Ascorbic Acid (Vitamin C)
Tablet, 100mg, 500mg, 1gm
Drops, 200mg/ml
Injection, 50mg/ml in 2ml ampoule, 100mg/ml in 5ml ampoule, 200mg/ml

Indications: - for prophylaxis and treatment of vitamin C (ascorbic acid) deficiency states which lead to scurvey.

Cautions: - caution should be necessary not to take large amount during pregnancy. Importance of not taking more than the recommended dietary allowance (RDA) should also be considered. Caution is required in those with sensitivity to ascorbic acid.

Drug interaction - cellulose sodium phosphate, deferoxamine, disulfiram and vitamin B12 (with large doses of vitamin C)

Side effect: - dizziness or faintness, kidney stones (oxalate)

Dose and Administration -

Adult -

Dietary supplement - Oral, 50 to 100mg a day

Treatment of deficiency - Oral, IV or IM 100 to 250mg one or three times a day.

Child -

Dietary supplement - Infants and children up to 4 years of age - Oral, 20 to 50mg a day.

Treatment of deficiency - Oral, IV or IM 100 to 300mg a day in divided doses.

Storage: - at room temperature in a tight, light resistant container.

Calciferol (Ergocalciferol/Vitamin D₂)
Tablet (strong), 1.25 mg (50,000units)
Oral solution, 20,000-units/ ml, 400,000 units/ml
Injection, 300,000-units/ml in2 ml ampoule

Indications: - used in the treatment of chronic hypocalcemia, hypophosphatemia, rickets and osteodystrophy associated with various medical conditions including chronic renal failure, familial hypophosphatemia, and hypoparathyroidism (post surgical or idiopathic or pseudohypoparathyroidism); for prevention and treatment of vitamin D deficiency states; and to treat anticonvulsant induced rickets & osteomalacia

Note: Ergocalciferol may not be the preferred agent in the treatment of familial hypophosphatemia or hypoparathyroidism because the large doses needed are associated with a risk of overdose and hypercalcemia, and ergocalciferol not usually preferred in patients with renal failure since these patients have impaired ability to synthesize calcitriol from colecalciferol and ergocalciferol.

Cautions: - ergocalciferol should be administered with extreme caution, if at all, to patients with impaired renal function and with extreme caution in patients with heart disease, renal stones, or arteriosclerosis; large doses of VitaminD analogs should not be administered to nursing women; take care to ensure correct dose in infants and pregnant

Drug interactions: - antacids (magnesium containing), in high doses of calcium containing preparations & diuretics (thiazide), vitamin D analogs.

Side effects: symptoms of over dosage include anorexia, lassitude, nausea and vomiting, diarrhoea, weight loss, polyuria, sweating, headache, thirst, vertigo, and raised concentrations of calcium and phosphate in plasma and urine.

Contraindications: - hypercalcemia, hypervitaminosis D, Renal Osteodystrophy with hyperphosphatemia, metastatic calcification, hypersensitivity to effects of Vitamin D.

Dose and Administrations:

Ergocalciferol injection

Usual adult and adolescent dose:

Deficiency (prophylaxis or treatment)-

Intravenous infusion, as part of total parenteral nutrition solutions, the specific amount determined by individual patient need.

Malabsorption - Intramuscular, 10,000 units per day

Usual pediatric dose: see usual adult and adolescent dose

Ergocalciferol oral solution

Usual adult and adolescent dose:

Deficiency (prophylaxis)-

Oral, amount based on normal daily-recommended intakes:

Deficiency treatment

Treatment dose is individualized by prescriber based on severity or deficiency

Vitamin D - resistant rickets - Oral, 12,000 to 500,000 units per day

Vitamin D - dependent rickets- Oral 10,000 to 60,000 units per day (up to 500,000 units/day)

Osteomalacia due to prolonged use of anticonvulsants - Oral 1000 to 4000 units per day

Familial hypo phosphatemia - Oral, 50,000 to 100,000 units per day

Hypoparathyroidism - Oral, 50,000 to 150,000 units per day

Usual pediatric dose:

Deficiency (prophylaxis)-

Oral amount based on normal daily-recommended intakes.

Deficiency (treatment) -

Treatment dose is individualized by prescriber based on severity of deficiency

Vitamin D-dependent rickets - Oral, 3000 to 10,000 units per day (up to 50,000 units/day).

Osteomalacia due to prolonged use of anticonvulsants - Oral, 1000 units per day

Hypoparathyroidism - Oral, 50,000 to 200,000 units per day.

Ergocalciferol tablets

Usual adult and adolescent dose: see Ergocalciferol oral solution

Usual pediatric dose: see Ergocalciferol oral solution

Storage: - in tight, light - resistant containers at a room temperature.

Cholecalciferol (Vitamin D₃)
Capsule, 250mcg
Injection (oily), 300,000 IU/ml

Indications, Cautions, Side effects, Drug interactions, Dose and Administration; See notes under ergocalciferol.

Folic Acid
Tablet, 200 mcg, 1 mg, 5 mg
Injection, 5 mg/ml in 1 ml ampoule

Indications: - for prevention and treatment of folic acid deficiency states, including megaloblastic anemia and in anemias of nutritional origin, pregnancy, infancy, or childhood; folic acid is being used in the diagnosis of folate deficiency

Cautions: - administer with extreme caution to patients with undiagnosed anemia. It should never be given alone for pernicious anaemia and other vitamin B₁₂ deficiency states.

Drug interactions: - phenytoin, chloramphenicol

Side effects: - allergic reaction, specifically; bronchospasm; erythema; fever; general malaise; skin rash; or itching.

Contraindications: - folic acid injection that contains benzyl alcohol as a preservative should not be used in new born and immature infants

Dose and Administrations: -

Folic acid Injection:

Usual adult and adolescent dose:

Deficiency (prophylaxis) -

Intravenous infusion, as part of total parenteral nutrition solutions, the specific amount determined by individual patients need.

Deficiency (treatment) -

Intramuscular, intravenous, or deep subcutaneous: 250 mcg (0.25 mg) to 1-mg a day until a hematologic response occurs.

Diagnostic aid (folate deficiency) -

Intramuscular, 100 to 200 mcg (0.1 to 0.2 mg) a day for ten days plus low dietary folic acid and Vitamin B_12.

Usual pediatric dose: See usual adult and adolescent dose.

Folic acid Tablets:

Deficiency (prophylaxis)-

Oral, amount based on normal daily-recommended intakes:

Diagnostic aid (folate deficiency) -

Oral, 100 to 200 mcg (0.1 to 0.2 mg) a day for ten days plus low dietary folic acid and vitamin B_12.

Deficiency (treatment)

Treatment dose is individualized by prescriber based on severity of deficiency.

Storage: - at room temperature in a well-closed container.

Menadiol sodium Diphosphate
Tablet, 10 mg
Injection, 10mg /ml

Indications - in the prevention and treatment of hypoprothrombinemia secondary to factors limiting absorption or synthesis of Vitamin K.

Cautions: - the drug should not be used in neonates; in patients with hepatic function impairment, G6PD deficiency and vitamin E deficiency.

Drug interactions: - anticoagulants (coumarin or indandione - derivative), hemolytics

Side effects: - anaphylaxis, cyanosis, dizziness, hypotension, profuse sweating, rapid and weak pulse, and in newborns, hemolytic anemia and liver toxicity, which may progress to kernicterus.

Contraindications: - neonates and infants, late pregnancy

Dose and Administration:

Oral dosage forms

Usual adult and adolescent dose:

Hypoprothrombinemia secondary to obstructive jaundice and biliary fistulas, Oral, 5 mg/day.

Hypoprothrombinemia anemia secondary to the administration of antibacterials or salicylates, Oral, 5 to 10 mg per day.

Usual pediatric dose:

Vitamin (prothrombogenic); or Antidote (to drug- induced hypoprothrombinemia), Oral, 5 to 10 mg per day,

Parenteral dosage forms

Usual adult and adolescent dose:

Nutritional supplement (Vitamin), prothrombogenic; or Antidote (to drug induced hypoprothrombinemia) - Intramuscular or subcutaneous, 5 to 15 mg one or two times a day.

Storage: - in a light resistant container at room temperature; especially menadiol sodium bicarbonate injection should be protected from freezing.

Nicotinamide
Tablet, 100 mg
Injection, 5 mg/ml, 100 mg/ml in 1 ml ampoule

Indications: - nicotinamide and nicotinic acid (niacin) are used to prevent niacin deficiency and to treat pellagra. Niacin (but not nicotinamide) is also indicated in the treatment of hyperlipidemia.

Cautions: - blood glucose concentration should be monitored periodically and also liver function should be determined periodically in patients receiving long-term niacin or nicotinamide therapy. Large doses of niacin or nicotinamide should be administered with caution to patients with gallbladder disease or a history of jaundice or liver disease, diabetes mellitus, gout, peptic ulcer, or allergy, in women who are or may become pregnant unless the possible benefits out weight the potential risks to the fetus.

Drug interactions: - niacin reportedly potentiates the hypotensive effect of ganglionic blocking drugs.

Side effects: - anaphylactic reaction with injection only, hepatotoxicity or cholestasis with high doses of extended - release niacin.

Contraindications: - niacin and nicotinamide are contraindicated in patients with, active peptic ulcer, or hypersensitivity to the drugs. Niacin is also contraindicated in patients with arterial hemorrhaging or severe hypotension

Dose and Administration: -

Oral dosage forms

Deficiency (prophylaxis) -

Oral, amount based on normal daily-recommended intakes

Deficiency (treatment)-

Treatment dose is individualized by prescriber based on severity of deficiency.

Parenteral Dosage Forms:

Deficiency (prophylaxis)-

Intravenous infusion, as part of total parenteral nutrition solutions, the specific amount determined by individual patient need.

Deficiency (treatment) - For adults & adolescent

Intramuscular, 50 to 100 mg five to more times a day

Intravenous (slow), 25 to 100 mg two to more times a day.

And for Pediatric

Intravenous (slow), up to 300 mg a day

Storage: - at room temperature in a tight container.

Nicotinic Acid
Tablet, 50 mg
Injection, 50 mg/ml in 1 ml ampoule

Indications, Cautions, Side effects, Drug interactions, Contraindications, see notes under nicotinamide

Dose and Administrations:

Oral dosage form

Usual adult and adolescent dose:

Antihyperlipidemic-

Initial: Oral, 1 gram three times a day, the dosage being increased in increments of 500 mg a day every two to four weeks as needed.

Maintenance: oral, 1 to 2 grams three times a day.

Parentral dosage form; see under nicotinamide

Storage: - at rooms temperature in a well closed container. Protected from freezing.

Phytomenadione (vitamin K₁)
Injection, 1mg/ml in 0.5ml ampoule, 10mg/ml in 1ml ampoule.

Indications: - prothrombogenic nutritional supplement, it is also used for treatment and prevention of various coagulation disorders including hypoprothrombinemia, or as an antidote to drug - induced hypoprothrombinemia; see also section 10.1

Cautions, Drug interactions, Side effect; see section 10.1 under phytomenadione

Dose and Administration - SC or IM, it should not be given repeatedly to patients with severe liver disease, once the response to the initial dose is unsatisfactory.

Adults - Nutritional supplement (Vitamins), prothrombogenic or Antidote (to drug-induced hypoprothrombinemia) - 2.5 to 10mg (up to 25mg), may be repeated after 6-8 hours if necessary.

Children - Nutritional supplement (vitamin), prothrombogenic or Antidote (to drug - induced hypoprothrombinemia), Treatment of hypoprothrombinemia.

Infants - IM or Sc, 1-2 mg.
Children - IM or Sc, 5-10mg.

Storage: at room temperature, protect from light and freezing.

Pyridoxine Hydrochloride (Vitamin B₆)
Tablet, 40mg, 100mg, 300mg.
Injection, 50mg/ml in 2ml ampoule, 150mg/ml

Indications: - for prevention and treatment of pyridoxine deficiency states that may occur as a result of inadequate nutrition or intestinal malabsorption.

It is also used as antidote in cyclosporin poisoning and to terminate seizures and prevent neuropathy associated with isoniazid poisoning.

Cautions: - sensitive to pyridoxine.

Drug interactions - levodopa, cycloserine, isoniazid, penicillamines, hydralazine.

Side effects: - sensory neuropathy in prolonged use

Dose and Administration:

Usual Adult dose -

Deficiency states - oral, 20-50mg up to 3 times daily isoniazid neuropathy, prophylaxis 10mg daily, therapeutic - 50mg three times daily.

Idiopathic sideroblastic anaemia - oral, 100-400mg daily in divided doses.

Nutritional supplement - Dietary supplement - oral, 10-20mg per day for three weeks followed by 2 to 5mg per day (in a multivitamin preparation) for several weeks.

Drug Induced deficiency -

Prevention - oral, 10-50mg per day for penicillamine or 100-300mg per day for cycloserine, hydralazine, or isoniazid.

Treatment - oral, 50 to 100mg per day as needed to prevent relapse; IM or IV, 50 to 200mg per day for three weeks, followed by 25 to 100mg per day as needed.

Usual child dose-

Dietary supplement - oral, 2.5 to 10mg per day for three weeks, followed by 2 to 5mg per day (in a multivitamin preparation) for several weeks.

Storage - at room temperature, protect from light and from freezing.

Thiamine Hydrochloride (Vitamin B₁)
Tablet, 5mg, 10mg, 100mg, 300mg
Injection, 50mg/ml in 2ml ampoule

Indications: - for prevention and treatment of thiamine deficiency states that may occur as a result of inadequate nutrition or intestinal malabsorption.

It is used for temporary metabolic correction of genetic enzyme deficiency diseases such as subacute nercotizing encephalomyelopathy (SNE, Leigh’s disease), maple syrup urine disease (branched-chain aminoacidopathy), and lactic acidosis associated with pyruvate carboxylase deficiency and hyperalaninemia.

Cautions: - patients sensitive to thiamine and in those with Wernicke's encephalopathy.

Side effects: - anaphylactic reaction (coughing, difficulty in swallowing; hives; itching of the skin, swelling of face, lips or eyelids, or wheezing or difficulty in breathing).

Dose and Administration:-

Usual Adult dose

Nutritional supplement (Vitamin)

Beriberi (initial in mild or maintenance following severe): oral, 5 to 10mg three times a day (in a multivitamin preparation).

Beriberi (critical illness): IM or slow IV, 5-100mg three times a day followed by maintenance oral administration.

Treatment of deficiency: oral, 1-10mg three times a day until improvement occurs, followed by recommended dietary allowance.

Usual child dose

Nutritional supplement (Vitamin)

Beriberi (mild): Infants - oral, 10mg per day.

Beriberi (critical illness): IM or slow IV, 10-25mg per day.

Treatment of deficiency: oral, 10 to 50mg per day in divided doses.

Dietary supplement:

Infants - oral, 300 to 500mcg (0.3-0.5mg) per day.
Children - oral, 500mcg (0.5mg) to 1mg per day.

Storage - at room temperature in a tight, light-resistant container. Protect from light and freezing.

Vitamin A
Tablet, 50,000 IU, 100,000 IU 200,000 IU
Capsule, 25,000 IU, 50,000 IU, 100,000 IU
Oral solution, 150,000 IU/ml (concentrated), 50,000 IU/ml
Injection, under 200,000 IU/ml

Indications: - for prevention or treatment of vitamin A deficiency states, causing keratomalacia, xerophthalmia and nyctalopia (night blindness). This may occur as a result of inadequate nutrition or intestinal malabsorption.

Note: Vitamin A is not useful for treatment of dry or wrinkled skin, eye problems, or prevention or treatment of infections not related to vitamin A deficiency.

Cautions: - high doses exceeding 6000 units are not recommended during pregnancy, caution is recommended in young children taking high doses of vitamin A; long-term vitamin A use in the elderly may increase the risk of vitamin A overload; in patients with chronic renal failure, chronic alcoholism, cirrhosis, hepatic disease and viral hepatitis.

Drug interactions - calcium supplements, isotretinoin, tetracycline, vitamin E, cholestyramine, colestipol, mineral oil, oral neomycin.

Contraindications: - hypervitaminosis A

Side effects: - symptoms of acute overdose - bleeding from gums or sore mouth; bulging soft spot on head-in babies, confusion or unusual excitement; diarrhoea, dizziness, or drowsiness, double vision, severe headache, severe irritability, peeling of skin, especially on lips and palms; severe vomiting

Dose and Administration -

Usual adult and adolescent dose:

Deficiency - oral, 30,000 RE (100,000units) a day for 3 days followed by 7500 to 15,000 RE (25,000 to 50,000 unit) a day for 14 days.

With xerophthalamia: oral, 7500 to15, 000 RE (25,000 to 50,000 units) a day.

Note: -RE=Retinol Equivalent; one RE = one mcg of Retinol = 3.33 units of vitamin A.

- IM, Intravenous infusion, as a part of total parenteral nutrition solution, the specific amount determined by individual patient need.

- IM 15,000 to 30,000 RE (50,000-100,000 units) a day for three days, followed by 15,000 RE (50,000 units) a day for two weeks.

Usual child dose:

Deficiency

- Infants less than 1year - oral, 3000 RE (10,000 units) per kg per day for 5 days followed by 2250 -4500 RE (7500 to 15,000 units) per day for 10 days; IM, 1500 - 3000 RE (500-10,000 units) a day for ten days; in severe deficiency - IM, 2250 to 4500 RE (7500 to 15,000 units) a day for ten days.

- Children 1-8 years of age - oral, 3000 RE (10,000 units) per kg per day for 5 days followed by 5100 to 10,500 RE (17,000 to35,000 units) a day for 10 days.

With xerophthalamia - oral, 1500 RE (5000 units) per kg of body weight for five days, then in combination with intramuscular Vitamin A (7500 RE or 25,000 units per kg of body weight a day) until recovery occurs.

IM, 1500-4500 RE (5000-15,000 units) a day for ten days; in severe deficiency - IM, 5250 to 10,500RE (17,500-35,000 units) a day for ten days.

Storage: - at room temperature in a tight, light-resistant container. Protect from light and freezing.