Hinuron-E

Vitamin B-complex with E.

Each tablet contains: Thiamine HCl (Vitamin B₁) 200 mg, Pyridoxine (Vitamin B₆) 200 mg, Cyanocobalamin (Vitamin B₁₂) 5000 mcg, dl-alpha Tocopherol acetate (Vitamin E) 100 IU.
Excipients: Ethyl cellulose, ethyl alcohol, propylene glycol, lactose monohydrate, povidone, magnesium stearate, coating materials (opadry yellow composed of hypromellose, titanium dioxide, PEG 400, FD&C yellow #5 and FD&C #1), ethyl alcohol, methylene chloride, Castor oil.

Pharmacology: Pharmacodynamics: Thiamine (Vitamin B₁) is a vitamin required in cellular aerobic metabolism, cell growth, nerve impulse transmission and production of acetylcholine. The salt form, thiamine hydrochloride, is phosphorylated by thiamine diphosphokinase to the active form thiamine pyrophosphate (TPP). TPP act as a coenzyme in several enzymatic reactions that involves fatty acids, amino acid and carbohydrate metabolism. Human daily requirement is about 0.8 to 1.5 mg.
Pyridoxine (Vitamin B₆) is a water-soluble vitamin. Pyridoxal 5'-phosphate is its biologically active coenzyme. It is important in amino acid metabolism as well as other biochemical reactions such as glycogen metabolism, nucleic acid synthesis, hemoglobin production, production of sphingomyelin and other sphingolipids, and the synthesis of the neurotransmitters serotonin, dopamine, norepinephrine and gamma-aminobutyric acid (GABA). Human daily requirement is about 1.5 to 2 mg.
Cyanocobalamin (Vitamin B₁₂) is a water-soluble organometallic compound containing a trivalent cobalt ion bound to a corrin ring. Vitamin B₁₂ is an essential coenzyme in nucleic acid synthesis as well as nerve functions and blood cell production. Adult recommended requirements is about 1 to 2 micrograms per day.
The antioxidant properties of vitamin E ameliorate free radical damage to biological membranes. Vitamin E protects polyunsaturated fatty acids (PUFA) within membrane phospholipids and within circulating lipoproteins. Peroxyl radicals (ROO·) react 1000-fold faster with vitamin E than with PUFA, forming the corresponding organic hydroperoxide and the tocopheroxyl radical (vitamin E-O·). The tocopheroxyl radical, in turn, interacts with other antioxidant compounds, such as ascorbic acid, which regenerates tocopherol.
Pharmacokinetics: Absorption: Thiamine is well absorbed from the gastrointestinal tract following oral administration, although the absorption of large doses is limited.
Pyridoxine (Vitamin B₆) is readily absorbed from the gastrointestinal tract after oral doses and are converted to the active forms pyridoxal phosphate and pyridoxamine phosphate.
Cyanocobalamin (Vitamin B₁₂) bind to intrinsic factor, a glycoprotein secreted by the gastric mucosa. The vitamin B₁₂-intrinsic factor complex is actively absorbed in the distal segment of the small intestine.
Absorption of dl-alpha tocopherol acetate (vitamin E) from the gastrointestinal tract is dependent on the presence of bile and on normal pancreatic function. The amount of vitamin E absorbed varies widely between about 20% and 80% and appears to decrease as the dose is increased. It enters the blood via the chylomicrons in the lymph and is bound to beta lipoproteins.
Distribution: Thiamine HCl (Vitamin B₁) is widely distributed to most body tissues, and appears in breastmilk.
Storage of vitamin B₆ is primarily the liver but smaller amounts may be present in the muscles and the brain. The principal forms found in blood are pyridoxal and pyridoxal phosphate. Pyridoxal is able to cross the placenta and appears in breastmilk.
Cyanocobalamin (Vitamin B₁₂) is extensively bound to specific plasma proteins called transcobalamins, transcobalamin II appears to be involved in the rapid transport of the cobalamins to tissues. It is distributed into the liver, bone marrow and other tissues. It diffuses across the placenta and also appears in breast milk. In pregnancy, vitamin B₁₂ is actively transported to the fetus.
dl-alpha Tocopherol acetate (Vitamin E) is widely distributed to all tissues. Storage of this vitamin is in the adipose tissue.
Metabolism: Thiamine HCl (Vitamin B₁) is quickly converted, via the liver, to the diphosphate and to a smaller extent the triphosphate esters in the tissues.
Pyridoxine (Vitamin B₆) is converted to the active forms, pyridoxal phosphate and pyridoxamine phosphate. It is mainly stored in the liver where it is oxidized to 4-pyridoxic acid and other inactive metabolites.
Cyanocobalamin (Vitamin B₁₂) occurs in the body mainly as methylcobalamin (mecobalamin) and as adenosylcobalamin (cobamamide) and hydroxocobalamin. Mecobalamin and cobamamide act as coenzymes in nucleic acid synthesis. Mecobalamin is also closely involved with folic acid in several metabolic pathways.
dl-alpha Tocopherol acetate (Vitamin E) is metabolized in the liver to glucuronides of tocopheronic acid and its y-lactone.
Excretion: Thiamine is not stored to any appreciable extent in the body and amounts in excess of the body's requirements are excreted in the urine unchanged or as metabolites.
Inactive metabolites of vitamin B₆ are excreted in the urine. Vitamin B₆ is expressed in breastmilk.
Vitamin B₁₂ is stored in the liver, excreted in the bile, and undergoes extensive enterohepatic recycling. Part of a dose is excreted in the urine, most of it in the first 8 hours.
Most of the vitamin E dose is slowly excreted in the bile and the remaining is excreted in the urine.

Prevention and treatment of vitamin B₁, B₆ and B₁₂ deficiencies.
Prevention of isoniazid-induced peripheral neuropathy.
Vitamin B₁₂ replacement in patients with pernicious anemia.
Vitamin B₁₂ replacement for food-cobalamin malabsorption.
Prevention of Wernicke encephalopathy in alcohol dependent individuals.

For oral administration.
Adults including elderly: Take 1 to 2 tablets, 3 times daily, or as prescribed by a physician.
Children: Children 12 years old and above, as adult dose or as prescribed by a physician.
Consider a more suitable dosage form for children less than 12 years old.

Chronic intake of high doses of vitamin B₆ has been associated with reversible sensory peripheral neuropathy.

Known hypersensitivity to B vitamins, vitamin E or any of the excipients.

The use of vitamin B complex + E in patients with Parkinson's disease taking levodopa should be taken into consideration.

Pregnancy: There are no known harmful effects with supplementation with vitamins B₁, B₆, B₁₂ or E during pregnancy.
Lactation: Vitamins B₁, B₆, B₁₂ and E are expressed in breastmilk. There are no known harmful effects to the breastfeeding mother or breastfed infants with supplementation with vitamin B₁, B₆, B₁₂ or E. Very large doses of vitamin B₆, however, have been reported to suppress lactation.

Adverse events with vitamins B₁, B₆, B₁₂ or E are rare although hypersensitivity reactions have been reported.

Pyridoxine (Vitamin B₆): Nitrofurantoin may increase pyridoxine level which could induce sensory neuropathy.
High daily doses of vitamin B₆ can decrease phenytoin and phenobarbital serum concentration.
Vitamin B₆ can reduce the effectiveness of altretamine (hexamethylmelamine).
Vitamin B₆ can reduce or abolish the effect of levodopa through increased peripheral metabolism by dopa-decarboxylase.
Isoniazid may reduce plasma vitamin B₆ levels.
Cyanocobalamin (Vitamin B12): Intestinal absorption of vitamin B₁₂ can be reduced by, colchicine, aspirin, proton pump inhibitors and H₂-receptor antagonists.
Prolonged metformin use can induce vitamin B₁₂ deficiency.
Contraceptive use may lower serum levels of vitamin B₁₂ most likely due to redistribution rather than depletion.
dl-alpha Tocopherol acetate (Vitamin E): Vitamin E can enhance the effect of warfarin and aspirin.
Vitamin E may decrease oral cyclosporine levels.
Statin may reduce plasma concentration of vitamin E.
Orlistat may reduce intestinal absorption of vitamin E by inhibition of gastrointestinal lipase.

Store at temperatures not exceeding 30°C.

Vitamin B-Complex / with C

A11EX - Vitamin B-complex, other combinations ; Used as dietary supplements.

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