Becoson-M

Approved Indications:

• Prevention of nutritional deficiencies in individuals with inadequate dietary intake due to poor nutrition, restrictive diets, or socioeconomic limitations.
• Treatment of clinically diagnosed vitamin and/or mineral deficiencies, including those caused by malabsorption syndromes, chronic diseases, or gastrointestinal surgery.
• Nutritional support during periods of increased demand, such as pregnancy, lactation, growth spurts, or recovery from illness or surgery.
• Supplementation in elderly patients who may have decreased nutrient absorption or intake.
• Adjunct therapy in chronic conditions like diabetes, cardiovascular disease, or cancer, where nutritional optimization is important.

Clinically Accepted Off-label Uses:

• Supportive care in long-term medication use (e.g., corticosteroids, anticonvulsants) that deplete micronutrients.
• Cognitive function support in elderly patients with mild cognitive impairment.
• Improved immune support in patients with frequent infections or stress-related immunosuppression.
• Enhancement of hair, skin, and nail health in individuals with subclinical micronutrient deficiencies.

Route: Oral (tablet, capsule, softgel, syrup, drops, or powder sachets)

Adults:

• Standard dose: 1 tablet or capsule once daily, preferably with a meal
• Therapeutic deficiency: Up to 2 tablets daily based on clinical judgment

Pediatrics:

• Infants (0–12 months): 0.5–1 mL (liquid drops) daily, based on formulation
• Children (1–3 years): 1–2.5 mL of syrup once daily
• Children (4–12 years): 5 mL syrup or 1 chewable tablet daily

Elderly:

• Same as adult dose, but consider formulations with lower iron content (if iron overload risk) and added Vitamin D, B12, and calcium for age-related needs

Pregnant and Lactating Women:

• Use a prenatal/postnatal formulation: 1 tablet or softgel daily
• Should contain adequate folic acid, iron, calcium, iodine, and DHA as per guidelines

Renal Impairment:

• Avoid high doses of fat-soluble vitamins (A, D, E, K) and certain minerals (e.g., potassium, magnesium) due to risk of accumulation
• Use renal-specific multivitamin formulations when needed

Hepatic Impairment:

• Caution with Vitamin A and iron—adjust dose to reduce hepatotoxic risk

Administration Tips:

• Take with meals to improve absorption and minimize GI upset
• Do not exceed the recommended daily dose unless prescribed

Multivitamin and multimineral supplements provide essential micronutrients required for the normal functioning of enzymatic systems, cellular repair, energy metabolism, and immune defense. Water-soluble vitamins (B-complex and C) function as coenzymes in carbohydrate, protein, and lipid metabolism, and support nerve function and hematopoiesis. Fat-soluble vitamins (A, D, E, K) play roles in vision, calcium homeostasis, antioxidation, and blood clotting. Minerals such as iron, zinc, calcium, magnesium, selenium, and iodine support bone health, oxygen transport, neurotransmission, and thyroid function. These combined effects help restore and maintain physiological balance, especially in states of deficiency or increased metabolic demand.

Absorption:

• Varies by component and formulation
• Water-soluble vitamins: Rapidly absorbed in the small intestine
• Fat-soluble vitamins: Require bile and dietary fat for absorption
• Minerals: Absorbed variably depending on form and dietary factors

Distribution:

• Water-soluble vitamins: Distribute in plasma and extracellular fluid; minimal storage
• Fat-soluble vitamins: Accumulate in liver and adipose tissue
• Minerals: Incorporated into bones, blood proteins, and enzymatic systems

Metabolism:

• Water-soluble vitamins: Primarily metabolized in liver; excess excreted
• Fat-soluble vitamins: Metabolized hepatically; slow clearance
• Minerals: Undergo minimal metabolism; integrated into functional proteins or excreted

Elimination:

• Water-soluble vitamins: Urinary excretion (rapid)
• Fat-soluble vitamins: Slow elimination via biliary and fecal routes
• Minerals: Renal or fecal elimination, depending on the element

Bioavailability: Depends on formulation and concurrent food intake
Onset: Clinical effect observed in days to weeks
Half-life: Varies significantly by nutrient

Pregnancy:

• Generally safe when used within recommended daily allowances
• High-dose formulations (especially Vitamin A >10,000 IU) should be avoided due to teratogenic risk
• Prenatal supplements are preferred for pregnant women

Lactation:

• Considered safe in appropriate doses
• Most vitamins and minerals are excreted into breast milk in low quantities
• Ensure adequate intake of calcium, Vitamin D, and iodine during breastfeeding

Note: Avoid excessive intake of fat-soluble vitamins; monitor for overdose symptoms if using multiple supplements concurrently

• Primary Class: Nutritional Supplement
• Subclass: Multivitamin-Multimineral Combination

• Known hypersensitivity to any component (vitamins, minerals, excipients)
• Hypervitaminosis A or D
• Hemochromatosis or other iron overload syndromes (if formulation contains iron)
• Wilson’s disease (if formulation contains copper)
• Severe renal or hepatic dysfunction (formulations containing high levels of certain minerals or fat-soluble vitamins)

• Use with caution in patients with chronic liver or kidney disease
• Avoid using multiple multivitamin products concurrently (risk of overdose)
• Monitor for signs of fat-soluble vitamin accumulation in long-term use
• Risk of iron toxicity in pediatric populations—store out of reach of children
• Do not exceed upper intake levels (UL) for each component
• Special care in patients with fat malabsorption syndromes—may require parenteral formulations

Common:

• GI: Nausea, constipation, diarrhea, metallic taste, stomach upset
• CNS: Mild headache, dizziness
• Skin: Mild rash or flushing

Less Common:

• Staining of teeth (liquid iron formulations)
• Increased urination (Vitamin C)
• Dark-colored stools (iron-containing products)

Rare but Serious:

• Anaphylaxis (rare hypersensitivity)
• Iron overdose—especially dangerous in children
• Vitamin A or D toxicity in long-term high-dose use (e.g., hepatotoxicity, hypercalcemia)
• Neuropathy with prolonged excessive Vitamin B6 intake

• Tetracycline, fluoroquinolones: Absorption reduced by iron, calcium, magnesium, and zinc
• Warfarin: Vitamin K may antagonize anticoagulant effect
• Levodopa: High-dose pyridoxine may reduce efficacy
• Thyroid medications: Calcium and iron reduce levothyroxine absorption—separate dosing by 4 hours
• Alcohol: Chronic use depletes B vitamins and interferes with absorption

Enzyme Interactions:

• Some components (e.g., Vitamin A, D) are metabolized via CYP450 enzymes—caution with potent inducers/inhibitors (e.g., rifampin, phenytoin)

• WHO and CDC continue to recommend population-specific supplementation:
• Folic acid for women of childbearing age
• Iron and Vitamin D for pregnant and lactating women
• New formulations introduced with omega-3 (DHA/EPA), choline, and antioxidants to support cognitive and cardiovascular health
• Reduced-iron adult multivitamin formulations now available for patients with low iron needs (e.g., men, postmenopausal women)

• Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15–30°C
• Protect from moisture, heat, and direct sunlight
• Keep tightly closed
• For liquid forms:
• Shake well before use
• Use within 30 days of opening unless specified otherwise
• Do not freeze liquid products
• Keep out of reach of children to prevent accidental overdose