This preparation is indicated as a daily multivitamin maintenance dose for adults and children aged 11 years and above receiving parenteral nutrition. It is also used in conditions where intravenous administration is required, such as surgery, extensive burns, fractures, major trauma, severe infections, and comatose states. These conditions may create a “stress state” leading to altered metabolic demands and depletion of body nutrients.

This is a sterile lyophilized powder for injection/infusion containing nine water-soluble and three fat-soluble vitamins. Mixed micelles are used as a solubilizing agent. It must be reconstituted with 5 ml of Water for Injection or other compatible parenteral fluids (such as 0.9% Sodium Chloride or 5% Glucose solution) before administration by the intravenous route.

This is a lyophilized sterile powder for injection/infusion containing both water-soluble and fat-soluble vitamins. Each vial contains:

• Vitamin A BP 3500 IU
• Vitamin D3 BP 220 IU
• Vitamin E USP 11.2 IU
• Ascorbic Acid BP 125 mg
• Vitamin B1 BP 3.51 mg
• Vitamin B2 BP 4.14 mg
• Nicotinamide BP 46 mg
• Pantothenic Acid BP 17.25 mg
• Vitamin B6 BP 4.53 mg
• Vitamin B12 BP 6 mcg
• Folic Acid BP 414 mcg
• Biotin BP 69 mcg

Adults and children aged 11 years and above: 1 vial/day. The single dose vial is reconstituted by adding 5 ml of sterile Water for injection or other intravenous fluids like 0.9% Sodium Chloride injection or 5% Glucose injection. 5 ml of diluent should be added by means of sterile syringe into the vial and gently mixed to dissolve the lyophilized powder. The entire volume of the resultant solution should then be administered by slow Intravenous injection (at least over 10  বাংলায় দেখুন minutes) or further diluted for intravenous infusion. To minimize vitamin losses in parenteral nutrition admixtures, add the vitamins immediately prior to administration and complete administration within 24 hours.

Patients receiving drugs that bind to α1-acid glycoprotein should be closely monitored, as the response to such drugs may be increased. Examples include propranolol, prazosin, and quinidine. Folic acid may enhance the metabolism of certain antiepileptic drugs such as phenobarbital, phenytoin, and primidone. Pyridoxine may reduce the effect of levodopa. Bleomycin activity may be reduced by ascorbic acid and riboflavin.

Contraindicated in patients with pre-existing hypervitaminosis or known hypersensitivity to any active ingredient. It should not be administered to patients with known thiamine intolerance or impaired hepatic function. It is also contraindicated in patients with hyperparathyroidism due to risk of hypercalcaemia.

Anaphylactic reactions have been reported after large intravenous doses of thiamine. Urticaria and skin rash may also occur. Very rare cases of anaphylactic shock have been reported following rapid IV injection or infusion (1–4 minutes).

The use of this preparation has not been adequately studied in pregnancy. It should be used during pregnancy only if clearly necessary. Use in breastfeeding women is not recommended.

Anaphylactic reactions may occur in sensitive individuals, especially due to thiamine (Vitamin B1) and nicotinamide. Early signs such as sneezing or mild asthma may indicate risk of severe allergic reactions on further administration. Due to glycocholic acid content, prolonged use in patients with jaundice of hepatic origin or cholestasis requires careful monitoring of liver function. In patients with renal impairment, fat-soluble vitamin levels should also be monitored carefully.

Multivitamin and multimineral combination preparations

Before reconstitution: Store below 25°C, protect from light and do not freeze. After reconstitution: Use immediately or store at 2°C–8°C for not more than 24 hours. Discard any unused portion.