Decamevit

Pharmacological properties

a multivitamin drug whose properties are determined by vitamins that are part of it and take an active part in almost all biochemical reactions of the body. a rationally selected composition contributes to the manifestation of a more pronounced and versatile biological effect of the drug.

Vitamin A (retinol acetate) is necessary for the development of epithelial cells and the synthesis of visual pigment.

Vitamin E (α-tocopherol acetate) - a fat-soluble vitamin with a pronounced antioxidant and radioprotective effect, takes part in the biosynthesis of heme and proteins, cell proliferation and other most important processes of cellular metabolism, improves oxygen consumption by tissues, and also has an angioprotective effect, affecting vascular tone and permeability, stimulating the formation of new capillaries.

Vitamin B₁ (thiamine hydrochloride) normalizes the functional activity of the nervous, cardiovascular and digestive systems.

Vitamin B₂ (riboflavin) plays an important role in protein, fat and carbohydrate metabolism, takes part in maintaining normal visual acuity, normalizes skin functions.

Vitamin B₆ (pyridoxine hydrochloride) is necessary for the regeneration of the skin and liver cells, the restoration of the nervous system, improves fat metabolism in atherosclerosis.

Vitamin C (ascorbic acid) plays an important role in the regulation of redox processes, carbohydrate metabolism, blood coagulation, tissue regeneration, normal capillary permeability, the formation of steroid hormones and constituents of connective tissue, and helps increase the bodys resistance to infectious diseases.

Vitamin B₉ (folic acid), in addition to the antianemic effect during pregnancy, protects the fetus from the influence of teratogenic factors, takes part in the exchange and synthesis of amino and nucleic acids.

Vitamin PP (nicotinamide) is a specific anti-pellargic drug that improves carbohydrate metabolism.

Vitamin P (rutin) - P-vitamin-like water-soluble substance, flavonoid. Rutin interacts with ascorbic acid, takes part in the regulation of collagen formation of connective tissue, prevents the depolymerization of hyaluronic acid with hyaluronidase, and activates tissue respiration.

The essential amino acid methionine plays a role in the synthesis of a number of biologically important compounds, activates the effects of hormones, vitamins and enzymes, and neutralizes toxic products.

Vitamin B₁₂ (cyanocobalamin) affects the normal maturation of all body cells, especially blood and liver cells, positively affects the functioning of the nervous system and liver.

Pharmacokinetics Fat-soluble vitamins that are part of the drug (vitamin A, vitamin E) are able to be deposited in the tissues. Water Soluble Vitamins (Vitamins B₁, AT₂, AT₆, AT₁₂, C, PP) turn into coenzymes and, when combined with an apoenzyme, are part of complex enzymes. Since the life of enzymes is limited, coenzymes break down and are excreted in the form of various metabolites. Fat-soluble vitamins are also catabolized and excreted, albeit more slowly than water-soluble ones.

Indications

As a remedy for vitamin deficiency and hypovitaminosis, an increased need for vitamins in the following conditions:

• with physical and mental exhaustion;
• in old age to optimize metabolism;
• for convalescence in the postoperative period, after serious illnesses, including intoxication of various origins;
• with prolonged antibiotic therapy.

Application

For therapeutic purposes, adults inside after eating 1 tablet 1-2 times a day.the course of treatment is usually 20 days. depending on the testimony, repeated courses are possible with breaks between them in 2-3 months.

Contraindications

Hypersensitivity to any component of the drug, severe renal impairment, gout, hyperuricemia, erythremia, erythrocytosis, thromboembolism, fructose intolerance, hypervitaminosis a and e, thyrotoxicosis, chronic glomerulonephritis, chronic heart failure, anemia and pepticemia bowel, impaired iron or copper metabolism, thrombosis, tendency to thrombosis, thrombophlebitis, urolithiasis, incurable cobalamin deficiency, malignant anemia, malignancy ennye neoplasms.

Side effects

The drug is usually well tolerated, but sometimes adverse reactions can occur, mainly when used in high doses.

On the part of the immune system: in patients with hypersensitivity, allergic reactions are possible, including anaphylactic shock, angioedema, hyperthermia; rarely - bronchospasm in individuals with hypersensitivity to vitamins A, C, group B.

From the endocrine system: damage to the insular apparatus of the pancreas (hyperglycemia, glucosuria) and impaired glycogen synthesis until diabetes mellitus appears.

On the part of the skin and subcutaneous tissue: rashes, urticaria, itching, redness of the skin, eczema.

From the cardiovascular system: arterial hypertension / hypotension, myocardial dystrophy.

From the nervous system: headache, dizziness, irritability, fatigue, sleep disturbance, drowsiness, sensation of heat.

From the digestive tract: dyspeptic disorders, heartburn, a feeling of bitterness in the mouth, nausea, vomiting, diarrhea, anorexia; rarely - possibly increased secretion of gastric juice.

From the side of the kidneys and urinary system: damage to the glomerular apparatus of the kidneys, crystalluria, the formation of urate, cystine and / or oxalate calculi in the kidneys and urinary tract, renal failure.

From the side of metabolism: metabolic imbalance of zinc, copper.

From the blood system and lymphatic system: thrombocytosis, hyperprothrombinemia, thrombosis, erythrocytopenia, neutrophilic leukocytosis; in patients with deficiency of glucose-6-phosphate dehydrogenase, blood cells can cause erythrocyte hemolysis, hemolytic anemia.

Others: it is possible to stain urine in yellow, increased sweating, visual impairment.

With prolonged use of the drug in high doses, it is possible: irritation of the gastrointestinal tract mucosa, paresthesia, hyperuricemia, transient increase in activity of AcAT, LDH, alkaline phosphatase, decreased glucose tolerance, hyperglycemia, impaired renal function, dryness and cracks in the palms and feet, hair loss, seborrheic rashes, tachycardia, arrhythmia.

special instructions

Women who use high doses of retinol (over 10,000 IU) can be scheduled for pregnancy no earlier than 6-12 months. this is due to the fact that during this time there is a risk of abnormal development of the fetus under the influence of a high content of vitamin A in the body.

It is possible to stain urine in yellow, which is a completely harmless factor and is explained by the presence of riboflavin in the preparation.

Use with caution in patients with kidney diseases, with severe liver damage, peptic ulcer of the stomach and duodenum in the anamnesis, acute nephritis, with decompensation of cardiac activity, gallstone disease, chronic pancreatitis, coronary heart disease, and diabetes mellitus.

The drug should be used with caution in patients with neoplasms (except in cases involving megaloblastic anemia).

The drug is prescribed with caution to patients with anemia of unknown etiology, since folic acid can interfere with the diagnosis of malignant anemia by reducing the severity of the hematological manifestations of the disease, while allowing neurological complications to progress.

When used in high doses or prolonged use of the drug, it is necessary to control the level of blood pressure. The simultaneous use of the drug with alkaline drink reduces the absorption of ascorbic acid, so you should not drink it with alkaline mineral water. Also, the absorption of ascorbic acid can be impaired with intestinal dyskinesia, enteritis and achilia. Use with caution for the treatment of patients with glucose-6-phosphate dehydrogenase deficiency. Ascorbic acid may affect laboratory results. For example, in the determination of blood glucose, bilirubin, transaminase activity, LDH.

High doses of the drug should not be prescribed to patients with increased blood coagulation.

Since ascorbic acid increases iron absorption, use in high doses can be dangerous for patients with hemochromatosis, thalassemia, polycythemia, leukemia and sideroblastic anemia. Patients with a high iron content in the body should use the drug in minimal doses.

Since ascorbic acid has a mild stimulating effect, it is not recommended to use the drug at the end of the day.

Use during pregnancy and lactation. During pregnancy and lactation, the drug is taken only on the recommendation of a doctor. The dose of vitamin A should not exceed 5000 IU in pregnant women and those planning a pregnancy.

Retinol should not be taken in high doses (over 10,000 IU) during lactation due to the threat of hypervitaminosis A in infants.

Children. Due to the lack of data on safety and effectiveness, the drug is not used in children.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms. Drivers and operators of complex machinery should consider the likelihood of side effects such as dizziness, drowsiness.

Interactions

The drug is not recommended to be prescribed along with other multivitamins, since an overdose of the latter in the body is possible.

High doses of the drug reduce the effectiveness of tricyclic antidepressants, antipsychotics - phenothiazine derivatives, tubular reabsorption of amphetamine, and disrupt kidney excretion of mexiletine.

Due to the possibility of developing hypervitaminosis A, the concomitant use of the drug with other medicines containing vitamin A or with oral retinoids is not recommended.

Retinol reduces the anti-inflammatory effect of glucocorticoids. Do not use simultaneously with nitrites and colestyramine, since they disrupt the absorption of retinol.

Medicines containing iron inhibit the action of vitamin E. Vitamin E can not be used together with iron, silver, drugs with an alkaline environment (such as sodium bicarbonate, trisamine), indirect anticoagulants (such as dicumarin, neodicumarin). Alpha-tocopherol acetate enhances the effects of steroidal and non-steroidal anti-inflammatory drugs (such as sodium diclofenac, ibuprofen, prednisone).

Thiamine hydrochloride, affecting the polarization processes in the area of ​​neuromuscular synapses, can weaken the curariform effect of muscle relaxants.

Pyridoxine hydrochloride weakens the effect of levodopa, prevents the onset or reduces the toxic effects of isoniazid and other anti-TB drugs.

When short-acting sulfanilamides are used with ascorbic acid, the risk of crystalluria increases. With simultaneous use, it enhances the effect of penicillin, increases the absorption of iron, reduces the effectiveness of heparin and indirect anticoagulants, enhances the absorption of aluminum (take into account with simultaneous treatment with antacids containing aluminum). Absorption of ascorbic acid decreases with the simultaneous use of oral contraceptives, the use of fruit or vegetable juices, alkaline drink. Ascorbic acid can be used only 2 hours after injection of deferoxamine. Long-term use of high doses of ascorbic acid reduces the effectiveness of disulfiram treatment. Ascorbic acid increases the overall clearance of ethyl alcohol. Quinolone drugs, calcium chloride, salicylates, tetracyclines, corticosteroids with prolonged use reduce the bodys ascorbic acid reserves. Ascorbic acid enhances the excretion of oxalates in the urine and increases the risk of crystalluria in the treatment of salicylates.

Riboflavin is incompatible with streptomycin and reduces the effectiveness of antibacterial drugs (oxytetracycline, doxycycline, erythromycin, tetracycline and lincomycin). Tricyclic antidepressants, imipramine and amitriptyline inhibit the metabolism of riboflavin, especially in the tissues of the heart.

Folic acid reduces plasma concentrations of phenytoin with other antiepileptic drugs, in particular phenobarbital, which causes a mutual decrease in clinical efficacy.

Ethanol, cycloserine, glutethimide, and methotrexate can affect folate metabolism. The absorption of folic acid decreases with the simultaneous use of analgesics, anticonvulsants, antacids, sulfonamides, antibiotics, cytostatics. A decrease or change in absorption may occur with the simultaneous use of colestyramine and folic acid. Therefore, the drug should be taken 1 hour before or 4-6 hours after taking colestyramine. It can not be used together with mineral acids, reducing agents, since folic acid inactivation occurs.

Overdose

Symptoms with an overdose of the drug, dyspeptic phenomena (nausea, vomiting, diarrhea, epigastric pain), allergic reactions (itching, skin rash), changes in the skin and hair, impaired liver function, headache, drowsiness, lethargy, hyperemia of the face, irritability, increased irritability of the central nervous system, which can cause seizures.

Treatment. Discontinuation of the drug. Therapy is symptomatic.

With prolonged use in high doses, inhibition of the function of the insular apparatus of the pancreas is possible, monitoring of the state of the latter is required. An overdose can lead to changes in renal excretion of ascorbic and uric acids during urine acetylation with the risk of precipitation of oxalate calculi.

Storage conditions

In the original packaging at a temperature not exceeding 25 ° C.