Coslev
Generic Name
L-Methylfolate, Methylcobalamin, Pyridoxal-5-Phosphate
Manufacturer
XYZ Pharmaceuticals
Country
Bangladesh
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Description
Overview of the medicine
Coslev is a nutritional supplement containing active forms of B vitamins: L-methylfolate (Vitamin B9), methylcobalamin (Vitamin B12), and pyridoxal-5-phosphate (Vitamin B6). It is used to manage and prevent vitamin deficiencies and to support nerve health, especially in conditions like diabetic neuropathy and hyperhomocysteinemia.
Uses & Indications
Dosage
Adults
Typically one capsule daily, or as directed by physician.
Elderly
No specific dosage adjustment required; use adult dose or as advised.
Renal_impairment
Caution advised; consult physician for dosage adjustment.
How to Take
Oral administration. Can be taken with or without food. Swallow whole, do not chew or crush.
Mechanism of Action
L-Methylfolate is the primary active form of folic acid, essential for DNA synthesis, amino acid metabolism, and methylation reactions. Methylcobalamin is the active form of Vitamin B12, crucial for nerve tissue health, brain function, and red blood cell production. Pyridoxal-5-Phosphate is the active form of Vitamin B6, involved in numerous enzymatic reactions, including amino acid metabolism, neurotransmitter synthesis, and myelin formation. This combination ensures optimal cellular function and nerve regeneration.
Pharmacokinetics
Onset
Therapeutic effects may be observed within weeks of consistent use, particularly for symptomatic relief in neuropathy.
Excretion
Primarily renal, with excess amounts excreted in urine.
Half life
L-Methylfolate: 3 hours; Methylcobalamin: variable, generally long due to tissue retention; Pyridoxal-5-Phosphate: 15-20 days (for total body B6 stores).
Absorption
L-Methylfolate is readily absorbed from the small intestine. Methylcobalamin is absorbed via an active transport system involving intrinsic factor and passive diffusion. Pyridoxal-5-Phosphate is also well absorbed.
Metabolism
L-Methylfolate is the active form and does not require further metabolism. Methylcobalamin is utilized directly. Pyridoxal-5-Phosphate is the active coenzyme form of Vitamin B6.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation
Drug Interactions
Levodopa
Pyridoxine (Vitamin B6) may reduce the efficacy of levodopa; however, P5P may have less interaction.
Anticonvulsants (e.g., phenytoin, phenobarbital, primidone)
May affect folate metabolism.
Folic acid antagonists (e.g., methotrexate, trimethoprim, pyrimethamine)
May reduce the effectiveness of L-methylfolate.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose is rare due to the water-soluble nature of these vitamins. High doses of pyridoxine can lead to peripheral neuropathy. Management is supportive and symptomatic.
Pregnancy & Lactation
Generally considered safe during pregnancy and lactation at recommended doses, as B vitamins are essential. Consult a physician before use.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation
Drug Interactions
Levodopa
Pyridoxine (Vitamin B6) may reduce the efficacy of levodopa; however, P5P may have less interaction.
Anticonvulsants (e.g., phenytoin, phenobarbital, primidone)
May affect folate metabolism.
Folic acid antagonists (e.g., methotrexate, trimethoprim, pyrimethamine)
May reduce the effectiveness of L-methylfolate.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose is rare due to the water-soluble nature of these vitamins. High doses of pyridoxine can lead to peripheral neuropathy. Management is supportive and symptomatic.
Pregnancy & Lactation
Generally considered safe during pregnancy and lactation at recommended doses, as B vitamins are essential. Consult a physician before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date.
Availability
Pharmacies and licensed drug stores
Approval Status
Approved as a dietary supplement
Patent Status
Generic available
Clinical Trials
Numerous clinical trials support the efficacy of L-methylfolate, methylcobalamin, and pyridoxal-5-phosphate individually and in combination for improving nerve function and reducing homocysteine levels, particularly in diabetic neuropathy.
Lab Monitoring
- Monitoring of vitamin B12, folate, and homocysteine levels may be done to assess treatment efficacy and deficiency status.
Doctor Notes
- Consider for patients with diabetic or other peripheral neuropathies.
- Check B12 levels before initiating, especially in cases of suspected pernicious anemia, as folate can mask B12 deficiency symptoms.
- Counsel patients on adherence and lifestyle modifications.
Patient Guidelines
- Take as directed by your healthcare provider.
- Do not exceed the recommended dose.
- Inform your doctor about all other medications and supplements you are taking.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Not known to impair ability to drive or operate machinery.
Lifestyle Advice
- Maintain a balanced diet.
- Regular exercise may support overall health and nerve function.
- Avoid excessive alcohol consumption.
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