Drugs List

Contraindications

Children under 11 years
Galactosaemia

Precautions and Warnings

Parkinson's disease: use with caution in patients receiving levodopa alone as pyridoxine may act as an antagonist.

The following groups should avoid increased intake of ascorbic acid:
Glucose-6-phosphate deficiency - ascorbic acid may denature haemoglobin and reduce the erythrocyte glutathione level.
Advanced cancer: tumour haemorrhage and necrosis reported.

This preparation contains lactose, therefore use with caution in glucose-galactose malabsorption syndrome and lactose intolerance.

Pregnancy and Lactation

Pregnancy

Vitamins are essential for human life. Preparations containing multiple vitamins are used in pregnant women, however, the practice of supplementation varies from country to country.
Doses in excess of those recommended should be avoided during pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Multivitamins can be used during breastfeeding if the mother is on a restricted diet or has malabsorption syndrome. Doses in excess of those recommended should be avoided during lactation.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Hypersensitivity reactions
Facial flushing

Presentation

Tablets containing:
Riboflavine 5mg
Pyridoxine hydrochloride 5mg
Nicotinamide 33.3mg
Ascorbic acid 100mg
Thiamine hydrochloride 10mg

Drugs List

Dosage

Adults

Elderly

Children

Contraindications

Children under 11 years
Galactosaemia

Precautions and Warnings

Parkinson's disease: use with caution in patients receiving levodopa alone as pyridoxine may act as an antagonist.

The following groups should avoid increased intake of ascorbic acid:
Glucose-6-phosphate deficiency - ascorbic acid may denature haemoglobin and reduce the erythrocyte glutathione level.
Advanced cancer: tumour haemorrhage and necrosis reported.

This preparation contains lactose, therefore use with caution in glucose-galactose malabsorption syndrome and lactose intolerance.

Pregnancy and Lactation

Pregnancy

Vitamins are essential for human life. Preparations containing multiple vitamins are used in pregnant women, however, the practice of supplementation varies from country to country.
Doses in excess of those recommended should be avoided during pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Multivitamins can be used during breastfeeding if the mother is on a restricted diet or has malabsorption syndrome. Doses in excess of those recommended should be avoided during lactation.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Hypersensitivity reactions
Facial flushing

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: January 2011

Reference Sources

British National Formulary, 60th Edition (2010) Pharmaceutical Press, London.

Drugs in Pregnancy and Lactation, 6th edition ed. Briggs, G et al Lippincott Williams & Wilkins, Philadelphia 2002

Dietary Supplements, 2nd edition ed. Mason, P Pharmaceutical Press, London, 2001

Meyler's Side Effects of Drugs, 14th edition ed. Dukes, M and Aronson, J Elsevier, Amsterdam, 2000

Summary of Product Characteristics, Orovite tablets, SSL International, December 2009

Therapeutics in Pregnancy and Lactation (2000) Lee, A., Inch, S. and Finnigan, D. Radcliffe Medical Press, Abingdon.