Vibee

Vitamin B₁, vitamin B₆, vitamin B₁₂.

Each tablet contains Vitamin B₁ (Thiamine Mononitrate) 100 mg, Vitamin B₆ (Pyridoxine Hydrochloride) 200 mg, Vitamin B₁₂ (Cyanocobalamin) 200 mcg.

Pharmacology: Pharmacodynamics: Vitamin B₁ is a water-soluble vitamin. The primary functions of thiamin include metabolism of carbohydrates, branched-chain amino acids, maintenance of normal growth, transmission of nerve impulses, and acetylcholine synthesis.
Vitamin B₆ is a coenzyme in the metabolism of amino acids, glycogen, and sphingoid bases and necessary for normal breakdown of proteins, carbohydrates, and fats. Vitamin B₆ is essential to make hemoglobin and helps increase the amount of oxygen carried by hemoglobin. Vitamin B₆ is also involved in maintaining the health of the immune system including maintaining the health of lymphoid organs (thymus, spleen, and lymph nodes) that make white blood cells. Vitamin B₆ maintains normal levels of blood glucose by helping convert stored carbohydrates or other nutrients to glucose. Vitamin B₆ also is needed for the conversion of tryptophan to niacin.
Vitamin B₁₂ is essential to growth, cell reproduction, hematopoiesis, and nucleoprotein and myelin synthesis. In nature, the vitamin B₁₂ is mainly in the 2-deoxyadenosyl(ado) form and methylcobalamin. They are cofactors for the enzyme methylmalonyl CoA mutase and methionine synthase, respectively.
Pharmacokinetics: Absorption: Vitamin B₁ is absorbed by a Na⁺ dependent active, carrier-mediated process at low concentration in the jejunum and by passive diffusion in the jejunum and ileum at high concentration. Maximum oral absorption is 8 to 15 mg/day. Oral absorption may be increased by administering in divided doses with food.
Vitamin B₆ is absorbed by passive diffusion in the jejunum and to a lesser extent in the ileum.
Vitamin B₁₂ is absorbed in the terminal ileum. Its amount of absorption is regulated by intrinsic factor which is secreted by the parietal cells of the stomach. Simple diffusion is responsible for absorption when more than 30 mcg of vitamin B₁₂ is ingested. Bioavailability of oral preparation is approximately 25%. Pancreatic disorders, bacterial overgrowth, intestinal parasites, sprue, and localized damage to ileal mucosa cells can interfere with absorption. In addition to intrinsic factor, GI absorption requires an alkaline pH. In pancreatic disease, it may be necessary to administer the oral vitamin with bicarbonate or give them the vitamin parenterally.
Distribution: Vitamin B₁ is mainly stored in the liver but is also found in the brain, kidney, heart, intestine, lung, spleen, and muscle.
Vitamin B₆ is stored mainly in the liver with lesser amounts in muscle and brain. The total body store of vitamin B₆ is estimated to be about 167 mg. Pyridoxal and pyridoxal phosphate, the principal forms of the vitamin present in blood, are highly protein bound. Pyridoxal crosses the placenta and breast milk.
Vitamin B₁₂ is bound to transcobalamine II, a specific B-globulin carrier protein. It normally carries only 20-60 ng of cobalamin per liter of plasma. And is distributed and stored primary in the liver, bone marrow and placenta by receptor-mediated endocytosis.
Metabolism/Excretion: Vitamin B₁ (exceed) is excreted in the urine both as thiamin acetic acid and metabolites. Approximately 100 mcg/day of thiamin are excreted in the urine with a daily intake of 0.5 mg/1000 kcal with normal renal function, 80% to 96% of an IV dose is excreted in the urine.
Vitamin B₆ is converted to pyridoxal-5-phosphate in the liver and excreted mostly as 4-pyridoxic acid in the urine.
Vitamin B₁₂ from bile and other intestinal secretions are recycled by enterohepatic circulation. If plasma-binding proteins are saturated, excess free vitamin B₁₂ will be excreted in the kidney.

Vibee tablets contains essential vitamin B complex, including vitamin B₁₂. The administration of Vibee is indicated as a dietary supplement to help in the prevention of vitamin B complex deficiency states. Vibee tablets are film-coated to minimize vitamin taste.

Adults: 1 tablet daily or more as directed by physicians.

Vitamin B₁ - symptoms: hypersensitivity and anaphylactic shock. Doses of 500 mg/day for a month were administered without toxic effects.
Vitamin B₆ - symptoms: patient receiving 2 to 7 g/day (or greater than 0.2 g/day for longer than 2 months) have developed sensory neuropathy with associated ataxia, numbness of hands and feet, unsteady gait, difficulty in handling small object, ataxia, severely impaired position and vibration sensation, less dramatic effects on light touch, pain sensation, and temperature, diminished deep tendon reflexes and Lhermitte's sign (neck pain and tingling that shoots down the spine to the legs and feet after neck flexion). When pyridoxine is discontinued, symptoms will lessen. It may take 6 months for sensation to normalize.
Vitamin B₁₂ - symptoms: vitamin B₁₂ is essential nontoxic in humans. Allergic reactions and hypersensitivity have been reported.

Vitamin B₁: Contraindicated in patients with known hypersensitivity to thiamin.
Vitamin B₆: Contraindicated in patients with known hypersensitivity to pyridoxine.
Vitamin B₁₂: None well document.

Should not take more than necessary.
Vitamin B₁: Serious hypersensitivity/anaphylactic reactions can occur.
Vitamin B₆: Noted in adults withdrawn from 200 mg/day of pyridoxine.
Vitamin B₁₂: Patients with early Leber disease (hereditary optic nerve atrophy) treated with vitamin B₁₂ suffered severe and swift optic atrophy.
Hypokalemia and sudden death may occur in severe megaloblastic anemia that is treated intensely with vitamin B₁₂.
Dosage of vitamin B₁₂ exceeding 10 mcg/day may produce a hematologic response in patients with folate deficiency.
Blunted or impeded therapeutic response to vitamin B₁₂ may be caused by such conditions as infection, uremia, drugs having bone marrow suppressant properties (eg, chloramphenicol), and concurrent iron or folic acid deficiency.

Pregnancy: Vitamin B₁ is category A (parenteral) in normal therapeutic doses. Category C if used in dose greater than recommended dietary allowances (RDA).
Vitamin B₆ is category A in normal therapeutic doses. Category C if used in dose greater than recommended dietary allowances (RDA). The RDA of pyridoxine is 1.9 mg/day during pregnancy.
Vitamin B₁₂ - absorption of vitamin B₁₂ may increase during pregnancy. Vitamin B₁₂ requirements may be increased in pregnant women compared with non-pregnant women. Serum concentration of vitamin B₁₂ are higher in the neonate at birth than the mother.
Lactation: Vitamin B₁ is not known whether that it is excreted in breast milk. Use with caution in nursing women.
Vitamin B₆ is excreted in breast milk and is directly proportional to maternal intake. Convulsions have been reported in infants fed a pyridoxine-deficient diet. Neonate seizures have been noted following birth in a mother consuming pyridoxine 80 mg/day or in infants whose mother's breast milk contained 67 mcg/day. Pyridoxine has been reported to inhibit lactation at oral doses of 600 mg/day. Avoid pyridoxine use in excess of the RDA during normal breastfeeding. The RDA of pyridoxine is 2 mg/day for nursing mothers.
Vitamin B₁₂ is found in breast milk. Milk concentrations are similar to maternal serum concentration and concentration may be decreased in women who are vegetarians. Vitamin B₁₂ requirements may be increased in breastfeeding women compared with non-breast-feeding women.

Vitamin B₁: feeling of warmth, pruritus, urticaria, weakness, sweating, nausea, restlessness, tightness of the throat, angioneurotic edema, cyanosis, pulmonary edema, hemorrhage into the GI tract, cardiovascular collapse, hypersensitivity, anaphylactic shock and death.
Vitamin B₆: sensory neuropathic syndrome, unstable gait, numb feet, awkwardness of hands, perioral numbness, decreased sensation to touch temperature and vibration, paresthesia, photo allergic reaction and ataxia.
Vitamin B₁₂: allergic hypersensitivity reaction has occurred rarely after cyanocobalamin and include skin reaction such as rash and itching and anaphylaxis. Other adverse effect reported with cyanocobalamin include gastrointestinal disturbances, fever, chills, hot flushing, dizziness, malaise, acneform and bullous eruptions, and tremor.

Vitamin B₁ is not known significant interactions.
Vitamin B₆ interacts with: Altretamine: Pyridoxine may diminish the therapeutic effect of altretamine. Specifically, when altretamine is used in combination with cisplatin the response duration may be diminished. Consider therapy modification.
Barbiturates: High pyridoxine dose (200 mg/day) may increase the metabolism of barbiturates. Monitor therapy.
Fosphenytoin: High pyridoxine dose (80 to 200 mg/day) may increase the metabolism of fosphenytoin. Monitor therapy.
Levodopa: Pyridoxine may diminish the therapeutic effect of levodopa. The concomitant use of pyridoxine and levodopa (in the absence of a dopa decarboxylase inhibitors (DDI)) should be avoided. Use of a dopa decarboxylase inhibitors (eg., carbidopa) with levodopa will essentially eliminate the risk of this interaction. Consider therapy modification.
Phenytoin: High pyridoxine dose (80 to 200 mg/day) may increase the metabolism of phenytoin. Monitor therapy.
Vitamin B₁₂ interacts with: Chloramphenicol: Chloramphenicol may diminish the therapeutic effect of vitamin B₁₂. Monitor therapy.
Colchicine: Colchicine may decrease the serum concentration of cyanocobalamin. Monitor therapy.

Store at temperature not exceeding 30°C.

Vitamin B-Complex / with C

A11DB - Vitamin B1 in combination with vitamin B6 and/or vitamin B12 ; Used as dietary supplements.

NDD