Neurotonic
Generic Name
Thiamine HCl 100 mg, Pyridoxine HCl 100 mg, Cyanocobalamin 1000 mcg
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| neurotonic 100 mg injection | ৳ 25.00 | N/A |
Description
Overview of the medicine
Neurotonic Injection contains a combination of three essential B vitamins: Thiamine (B1), Pyridoxine (B6), and Cyanocobalamin (B12). These vitamins are crucial for proper nerve function, energy metabolism, and red blood cell formation. It is primarily used to treat and prevent deficiencies of these vitamins, especially in conditions affecting the nervous system.
Uses & Indications
Dosage
Adults
Usually 1 ampoule (2-3 ml) daily or 2-3 times per week by intramuscular injection, or as directed by the physician.
Elderly
No specific dose adjustment required, use adult dosage under medical supervision.
Renal_impairment
No specific dose adjustment for mild to moderate impairment. Use with caution in severe renal impairment, consult physician.
How to Take
Administer intramuscularly (IM) slowly. For intravenous (IV) administration, it should be diluted and infused slowly, strictly under medical supervision.
Mechanism of Action
Thiamine (B1) is a coenzyme in carbohydrate metabolism and nerve impulse transmission. Pyridoxine (B6) acts as a coenzyme in amino acid metabolism, neurotransmitter synthesis, and myelin formation. Cyanocobalamin (B12) is essential for DNA synthesis, neurological function, and myelin sheath maintenance. Together, they support nerve health and repair.
Pharmacokinetics
Onset
Effects on symptoms may be observed within days to weeks depending on the deficiency severity.
Excretion
Thiamine: Primarily excreted in urine as metabolites and unchanged drug. Pyridoxine: Excreted in urine as metabolites. Cyanocobalamin: Excreted primarily in bile, with some renal excretion (especially if parenteral administration results in high plasma levels).
Half life
Thiamine: 98 minutes (elimination half-life). Pyridoxine: 15-20 days (for active form). Cyanocobalamin: Up to 6 days (initial phase), but retained in liver for months to years.
Absorption
Rapidly absorbed from intramuscular injection site. Water-soluble vitamins are not stored extensively in the body.
Metabolism
Thiamine: Metabolized in the liver. Pyridoxine: Metabolized in the liver to active form (pyridoxal phosphate). Cyanocobalamin: Metabolized in the liver; enterohepatic recirculation occurs.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation.
- Patients with Leber's disease or tobacco amblyopia due to risk of optic nerve damage with cyanocobalamin (B12).
Drug Interactions
Levodopa
Pyridoxine (B6) may reduce the effectiveness of levodopa (used in Parkinson's disease) unless a peripheral dopa decarboxylase inhibitor is also given.
Phenytoin, Phenobarbital
Thiamine (B1) absorption may be reduced.
Loop diuretics (e.g., Furosemide)
May increase urinary excretion of thiamine, potentially leading to deficiency.
Isoniazid, Penicillamine, Oral Contraceptives
May increase the requirement for pyridoxine (B6).
Storage
Store in a cool, dry place below 30°C, protected from light. Do not freeze. Keep out of reach of children.
Overdose
B vitamins are water-soluble and generally have low toxicity. However, very high doses of pyridoxine (B6) over a long period can lead to sensory neuropathy. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Generally considered safe during pregnancy and lactation when used at recommended doses. Consult a healthcare professional before use.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation.
- Patients with Leber's disease or tobacco amblyopia due to risk of optic nerve damage with cyanocobalamin (B12).
Drug Interactions
Levodopa
Pyridoxine (B6) may reduce the effectiveness of levodopa (used in Parkinson's disease) unless a peripheral dopa decarboxylase inhibitor is also given.
Phenytoin, Phenobarbital
Thiamine (B1) absorption may be reduced.
Loop diuretics (e.g., Furosemide)
May increase urinary excretion of thiamine, potentially leading to deficiency.
Isoniazid, Penicillamine, Oral Contraceptives
May increase the requirement for pyridoxine (B6).
Storage
Store in a cool, dry place below 30°C, protected from light. Do not freeze. Keep out of reach of children.
Overdose
B vitamins are water-soluble and generally have low toxicity. However, very high doses of pyridoxine (B6) over a long period can lead to sensory neuropathy. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Generally considered safe during pregnancy and lactation when used at recommended doses. Consult a healthcare professional before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date, refer to package insert.
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Approved for use in various countries
Patent Status
Off-patent, widely available as generics
WHO Essential Medicine
YesClinical Trials
Extensive clinical experience and numerous studies support the efficacy of B vitamins in treating deficiencies and related neurological conditions. Specific trials for brand formulations generally confirm bioequivalence.
Lab Monitoring
- Monitoring of B vitamin levels may be done if deficiency is suspected or for specific neurological conditions. Routine monitoring is not typically required.
Doctor Notes
- Assess patient's B vitamin status before initiating therapy.
- Educate patients on the importance of adhering to the prescribed dosage and administration route.
- Monitor for any signs of allergic reaction or worsening neurological symptoms.
Patient Guidelines
- Follow the doctor's instructions regarding dose and duration of treatment.
- Do not self-administer the injection.
- Report any unusual side effects or allergic reactions immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Neurotonic is not known to impair the ability to drive or operate machinery. However, if dizziness occurs, avoid such activities.
Lifestyle Advice
- Maintain a balanced diet rich in essential nutrients.
- Limit alcohol intake, as it can affect B vitamin absorption.
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