A fixed-dose combination (FDC) of essential B-complex vitamins, primarily indicated for the treatment and prevention of neuropathic pain, peripheral neuropathy, and B-vitamin deficiencies. Methylcobalamin is the active, coenzymatic form of Vitamin B12, crucial for nerve myelination and hematopoiesis. Pyridoxine is involved in neurotransmitter synthesis and homocysteine metabolism. Nicotinamide (Vitamin B3) supports cellular energy production and nerve health. Folic Acid is essential for DNA synthesis and works synergistically with B12 in homocysteine reduction. This combination is widely prescribed in India for diabetic neuropathy, nutritional deficiencies, and chronic pain management.
Adult: One tablet once daily, or as directed by the physician. Often prescribed for 3-6 months for neuropathic conditions.
Note: Administer orally, preferably after a meal to reduce potential gastric irritation. Tablet can be taken with a full glass of water. Do not crush or chew unless advised. For best absorption of Folic Acid, a gap of 2 hours from antacids or cholestyramine is recommended.
The combination exerts synergistic effects on nerve health, homocysteine metabolism, and cellular energy production. Methylcobalamin acts as a cofactor for methionine synthase, converting homocysteine to methionine, crucial for myelin synthesis and nerve repair. It also supports the methylation cycle. Pyridoxine (as PLP) is a cofactor for over 140 enzymatic reactions, including the synthesis of neurotransmitters (GABA, serotonin, dopamine) and the transsulfuration pathway converting homocysteine to cysteine. Nicotinamide is a precursor for NAD+, essential for mitochondrial respiration, ATP production, and DNA repair. Folic Acid (as THF) is a one-carbon donor in nucleotide synthesis and works in tandem with B12 in the remethylation of homocysteine.
Pregnancy: Category A (Indian FDA/Pregnancy Category). Considered safe. Folic Acid is crucial for preventing neural tube defects. Methylcobalamin and other B vitamins are essential for fetal development. Use only under medical supervision; recommended dose should not be exceeded.
Driving: No known effects on driving ability. Dizziness is a rare side effect.
| Levodopa | Pyridoxine (>5mg) accelerates peripheral decarboxylation of Levodopa, reducing its central availability and efficacy. | Major |
| Phenobarbital / Phenytoin | Folic Acid may decrease serum levels of these antiepileptics, potentially reducing seizure control. Phenytoin may also reduce folate levels. | Moderate |
| Methotrexate | Folic Acid can reduce the hematological toxicity of Methotrexate but may also interfere with its efficacy in cancer chemotherapy. Use under strict oncology supervision. | Major |
| Chloramphenicol | May antagonize the hematological response to Vitamin B12. | Moderate |
| Proton Pump Inhibitors (Omeprazole), H2 Blockers (Ranitidine) | Long-term use can reduce Vitamin B12 absorption by causing hypochlorhydria. This formulation's high B12 dose may help overcome this. | Moderate |
| Metformin | Long-term use is associated with reduced Vitamin B12 absorption. This formulation is often co-prescribed to counter this effect. | Moderate |
| Isoniazid | May increase Pyridoxine requirements and can cause peripheral neuropathy. | Moderate |
Same composition (Methylcobalamin (750mcg) + Vitamin B6 (Pyridoxine) (50mg) + Nicotinamide (6mg) + Folic Acid (0.35mg)), different brands: