A fixed-dose combination of four essential trace minerals (Chromium, Copper, Manganese, Selenium) formulated as a nutritional supplement. It is primarily indicated for the prevention and correction of deficiencies of these micronutrients, which are crucial cofactors for numerous enzymatic and metabolic processes. In the Indian context, it is widely used as an adjunct in the management of diabetes, metabolic syndrome, oxidative stress, and to support immune function, bone health, and thyroid metabolism.
Adult: One tablet/capsule once daily, or as directed by the physician. Usually taken with a meal to improve tolerance and absorption.
Note: Oral administration. Swallow whole with a full glass of water. Take with food to minimize potential gastrointestinal upset and to enhance absorption of fat-soluble components. Do not crush or chew unless specified. Maintain at least 2 hours gap with tetracycline/quinolone antibiotics, antacids, zinc, or iron supplements to avoid absorption interference.
The combination acts by replenishing essential trace minerals that serve as critical cofactors for hundreds of enzymes. Chromium potentiates the action of insulin by facilitating insulin receptor signaling. Copper is a cofactor for cytochrome c oxidase (energy production), superoxide dismutase (antioxidant), and lysyl oxidase (collagen cross-linking). Manganese is a cofactor for superoxide dismutase (MnSOD), pyruvate carboxylase (gluconeogenesis), and glycosyltransferases (bone matrix formation). Selenium is an integral component of the active site of glutathione peroxidases and thioredoxin reductases, key antioxidant enzymes, and is essential for the conversion of thyroxine (T4) to triiodothyronine (T3).
Pregnancy: Category C (US FDA equivalent). Trace minerals are essential for fetal development, but supplementation should not exceed recommended dietary allowances (RDAs). This combination dose is generally within safe limits, but should be used only under medical supervision during pregnancy. High-dose selenium is teratogenic in animals.
Driving: No known effects on driving ability at recommended doses.
| Levothyroxine | Selenium may enhance conversion of T4 to T3, potentially altering thyroid hormone levels. Monitor TSH. | Moderate |
| Antacids (Aluminum, Magnesium, Calcium containing) | Reduce absorption of all trace minerals. Administer at least 2-3 hours apart. | Moderate |
| Tetracycline & Quinolone antibiotics | Chelation by minerals reduces antibiotic absorption. Separate administration by 2-3 hours. | Major |
| Penicillamine | Chelates copper, reducing its efficacy for Wilson's disease. Contraindicated. | Major |
| Zinc supplements (high dose) | Competes with copper for absorption, can induce copper deficiency. Monitor if used concurrently. | Moderate |
| Iron supplements | May compete with manganese and chromium for absorption. Separate doses. | Moderate |
| Vitamin C (high dose >1g) | May reduce the absorption of copper. Moderate doses are acceptable. | Minor |
Same composition (Chromium (0.4mg) + Copper (0.4mg) + Manganese (0.1mg) + Selenium (0.02mg)), different brands: