Indoplex

• Prevention and Treatment of Vitamin B Deficiencies:
  Indicated for correcting deficiencies of one or multiple B vitamins due to inadequate dietary intake, malabsorption, chronic alcoholism, or increased physiological demand.
• Peripheral Neuropathy:
  Used to treat neuropathies related to deficiencies of B1 (thiamine), B6 (pyridoxine), and B12 (cobalamin).
• Anemia:
  Management of megaloblastic anemia caused by folate (B9) or vitamin B12 deficiency.
• Neurological Disorders:
  Adjunctive treatment for diabetic neuropathy, neuralgia, and some neurodegenerative diseases.
• Hyperhomocysteinemia:
  Used to lower elevated homocysteine levels with B6, B9 (folate), and B12 supplementation to reduce cardiovascular risk.
• Supportive Nutritional Therapy:
  Used during pregnancy, lactation, periods of rapid growth, recovery from illness or surgery, and in malnourished patients.
• Alcohol-Related Disorders:
  Prevention and treatment of Wernicke-Korsakoff syndrome and other neurological complications from chronic alcohol use.

• Route: Oral (tablets, capsules, liquids), intramuscular (IM), intravenous (IV) when indicated.
• Adults:
  Dosage depends on specific B vitamins included; typical daily doses in supplements:
• Thiamine (B1): 1.1–1.2 mg
• Riboflavin (B2): 1.1–1.3 mg
• Niacin (B3): 14–16 mg NE (Niacin Equivalents)
• Pyridoxine (B6): 1.3–2 mg (therapeutic doses may be up to 100 mg daily with monitoring)
• Folate (B9): 400 mcg (0.4 mg)
• Cobalamin (B12): 2.4 mcg (higher doses for deficiency treatment)
• Pediatrics:
  Dose adjusted by age and weight per specific vitamin content.
• Elderly:
  Generally same as adults; monitor for deficiency or malabsorption.
• Renal/Hepatic Impairment:
  Use cautiously; dose adjustment based on clinical response.
• Administration Notes:
  Oral supplements should be taken with food to enhance absorption. Parenteral forms reserved for severe deficiencies or malabsorption.

Vitamin B complex consists of eight water-soluble vitamins that act primarily as coenzymes in enzymatic reactions critical for cellular energy production, DNA synthesis, and neurological function. For example, thiamine (B1) is essential for carbohydrate metabolism and nerve conduction; riboflavin (B2) functions in oxidation-reduction reactions; niacin (B3) is a precursor to NAD/NADP involved in energy metabolism; pyridoxine (B6) is necessary for amino acid metabolism and neurotransmitter synthesis; folate (B9) and cobalamin (B12) are vital for DNA synthesis and red blood cell formation. Together, they support metabolic, hematologic, and neurologic health.

• Absorption: Rapidly absorbed in the small intestine via active transport and passive diffusion.
• Distribution: Widely distributed in body tissues; vitamin B12 is stored mainly in the liver, while others have limited reserves.
• Metabolism: Converted intracellularly to active coenzyme forms (e.g., pyridoxal phosphate for B6).
• Elimination: Excess water-soluble vitamins are primarily excreted via urine.
• Half-life: Variable; B12 has a half-life of days to weeks, while others range from hours to days.

• Pregnancy:
  Vitamin B complex vitamins are generally safe and essential during pregnancy; folate supplementation is critical to prevent neural tube defects. No evidence of teratogenicity at recommended doses.
• Lactation:
  B vitamins are secreted in breast milk in small amounts and support infant development.
• Caution:
  High doses of certain vitamins (e.g., B6) should be avoided unless clinically indicated.

• Primary Class: Water-soluble vitamins.
• Subclass: B-complex vitamins.
• Pharmacologic Category: Essential micronutrient group.

• Hypersensitivity to any vitamin B complex components.
• Caution in conditions sensitive to specific B vitamins.

• High-dose pyridoxine (>100 mg/day) may cause sensory neuropathy.
• Rare allergic reactions; discontinue if hypersensitivity occurs.
• Use caution in renal or hepatic impairment.
• Monitor parenteral administration for injection site reactions.

• Common: Mild gastrointestinal upset, flushing (with niacin), headache.
• Serious/Rare: Sensory neuropathy with excessive B6 intake, hypersensitivity reactions, hepatotoxicity with high-dose niacin.
• Dose-dependence: Side effects mainly occur with doses exceeding normal dietary supplementation or prolonged high-dose therapy.

• Pyridoxine can reduce efficacy of levodopa by increasing peripheral metabolism.
• Phenytoin and phenobarbital may lower B vitamin levels.
• Isoniazid induces B6 deficiency; supplementation recommended.
• Alcohol interferes with absorption and metabolism of B vitamins.
• Methotrexate antagonizes folate; folate supplementation advised.

• WHO and CDC recommend folic acid supplementation during pregnancy to prevent neural tube defects.
• Emphasis on screening for vitamin B12 deficiency in elderly and at-risk populations.
• FDA warnings about hepatotoxicity risks with high-dose niacin therapy.
• Individualized supplementation based on clinical need is advised.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep container tightly closed.
• Avoid exposure to excessive heat and humidity.
• Keep out of reach of children.
• Refrigeration not required.