Vitamin B Complex + Vitamin C + Fat Emulsion

Indications

Vitamin B Complex + Vitamin C + Fat Emulsion is used for: Parenteral nutrition, Preoperative and postoperative nutritional disturbances where an improved nitrogen balance is required Nutritional disorders or disturbances of nitrogen balance due to inadequate or failing intestinal absorption caused by tumors in the gastrointestinal tract, acute or chronic intestinal diseases (peritonitis, ulcerative colitis, terminal ileitis) Burns, to reduce the frequently excessive nitrogen losses; Prolonged unconsciousness, eg. following cranial trauma or poisoning in cases where enteral feeding is inappropriate or impossible Impaired renal function where a concentrated source of energy may be indicated to reduce protein breakdown Cachexia and Patients with essential fatty acid deficiency who cannot maintain or restore a normal essential fatty acid pattern by oral intake.

Adult Dose

Total Parenteral nutrition: As a part of TPN, administer IV via a peripheral vein or by central venous catheter. Fat emulsion should comprise no more than 60% of the patient's total caloric intake, with carbohydrates. Adult: Initial infusion rate is 1ml/min for the first 15 to 30 mins. If no adverse reactions occur, the infusion rate can be increased to 2 ml/min. Infuse only 500 ml the first day and increase the dose the following day. Do not exceed a daily dosage of 2.5 g/kg.

Child Dose

Total Parenteral nutrition: As a part of TPN, administer IV via a peripheral vein or by central venous catheter. Fat emulsion should comprise no more than 60% of the patient's total caloric intake, with carbohydrates. Children: Initial infusion rate is 0.1ml/min for the first 10 to 15 mins. If no adverse reactions occur, the infusion rate can be increased to 1g/kg in 4 hours. Do not exceed a daily dosage of 3 g/kg. Infants: Starts at 0.5g/kg/24 hours and may be increased in relation to the infant's ability to eliminate fat. The maximum recommended dosage is 3g/kg/24 hours.

Renal Dose

Administration

Instructions for Use- Take 10 ml emulsion from 250 ml glass bottle by syringe Open the cap of 10 ml vial and inject the syringe containing 10 ml emulsion into the vial. It will make a light yellowish colored emulsion inside the vial Take the emulsion from vial into syringe Inject the syringe containing emulsion into the 250 ml glass bottle Now give intravenously at 10 drops/ minute for the first 15 minutes and the rest at 20 drops/minute

Contra Indications

It is contraindicated in conditions with severely disordered fat metabolism, such as in severe liver damage and acute shock. Hypersensitivity to egg-, soya- or peanut protein or to any of active substances or excipients.

Precautions

This contains soya oil and egg lecithin which may rarely cause allergic reactions. Cross allergic reaction has been observed between soya bean and peanut. Fat metabolism may be disturbed in conditions such as renal insufficiency, uncompensated diabetes, pancreatitis, certain forms of liver insufficiency, metabolic disorders, and sepsis. This should be administered with caution as a strong correlation exists between C-reactive protein and the agglutination of Fatisol in seriously ill patients. It should be given with caution to neonates and premature infants with hyperbilirubinaemia and in cases with suspected pulmonary hypertension. In low birth weight infants, the risk of lipid infusions may outweigh the potential benefits due to the further diminution of defenses against infection. In infants, the metabolism of lipids in peripheral tissues may be diminished by infection and heparin administration. In neonates receiving long-term parenteral nutrition, particularly premature neonates, platelet count, liver function tests, and serum triglyceride concentration should be monitored.

Pregnancy-Lactation

Use in Pregnancy & Lactation: Absolute safety of the fetus and the nursing infant has not been established. Therefore, it should be administered with caution during pregnancy and lactation.

Interactions

Adverse Effects

Side effects of Vitamin B Complex + Vitamin C + Fat Emulsion : This may cause a rise in body temperature (incidence <3%) and, less frequently, shivering, chills and nausea/vomiting (incidence <1%). Reports of other adverse events in conjunction with 10% fat emulsion infusion are extremely rare, less than one report of certain events per one million infusions. Hypersensitivity reactions (anaphylactic reaction, skin rash, urticaria), respiratory symptoms (tachypnoea) and circulatory effects (hypertension, hypotension) have been described. Thrombosis, haemolysis, reticulocytosis, abdominal pain, tiredness, priapism and neurological adverse reactions including headaches, flushing, dyspnoea, slight pressure over the eyes and dizziness have been reported.

Mechanism of Action

This lyophilized powder of water-soluble vitamins for infusion. It contains balanced amount of all the important water-soluble vitamins which act as coenzymes of vital enzymes associated with crucial physiological processes, energy metabolism, cell growth and replenishment especially in brain and nerve cells. Vitamin C acts as an antioxidant and helps in collagen formation. Intravenous administration of this combination gives prompt action. This is a preparation of 20% refined soyabean oil intended to be used as an intravenous nutrient. It prevents Essential Fatty Acid Deficiency (EFAD) and corrects the clinical manifestations of EFAD.