This is indicated as a daily multivitamin maintenance dose for adults and children aged 11 years and above receiving parenteral nutrition. It is also indicated in other conditions where intravenous administration is required, such as surgery, extensive burns, fractures and other trauma, severe infections, and comatose states, which may cause a stress condition with marked changes in metabolic demand and consequent 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 is supplied as a sterile powder that must be reconstituted with 5 ml of Water for Injection or other parenteral fluids such as 0.9% Sodium Chloride or 5% Glucose solution before parenteral administration.

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

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 is presented as a sterile, orange-yellow lyophilized powder that is reconstituted with 5 ml of Water for Injection or other parenteral fluids such as 0.9% Sodium Chloride or 5% Glucose solution prior to parenteral administration.

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 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 carefully monitored, as enhanced response may occur with agents such as propranolol, prazosin, and quinidine. Folic acid may increase the metabolism of certain antiepileptic drugs including phenobarbital, phenytoin, and primidone. Pyridoxine may reduce the therapeutic effect of levodopa. Ascorbic acid and riboflavin may inactivate bleomycin.

Contraindicated in patients with known hypersensitivity to any component or pre-existing hypervitaminosis. It should not be used in patients with thiamine intolerance, impaired hepatic function, or hyperparathyroidism due to risk of hypercalcaemia.

Anaphylactic reactions have been reported following high intravenous doses of thiamine. Urticaria and skin rash may occur. Rare cases of anaphylaxis have been reported during rapid IV administration (1–4 minutes).

Safety in pregnancy has not been fully established. It should be used during pregnancy only when clearly necessary. Use during breastfeeding is not recommended.

Hypersensitivity reactions may occur in individuals sensitive to thiamine and nicotinamide. Early mild allergic symptoms such as sneezing or mild asthma may indicate risk of severe reactions. Patients with hepatic jaundice or cholestasis require close monitoring of liver function. In renal impairment, fat-soluble vitamin levels should be monitored carefully.

Prolonged high-dose use may result in accumulation of vitamins A and D.

Specific combined vitamin 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 up to 24 hours. Discard unused portion.