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B-cobal

Film-coated tablet


Description

A round, red film-coated tablet with diameter about 12mm.


Composition
Each tablet contains active ingredients: mecobalamin 0.5 mg, vitamin B1 100 mg and Vitamin B6 200 mg

 

Actions
B-cobal is a combination of the 3 essential neurotropic vitamin B group. Vitamin B1 is involved in carbohydrate metabolisme and in nerve transmission. Vitamin B6 is involved in amino acid metabolism and in protein metabolism. Mecobalamin is a B12-containing co-enzyme with an active methyl base. It participates in transmethylation reactions and is the most active of all B12 homologs in the body with respect to nucleic acid, protein and lipid metabolism. Mecobalamin acts to repair damaged nerve tissue in nerve disorders eg: axonal degeneration and demylination; and it is involved in erythroblast maturation, promotion of erythroblast division, and heme synthesis, thus acting to improve the status of the blood in megablastic anemia.


Pharmacology
Mecobalamin promotes the metabolism of nucleic acids proteins and lipids. In animal studies, mecobalamin acted as co-enzyme in methionine synthesis. In particular, it was found to be involved in the synthesis of thymidine from deoxyuridine and to accelerate the synthesis of DNA and RNA, and also found to accelerate the synthesis of lecithin, a major component of the myelin sheath.

Mecobalamin is efficiently transferred to nervous tissue and improves metabolic disorder:
Mecobalamin is a CH3-vitamin B12 which is found in high concentration in blood and cerebrospinal fluid. It also accelerated the synthesis of the major structural component of the axon in sciatic nerve cell of rats with experimental diabetes and returned the protein transport rate close to normal, resulting in maintenance of axonal function.
Mecobalamin repairs nerve tissues in experimental nerve injury models.
Mecobalamin inhibits abnormal excitation transmission by nerve tissues.
Mecobalamin improves anemia by accelerating the maturation and division of erythroblast.


Pharmacokinetics
Vitamin B1 is absorbed from the gastrointestinal tract and is widely distributed to most bony tissues. it is not stored in the body and amounts in excess of the body's requirements are excreted in urine as unchanged thiamine or its metabolite, pyrimidine. Vitamin B6 is absorbed from the gastrointestinal tract and is converted to the active form: Pyridoxal phosphate. Pyridoxal phosphate is transformed to pyridoxic acid and excreted in the urine . When mecobalamin administered by oral, peak plasma concentration is achieved after 3 hrs and it is dose-related. The excretion mainly through urine, approximately 40-80% of the total urine excretion is excreted within first 8 hours.


Indications
For neurological and other disorders associated with disturbance of the nerve cell metabolism in which high dose B-complex vitamins play a role. These include: Polyneuritis (of toxic and non toxic etiology): neuralgias eg: lumbago, sciatica, root irritation due to degenerative changes of the vertebral column , shoulder-arm syndrome, herpes zoster, cervical syndrome, ischialgia, etc: diabetic neuropathy; metabolic and neuropathic changes due to pregnancy and oral contraceptives ; convalescence.
Megaloblastic anemia due to vitamin B12 deficiency.


Dosage

Usually for adults, orally administer 1 tab 3 times a day.
The dosage should be adjusted according to age of patient and severity of symptoms.


Side-effects
Gastrointestinal Symptoms, eg anorexia, nausea or diarrhea may occur infrequently.
Dermatological: Skin rash may occur rarely.
Others: Prolonged use of larger doses of mecobalamin is not recommended to patients whose occupation requires handling of mercury or its compounds.


PRECAUTIONS/WARNINGS
Cyanocobalamin should not be given before a diagnosis has been fully established because of the possibility of masking symptoms of subacute degeneration of the spinal cord. Cyanocobalamin is not a suitable form of vitamin B12 for the treatment of optic neuropathies associated with raised plasma concentrations of cyanocobalamin. Long term administration of large doses of pyridoxine is associated with the development of severe peripheral neuropathies. This may occur with doses in excess of about 2g daily. Cyanocobalamin should not be used in megaloblastic anaemia of pregnancy. Administration of doses greater than 10 microgram daily may produce a haematological response in patients with folate deficiency.

CONTRAINDICATIONS

Patients with a history of hypersensitive to vitamin B and mecobalamin


DRUG INTERACTIONS
Metformin, histamin H-2 receptor antagonists (cimetidine, ranitidine), aminoglycosides, colchicines, aminosalicylic acid, anticonvulsants, neomycin and alcohol may decrease the absorption of vitamin B12.


Antibiotics, Tetracycline - Vitamin B1 and Vitamin B12 should not be taken at the same time as the antibiotic tetracycline because it interferes with the absorption and effectiveness of this medication. B-cobal tablet should be taken at different times from tetracycline.

 

Antidepressant Medications, Tricylic - Taking vitamin B1 supplements may improve treatment with antidepressants such as nortriptyline, especially in elderly patients. Other medications in this class of antidepressants include desimipramine and imipramine.


Digoxin - Laboratory studies suggest that digoxin may reduce the ability of heart cells to absorb and use vitamin B1. Diuretics particularly furosemide, may reduce the levels of vitamin B1 in the body.
Vitamin B6 decreases the effects of the levodopa


Symptoms and treatment for overdosage

In case of overdose, treatment is symptomatic and supportive.

 

Packing

Amber glass bottle of 15's, 30's, 60's and 90's.

Blister pack of 200's.
Store below 25C in an airtight container.

Protect from light and moisture.


Shelf-life

Three years from the date of manufacture.

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