V Plex Capsule

✔️ Vitamin B Complex Deficiency Disorders

• Beriberi: A disorder resulting from thiamine (Vitamin B1) deficiency, presenting as peripheral neuropathy (dry beriberi) or cardiovascular complications with oedema (wet beriberi). It is commonly observed in populations whose diets rely heavily on polished rice.
• Wernicke's Encephalopathy: An acute neurological condition caused by severe Vitamin B1 deficiency, typically characterized by confusion, impaired coordination (ataxia), and eye movement abnormalities (ophthalmoplegia). It most frequently occurs in individuals with chronic alcohol use or prolonged malnutrition.
• Pellagra: A deficiency disease caused by inadequate niacin (Vitamin B3), classically presenting with the "4 Ds"—diarrhoea, dermatitis, dementia, and, if untreated, death.
• Cheilosis: Painful cracking and inflammation at the corners of the mouth associated primarily with deficiencies of riboflavin (Vitamin B2) and pyridoxine (Vitamin B6).
• Glossitis: Inflammation of the tongue characterized by redness, smoothness, soreness, and tenderness, commonly linked to deficiencies of Vitamin B2, B3, and B6.
• Angular Stomatitis: Painful fissures and ulceration at the angles of the mouth resulting from inadequate levels of riboflavin (B2) and pyridoxine (B6).
• Keratitis and Corneal Vascularization: Ocular complications involving corneal inflammation and abnormal blood vessel growth, primarily associated with riboflavin (Vitamin B2) deficiency.
• Seborrhoeic Dermatitis: A chronic inflammatory skin disorder characterized by greasy, scaly lesions that may develop due to deficiencies of Vitamin B2 and Vitamin B6.
• Photophobia: Increased sensitivity to light, which may occur as a manifestation of riboflavin deficiency.
• Peripheral Neuritis: Inflammation or dysfunction of peripheral nerves causing numbness, tingling, pain, and muscle weakness, commonly related to deficiencies of Vitamin B1, Vitamin B6, and other B vitamins.
• Loss of Appetite (Anorexia): Deficiency of thiamine (B1) and niacin (B3) may contribute to reduced appetite and inadequate nutritional intake.

✔️ Pharmacology

Vitamin B Complex is a scientifically balanced combination of water-soluble B-group vitamins formulated to provide both preventive and therapeutic nutritional support. These vitamins play indispensable roles in cellular metabolism, energy production, nervous system function, tissue maintenance, and hematopoiesis. Since the body stores only limited amounts of most B vitamins, continuous dietary intake or supplementation is necessary to maintain optimal physiological function.

✔️ Injection (Intramuscular or Intravenous)

The injectable formulation is intended for patients who cannot take oral therapy or who require rapid vitamin replacement, including those with severe malabsorption, persistent vomiting, unconsciousness, or acute vitamin B deficiency.

Intramuscular (IM) Administration

• Inject deeply into a large muscle, such as the gluteal muscle.
• Mild pain or a temporary burning sensation at the injection site may occur.
• Rotate injection sites during repeated therapy.

Intravenous (IV) Administration

• Administer slowly by intravenous injection to minimize the risk of adverse reactions, including hypersensitivity and flushing.
• Rapid IV administration of undiluted solution should be avoided.
• Inspect the solution before administration and discard if discoloration or particulate matter is present.
• Do not mix the injection with alkaline, strongly acidic, or oxidizing solutions because these may reduce vitamin stability.
• Ampoules are intended for single use only; discard any remaining solution after administration.

✔️ Recommended Dosage

The dosage of Vitamin B Complex should be individualized according to the dosage form, severity of deficiency, patient's age, clinical condition, and therapeutic response. The recommended dose should always be determined by a registered physician. Do not exceed the prescribed dose without medical supervision.

Recommended Dosage

Dosage in Special Populations

Adults:
The usual dose is 1–2 tablets or capsules three times daily with meals, or as directed by the physician.

Children:
The syrup formulation is generally preferred. Dosage should be determined according to the child's age, body weight, and severity of vitamin deficiency.

Pregnancy and Lactation:
Use only under medical supervision. Recommended doses should not be exceeded, particularly because excessive intake of Vitamin B6 (pyridoxine) over prolonged periods may lead to peripheral neuropathy.

Severe Deficiency or Acute Conditions:
Intramuscular or intravenous administration may be required for rapid correction of deficiency, particularly in patients with impaired gastrointestinal absorption, severe postoperative recovery, or acute neurological conditions such as Wernicke's encephalopathy.

Chronic Alcohol Use:
Patients with alcohol dependence often require prompt thiamine supplementation. In suspected or confirmed Wernicke's encephalopathy, high-dose intravenous thiamine should be administered before glucose therapy to prevent worsening neurological injury.

Administration

Tablets and Capsules

• Take with or immediately after meals to improve gastrointestinal tolerance and optimize absorption.
• Swallow each dose whole with a full glass of water.
• If prescribed three times daily, distribute doses evenly throughout the day, such as with breakfast, lunch, and dinner.
• Avoid taking the medicine simultaneously with aluminum- or magnesium-containing antacids, as they may reduce vitamin absorption.
• Riboflavin (Vitamin B2) may cause bright yellow discoloration of the urine; this is a normal and harmless effect.

✔️ Syrup

• Shake the bottle thoroughly before every dose.
• Use the supplied measuring device to ensure accurate dosing; avoid using household teaspoons.
• The syrup may be taken directly or diluted with a small amount of water or fruit juice if preferred, especially for children.
• Administer with or after meals.
• Store below 25°C, protected from light, or according to the manufacturer's instructions.

✔️ Drug Interactions

Levodopa

Pyridoxine (Vitamin B6) may significantly reduce the effectiveness of levodopa when levodopa is used alone by increasing its peripheral metabolism before it reaches the central nervous system. Consequently, patients receiving levodopa without a peripheral decarboxylase inhibitor should avoid Vitamin B Complex supplements unless advised by their physician. This interaction is not clinically significant when levodopa is administered together with carbidopa or benserazide.

Isoniazid and Pyrazinamide

Isoniazid interferes with pyridoxine metabolism and may lead to Vitamin B6 deficiency, increasing the risk of peripheral neuropathy. Vitamin B Complex supplementation can help prevent this complication, particularly in high-risk individuals such as those with malnutrition, diabetes, renal impairment, pregnancy, or chronic alcohol use.

Certain Antibiotics

Some antibiotics, particularly tetracyclines, may interfere with the gastrointestinal absorption of certain B vitamins. When possible, administer Vitamin B Complex at least 2 hours before or after these antibiotics.

Antacids and Acid-Suppressive Therapy

Antacids containing aluminum or magnesium may reduce the absorption of several B vitamins and should be taken at least 2 hours apart from Vitamin B Complex. Long-term use of proton pump inhibitors (PPIs) and H2-receptor antagonists may also impair the absorption of Vitamin B12 in formulations containing this vitamin.

Oral Contraceptives

Combined estrogen-progestin oral contraceptives may increase the body's requirement for Vitamin B6 and lower circulating pyridoxine levels. Long-term users may benefit from supplementation, particularly when dietary intake is inadequate.

Methotrexate and Other Antifolate Agents

Although standard Vitamin B Complex preparations do not usually contain folic acid, antifolate medications such as methotrexate may indirectly affect B-vitamin-dependent metabolic pathways. This interaction is of greater clinical importance in formulations containing folate.

✔️ Storage Condition

• Store all Vitamin B Complex formulations below 25°C, away from direct light and moisture. B vitamins — particularly riboflavin (B2) and thiamine (B1) — are sensitive to light and heat, which can degrade their potency.
• Keep out of the reach of children.