These tablets are indicated for the specific nutritional requirements of patients undergoing treatment for hyperhomocysteinemia, nutrient malabsorption, or inadequate dietary intake. It is particularly recommended for individuals with, or at risk of, atherosclerotic vascular diseases affecting the coronary, peripheral, or cerebral vessels, as well as neurological disorders.

Pyridoxine (Vitamin B6) is a water-soluble vitamin involved in the metabolism of carbohydrates, proteins, and fats. It is essential for hemoglobin formation and GABA synthesis within the central nervous system. It also assists in releasing glycogen stored in the liver and muscles.

Folic acid (Vitamin B9) is essential for the production of certain coenzymes involved in metabolic pathways such as purine and pyrimidine synthesis. It is also necessary for the synthesis and maintenance of nucleoproteins during erythropoiesis. In folate-deficiency anemia, it helps promote white blood cell and platelet production.

Cyanocobalamin (Vitamin B12) is important for growth, hematopoiesis, and the synthesis of nucleoproteins and myelin. As a hematopoietic agent, it acts as a coenzyme for vitamin B12-dependent reactions including the conversion of methylmalonate to succinate and the synthesis of methionine from homocysteine, a process that requires folate. In the absence of folate, these metabolites cannot be produced and folate deficiency may develop. Cyanocobalamin also contributes to the maintenance of reduced sulfhydryl (SH) groups required by several SH-activated enzyme systems. Through these mechanisms, it participates in fat and carbohydrate metabolism as well as protein synthesis.

Usual adult dose is one to two tablets daily or as directed by a physician.

Pyridoxine Hydrochloride should not be administered to patients receiving levodopa alone, as pyridoxine may antagonize the therapeutic effect of levodopa. However, pyridoxine may be used safely in patients receiving combined therapy containing both carbidopa and levodopa. Concurrent administration of phenytoin and folic acid may reduce the therapeutic effectiveness of phenytoin.

This preparation is contraindicated in patients with known hypersensitivity to any of its ingredients.

Allergic sensitization has been reported following both oral and parenteral administration of folic acid. Pyridoxine Hydrochloride has been associated with paraesthesia, drowsiness, nausea, and headache. Mild transient diarrhea, polycythemia vera, itching, temporary skin eruptions, and generalized swelling have been reported with cyanocobalamin.

Pregnancy category: Not classified.

Folic acid administered alone at doses above 0.1 mg daily may mask pernicious anemia because hematological remission may occur while neurological complications continue to progress. Unmetabolized folic acid may reduce natural killer cell cytotoxicity, potentially leading to impaired immune response.

Specific combined vitamin preparations, Vitamin-B preparations