretion), which occurs more frequently with proton pump inhibitors than H2 blockers. Vitamin B12 levels should be monitored in people taking high doses of H2 blockers for prolonged periods. Metformin (Glucophage): Metformin may reduce serum folic acid and vitamin B12 levels. These changes can lead to hyperhomocysteinemia, adding to the risk of cardiovascular disease in people with diabetes.[citation needed] There are also rare reports of megaloblastic anemia in people who have taken metformin for five years or more. Reduced serum levels of vitamin B12 occur in up to 30% of people taking metformin chronically.[20][21] However, clinically significant deficiency is not likely to develop if dietary intake of vitamin B12 is adequate. Deficiency can be corrected with vitamin B12 supplements even if metformin is continued. The metformin-induced malabsorption of vitamin B12 is reversible by oral calcium supplementation.[22] The general clinical significance of metformin upon B12 levels is as yet unknown.[23] Neomycin: Absorption of vitamin B12 can be reduced by neomycin, but prolonged use of large doses is needed to induce pernicious anemia. Supplements are not usually needed with normal doses. Nicotine: Nicotine can reduce serum vitamin B12 levels. The need for vitamin B12 supplementation in smokers has not been adequately studied. Nitrous oxide: Nitrous oxide inactivates the cobalamin form of vitamin B12 by oxidation. Symptoms of vitamin B12 deficiency, including sensory neuropathy, myelopathy, and encephalopathy, can occur within days or weeks of exposure to nitrous oxide anesthesia in people with subclinical vitamin B12 deficiency. Symptoms are treated with high doses of vitamin B12, but recovery can be slow and incomplete. People with normal vitamin B12 levels have sufficient vitamin B12 stores to make the effects of nitrous oxide insignificant, unless exposure is repeated and prolonged (such as recreational use). Vitamin B12 levels should be checked in people with risk factors for vitamin B12 deficiency prior to using nitrous oxide anesthesia. Chronic nitrous oxide B12 poisoning (usually from use of nitrous oxide as a recreational drug), however, may result in B12 functional deficiency even with normal measured blood levels of B12.[24] Phenytoin (Dilantin), phenobarbital, primidone (Mysoline): These anticonvulsants have been associated with reduced vitamin B12 absorption, and reduced serum and cerebrospinal fluidlevels in some patients. This may contribute to the megaloblastic anemia, primarily caused by folate deficiency, associated with these drugs. It is also suggested that reduced vitamin B12 levels may contribute to the neuropsychiatric side effects of these drugs. Patients should be encouraged to maintain adequate dietary vitamin B12 intake. Folate and vitamin B12 status should be checked if symptoms of anemia develop. Proton pump inhibitors (PPIs): The PPIs include omeprazole (Prilosec, Losec), lansoprazole(Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix, Pantoloc), and esomeprazole (Nexium). The reduced secretion of gastric acid and pepsin produced by PPIs can reduce absorption of protein-bound (dietary) vitamin B12, but not supplemental vitamin B12. Gastric acid is needed to release vitamin B12 from protein for absorption. Reduced vitamin B12 levels may be more common with PPIs than with H2-blockers, because they are more likely to produce achlorhydria (complete absence of gastric acid secretion). However, clinically significant vitamin B12 deficiency is unlikely, unless PPI therapy is prolonged (2 years or more) or dietary vitamin intake is low. Vitamin B12 levels should be monitored in people taking high doses of PPIs for prolonged periods. Zidovudine (AZT, Combivir, Retrovir): Reduced serum vitamin B12 levels may occur when zidovudine therapy is started. This adds to other factors that cause low vitamin B12 levels in people with HIV, and might contribute to the hematological toxicity associated with zidovudine. However, the data suggest vitamin B12 supplements are not helpful for people taking zidovudine.[citation needed] Folic acid: Folic acid, particularly in large doses, can mask vitamin B12 deficiency by completely correcting hematological abnormalities. In vitamin B12 deficiency, folic acid can produce complete resolution of the characteristic megaloblastic anemia, while allowing potentially irreversible neurological damage (from continued inactivity of methylmalonyl mutase) to progress. Thus, vitamin B12 status should be determined before folic acid is given as monotherapy. Potassium: Potassium supplements can reduce absorption of vitamin B12 in some people. This effect has been reported with potassium chloride and, to a lesser extent, with potassium citrate. Potassium might contribute to vitamin B12 deficiency in some people with other risk factors, but routine supplements are not necessary.[
Drug Pregnancy Interaction no data available
Drug Breast feeding Interaction no data available
Drug Machinery Interaction no data available
Drug More Information Alcohol (ethanol): Excessive alcohol intake lasting longer than two weeks can decrease vitamin B12 absorption from the gastrointestinal tract.[c
How to take the Medicine
Consumption Info no data available
Drug quanitty The dietary reference intake for an adult ranges from 2 to 3 µg per day.[9] Vitamin B12 is believed to be safe when used orally in amounts that do not exceed the recommended dietary allowance (RDA). There have also been studies that showed no adverse consequences of doses above the RDA.[10] The RDA for vitamin B12 in pregnant women is 2.6 µg per day and 2.8 µg during lactation periods.[citation needed] There is insufficient reliable information available about the safety of consuming greater amounts of vitamin B12 during pregnancy. The Vegan Society, the Vegetarian Resource Group, and the Physicians Committee for Responsible Medicine, among others, recommend that vegans either consistently eat foods fortified with B12 or take a daily or weekly B12 supplement.[11][12][13] Fortified breakfast cereals are a particularly valuable source of vitamin B12 for vegetarians and vegans. In addition, adults age 51 and older are recommended to consume B12 fortified food or supplements to meet the RDA, because they are a population at an increased risk of deficiency
Drug Dose Can you take too much? No. Unlike other supplements which you can overdose on, your body doesn’t store excess vitamin B12. But you don’t want to waste it. I usually go with ~1cc every week or so.
Excess Drug Consumption no data available
Forgot Drug Consumption contact your doctor
Stop Drug Consumption do not stop the medicine untill adviced by your doctor
Possible Side Effects
General Information no data available
Common Drug Side Effects Vitamin B12 has extremely low toxicity and even taking it in enormous doses appears not to be harmful to healthy individuals.[17][18] Hematologic: Peripheral vascular thrombosis has been reported. Treatment of vitamin B12 deficiency can unmask polycythemia vera, which is characterized by an increase in blood volume and the number of red blood cells. The correction of megaloblastic anemia with vitamin B12 can result in fatal hypokalemia and gout in susceptible individuals, and it can obscure folate deficiency in megaloblastic anemia. Caution is warranted. Leber's disease: Vitamin B12 in the form of cyanocobalamin is contraindicated in early Leber's disease, which is hereditary optic nerve atrophy. Cyanocobalamin can cause severe and swift optic atrophy, but other forms of vitamin B12 are available. However, the sources of this statement are not clear, while an opposing view[19] concludes: "The clinical picture of optic neuropathy associated with vitamin B12 deficiency shows similarity to that of Leber's disease optic neuropathy. Both involve the nerve fibres of the papillomacular bundle. The present case reports suggest that optic neuropathy in patients carrying a primary LHON mtDNA mutation may be precipitated by vitamin B12 deficiency. Therefore, known carriers should take care to have an adequate dietary intake of vitamin B12 and malabsorption syndromes like those occurring in familial pernicious anaemia or after gastric surgery should be excluded."
Rare Drug Side Effects no data available
Very Rare Drug Side Effects no data available
Drug Side Effects Symptoms no data available
How to Store the Medicine
How to Store the Medicine Precautions: Keep away from heat. Keep away from sources of ignition. Empty containers pose a fire risk, evaporate the residue under a fume hood. Ground all equipment containing material. Do not ingest. Do not breathe dust. If ingested, seek medical advice immediately and show the container or the label. Keep away from incompatibles such as oxidizing agents. Storage: Keep container tightly closed. Keep container in a cool, well-ventilated area.

PYRIDOXINE (VITB6)

Information for patients
Drug Information Pyridoxine is vitamin B6. Vitamins occur naturally in foods such as meat, poultry, nuts, whole grains, bananas, and avocados. Vitamin B6 is important for many processes in the body. Pyridoxine is used to treat or prevent vitamin B6 deficiency. It is also used to treat a certain type of anemia (lack of red blood cells). Pyridoxine injection is also used to treat some types of seizure in babies. Pyridoxine taken by mouth (oral) is available without a prescription. Injectable pyridoxine must be given by a healthcare professional.
Drug Alert
Alert do not exceed stated dose
Before Consuming the Medicine
Avoid Drug Many drugs may alter the metabolism or bioavailability of pyridoxine, including isoniazid, penicillamine and oral contraceptives, which may increase the requirements for pyridoxine. Pyridoxine hydrochloride may reduce the effect of levodopa, a drug used in the treatment of Parkinsons Disease unless a dopa decarboxylase inhibitor is also given.
Drug Special Care You should not use pyridoxine if you have ever had an allergic reaction to it.
Drug Drug Interactions Many drugs may alter the metabolism or bioavailability of pyridoxine, including isoniazid, penicillamine and oral contraceptives, which may increase the requirements for pyridoxine. Pyridoxine hydrochloride may reduce the effect of levodopa, a drug used in the treatment of Parkinsons Disease unless a dopa decarboxylase inhibitor is also given.
Drug Pregnancy Interaction Data on exposed pregnancies indicate no adverse effects of pyridoxine in therapeutic doses on pregnancy or the health of the foetus or newborn child, or during lactation. Animal studies are insufficient with respect to effects on pregnancy, embryonal/foetal development, parturition or postnatal development. Caution should be exercised when prescribing to pregnant women.
Drug Breast feeding Interaction Data on exposed pregnancies indicate no adverse effects of pyridoxine in therapeutic doses on pregnancy or the health of the foetus or newborn child, or during lactation.
Drug Machinery Interaction no data
Drug More Information Long term administration of large doses of pyridoxine is associated with the development of severe peripheral neuritis.
How to take the Medicine
Consumption Info Pyridoxine Hydrochloride is used for isoniazid-induced peripheral neuritis, idiopathic sideroblastic anaemia and Vitamin B6 deficiency states.
Drug quanitty 50mg three times a day
Drug Dose no data
Excess Drug Consumption a) Symptoms – None reported b) Treatment – no treatment necessary
Forgot Drug Consumption no data
Stop Drug Consumption no data
Possible Side Effects
General Information As well as its needed effects, pyridoxine may cause unwanted side effects that require medical attention
Common Drug Side Effects With large doses Clumsiness numbness of hands or feet
Rare Drug Side Effects Nervous system side effects have included sensory neuropathy with axonal degeneration. The adverse neurologic side effects have been reported following a single large dose (10 g) administered intravenously. It may rarely occur following chronic administration of lower doses. Peripheral sensory neuropathy has also been reported
Very Rare Drug Side Effects Dermatologic side effects have included allergic contact dermatitis. Photosensitivity has been confirmed in a female patient taking pyridoxine 100 mg orally daily
Drug Side Effects Symptoms no data
How to Store the Medicine
How to Store the Medicine Store below 25°C Protect from light and moisture.

NICOTINAMIDE

Information for patients
Drug Information Niacinamide (nicotinamide) is a form of vitamin B3 (niacin) and is used to prevent and treat niacin deficiency (pellagra). Niacin deficiency can cause diarrhea, confusion (dementia), tongue redness/swelling, and peeling red skin. Niacinamide is often used instead of niacin because it causes fewer side effects (e.g., flushing). Unlike niacin, niacinamide does not help correct blood fat levels and cannot be substituted for niacin if you are being treated for a blood fat problem (e.g., high cholesterol). Niacin deficiency may happen as a result of poor diet, certain medical conditions (e.g., alcohol abuse, malabsorption syndrome, Hartnup disease), or long-term use of certain medications (e.g., isoniazid). It is best to get your vitamins from healthy foods. A multivitamin may be recommended by your doctor instead of niacinamide because poor diet usually causes deficiencies in more than one vitamin. Vitamins help to support the body's ability to make and break down natural substances (metabolism) and are needed for good health.
Drug Alert
Alert no data available
Before Consuming the Medicine
Avoid Drug Before taking niacinamide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This product should not be used if you have certain medical conditions. Before using this product, consult your doctor or pharmacist if you have: current liver disease, current ulcer. If you have any of the following health problems, consult your doctor or pharmacist before using this product: bleeding problems (low platelets), diabetes, gout, kidney disease, history of liver disease, history of stomach/ulcer problems. If you have diabetes, this drug may increase your blood sugar levels. Check your blood glucose levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms of high blood sugar such as increased thirst and urination. Your anti-diabetic medication or diet may need to be adjusted. Tell your doctor if you are pregnant before using this medication. This drug passes into breast milk. Consult your doctor before breast-feeding.
Drug Special Care no data available
Drug Drug Interactions If you are taking this medication under your doctor's direction, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. Before using this product, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: blood thinners (e.g., warfarin, heparins), drugs for diabetes (e.g., insulin, glyburide, metformin), vitamins/dietary supplements/products that also contain niacin or niacinamide. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
Drug Pregnancy Interaction Tell your doctor if you are pregnant before using this medication.
Drug Breast feeding Interaction This drug passes into breast milk. Consult your doctor before breast-feeding.
Drug Machinery Interaction no data available
Drug More Information no data available
How to take the Medicine
Consumption Info no data available
Drug quanitty no data available
Drug Dose Take this product by mouth as directed, usually once or twice daily. Follow all directions on the product package, or use as directed by your doctor. If you are uncertain about any of the information, consult your doctor or pharmacist. Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. If you take certain drugs to lower blood fats (bile acid-binding resins such as cholestyramine or colestipol), take niacinamide at least 4 to 6 hours before or after taking these medications. These products may bind with niacinamide, preventing its full absorption. If your condition persists or worsens, or if you think you may have a serious medical problem, seek immediate medical attention.
Excess Drug Consumption If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. NOTES: Laboratory tests (e.g., blood sugar, liver function tests) may be performed to monitor for possible side effects. Keep all regular medical and laboratory appointments. Remember that it is best to get your vitamins and minerals from healthy foods. Maintain a well-balanced diet, and follow any dietary guidelines as directed by your doctor. B vitamins (including niacin) are found in meat, fish, poultry, enriched/whole grain bread products, and fortified cereals. Eat more of these foods to increase the amount of niacin in your diet if you have a niacin deficiency.
Forgot Drug Consumption If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Stop Drug Consumption Do not stop the drug untill your doctor says you to do so.
Possible Side Effects
General Information no data available
Common Drug Side Effects Niacinamide is generally well tolerated in usual doses. Upset stomach, nausea, and diarrhea may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these rare but very serious side effects occur: black/tarry stools, easy bruising/bleeding, persistent nausea/vomiting, swelling of arms/legs, change in the amount of urine, dark urine, vomit that looks like coffee grounds, yellowing eyes/skin. A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Rare Drug Side Effects no data available
Very Rare Drug Side Effects no data available
Drug Side Effects Symptoms no data available
How to Store the Medicine
How to Store the Medicine Refer to storage information printed on the package. If you have any questions about storage, ask your pharmacist. Keep all products away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

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