B-Complex

Drug overview for B-COMPLEX (thiamine hcl/riboflavin/niacinamide/dexpanthenol/pyridoxine):

Generic name: THIAMINE HCL/RIBOFLAVIN/NIACINAMIDE/DEXPANTHENOL/PYRIDOXINE
Drug class: Vitamin B-1
Therapeutic class: Electrolyte Balance-Nutritional Products

No enhanced Introduction information available for this drug.

No enhanced Uses information available for this drug.

DRUG IMAGES

B-COMPLEX 100 INJECTION

The following indications for B-COMPLEX (thiamine hcl/riboflavin/niacinamide/dexpanthenol/pyridoxine) have been approved by the FDA:

Indications:
Vitamin deficiency prevention
Vitamin deficiency

Professional Synonyms:
Vitamin deficiency prophylaxis

The following drug interaction information is available for B-COMPLEX (thiamine hcl/riboflavin/niacinamide/dexpanthenol/pyridoxine):

Contraindicated
Severe
Moderate

There are 0 contraindications.

There are 0 severe interactions.

There are 1 moderate interactions. The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.

Drug Interaction	Drug Names
Levodopa/Pyridoxine SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Pyridoxine increases levodopa metabolism, decreasing the amount of levodopa available to the central nervous system. CLINICAL EFFECTS: The pharmacologic effects of levodopa may be decreased. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Avoid pyridoxine in patients receiving levodopa alone; however, the interaction can be minimized by giving levodopa with a peripheral decarboxylase inhibitor (e.g. carbidopa, benserazide). Treatment with combination carbidopa-levodopa may contribute to reduced vitamin B6 levels. Higher doses of carbidopa-levodopa may increase the risk of vitamin B6 deficiency. Seizures associated with vitamin B6 deficiency have been reported in the postmarketing setting. In patients taking combination therapy with carbidopa/levodopa, evaluate vitamin B6 levels periodically while on treatment or if symptoms associated with vitamin B6 deficiency are identified. Supplement with vitamin B6 as necessary. DISCUSSION: In patients with Parkinson's disease, as little as 10 mg of pyridoxine may reverse the clinical benefits as well as the adverse effects of levodopa. Coadministration of levodopa with either carbidopa or benserazide has minimized the effects of this interaction.	INBRIJA, LEVODOPA

Drug Interaction

Drug Names

Levodopa/Pyridoxine

SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.

MECHANISM OF ACTION: Pyridoxine increases levodopa metabolism, decreasing the amount of levodopa available to the central nervous system.

CLINICAL EFFECTS: The pharmacologic effects of levodopa may be decreased.

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: Avoid pyridoxine in patients receiving levodopa alone; however, the interaction can be minimized by giving levodopa with a peripheral decarboxylase inhibitor (e.g. carbidopa, benserazide). Treatment with combination carbidopa-levodopa may contribute to reduced vitamin B6 levels. Higher doses of carbidopa-levodopa may increase the risk of vitamin B6 deficiency.

Seizures associated with vitamin B6 deficiency have been reported in the postmarketing setting. In patients taking combination therapy with carbidopa/levodopa, evaluate vitamin B6 levels periodically while on treatment or if symptoms associated with vitamin B6 deficiency are identified. Supplement with vitamin B6 as necessary.

DISCUSSION: In patients with Parkinson's disease, as little as 10 mg of pyridoxine may reverse the clinical benefits as well as the adverse effects of levodopa. Coadministration of levodopa with either carbidopa or benserazide has minimized the effects of this interaction.

INBRIJA, LEVODOPA

Severe List
Hemophilia

The following adverse reaction information is available for B-COMPLEX (thiamine hcl/riboflavin/niacinamide/dexpanthenol/pyridoxine):

Overview
Severe
Less Severe

Adverse reaction overview.

No enhanced Common Adverse Effects information available for this drug.

There are 6 severe adverse reactions.

More Frequent	Less Frequent
None.	None.

Rare/Very Rare
Anaphylaxis Angioedema Cyanosis Gastrointestinal hemorrhage Pulmonary edema Throat constriction

There are 8 less severe adverse reactions.

More Frequent	Less Frequent
None.	None.

Rare/Very Rare
General weakness Hyperhidrosis Induration of skin Nausea Nervousness Pruritus of skin Sensation of warmth Urticaria

The following precautions are available for B-COMPLEX (thiamine hcl/riboflavin/niacinamide/dexpanthenol/pyridoxine):

Pediatric
Pregnant
Lactation
Geriatric

No enhanced Pediatric Use information available for this drug.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None

No enhanced Pregnancy information available for this drug.

No enhanced Lactation information available for this drug.

No enhanced Geriatric Use information available for this drug.

Vitamin deficiency
E56.9	Vitamin deficiency, unspecified