This combination is indicated in conditions associated with deficiency of the relevant vitamins. It is used in the treatment of polyneuropathy of any origin, including diabetic, alcoholic, or toxic neuropathies. It is also indicated in neuritis, neuralgia, cervical syndrome, shoulder-arm syndrome, lumbago, sciatica, myalgia, intercostal neuralgia, herpes zoster, trigeminal neuralgia, and as supportive therapy in facial paresis.

Vitamin B1 converts carbohydrates, fatty acids, and amino acids into energy. It supports healthy nerve function, improves mood, strengthens cardiac function, and contributes to overall energy metabolism. Vitamin B6 is involved in red blood cell formation, protein synthesis, and neurotransmitter production such as serotonin. It also assists in releasing stored energy, may help reduce the risk of cardiovascular diseases and stroke, supports relief from depression, and may improve insomnia. Vitamin B12 is essential for cell replication and red blood cell production. It helps prevent anemia, supports nerve function, reduces nerve pain, numbness, and tingling sensations, and may lower the risk of heart disease.

These vitamins are well absorbed after oral administration and are widely distributed throughout body tissues, including breast milk. Within cells, thiamine is primarily present in diphosphate form. Thiamine is not stored in significant amounts in the body, and excess quantities are excreted through urine either unchanged or as metabolites. Following oral administration, pyridoxine, pyridoxal, and pyridoxamine are readily absorbed from the gastrointestinal tract and converted into their active forms, pyridoxal phosphate and pyridoxamine phosphate. These compounds are mainly stored in the liver and metabolized into 4-pyridoxic acid and other inactive metabolites, which are excreted in urine. With increasing doses, proportionately larger amounts are excreted unchanged in urine.

Tablet: 1-3 Tablets per day or as advised by the physician.

Injection:

• In severe (acute) cases: 1 injection daily until the acute symptoms subside or taken as advised by the physician.
• In mild cases: 1 injection 2-3 times per week. Ampoules are preferably injected intramuscularly.

Use in children: There is no information on the use of this drug in children.

Vitamin B1, Vitamin B6, and Vitamin B12 are contraindicated in patients receiving levodopa therapy and in patients with hypersensitivity to any ingredient of this preparation.

This preparation is generally well tolerated; however, allergic reactions may occur in a small number of cases.

The oral tablet form is recommended during pregnancy and lactation. However, due to the presence of benzyl alcohol, the injectable form is not recommended during these periods.

Cyanocobalamin should not be administered to patients with subacute degeneration of the spinal cord. It is also not considered a suitable form of vitamin B12 for the treatment of optic neuropathies associated with elevated plasma concentrations of cyanocobalamin.

No overdose symptoms are expected when used at the recommended dosage. In cases of known overdose, treatment should be symptomatic and supportive.

Specific combined vitamin preparations

Keep out of the reach of children. Store in a cool and dry place below 25°C, protected from light.