Polynerv 250/Polynerv 500

Thiamine HCl, pyridoxine HCl, cyanocobalamin.

Polynerv 250: Each film-coated tablet contains thiamine hydrochloride (vitamin B₁) 250 mg, pyridoxine hydrochloride (vitamin B₆) 250 mg, cyanocobalamin (vitamin B₁₂) 1 mg (eq. to 1,000 mcg).
Polynerv 500: Each film-coated tablet contains thiamine hydrochloride (vitamin B₁) 500 mg, pyridoxine hydrochloride (vitamin B₆) 250 mg, cyanocobalamin (vitamin B₁₂) 1 mg.
Vitamins B₁, B₆, B₁₂ (POLYNERV 250) & (POLYNERV 500) is a high potency formulation of the neurotrophic vitamins B₁, B₆, B₁₂. This fortified combination of B vitamins, is a valuable adjuvant in the comprehensive management of neural disorders and certain diseases associated with painful neurologic manifestations.
Vitamins B₁, B₆, B₁₂ (POLYNERV 250) & (POLYNERV 500) is useful in the prevention and treatment of B deficiencies arising from poor dietary intake, chronic alcoholism, impaired B vitamins absorption (as in excessive vomiting, prolonged diarrhea and antibiotic therapy) and intake of certain drugs which interfere with the utilization of B vitamins (i.e. isoniazid, estrogen, phenothiazines).

Pharmacology: The neurotrophic agents, Vitamins B₁, B₆, and B₁₂ activate specific biochemical pathways involved in nervous system physiology.
Polynerv 250: Normal cellular activities depend on the availability of the biochemical energy derived mainly from the metabolism of food nutrients. In the metabolic systems of the body, the breakdown products of carbohydrates, fats and proteins are acted upon by enzymes together with their coenzymes (primarily vitamin B₁, B₆ and B₁₂). In order that the cellular reactions by which these nutrients are further biotransformed and utilized may continue. Vitamins B₁, B₆ and B₁₂ stimulate the various metabolic processes which produce the energy needed to fuel the cellular activities of the body, specifically the physiologic activities of the nervous system.
Thiamine (Vitamin B1) functions a coenzyme, operating as a cocarboxylase in various reactions of glucose metabolism (i.e, decarboxylation of pyruvic acid and other alpha-keto acids, leading to synthesis of ATP). Thiamine enhances production of energy from glucose and the conversion of glucose into other substances such as ribose, a major component of DNA and RNA. Glucose provides the basic nutritional needs of the nervous system serving as a major energy source. Thiamine deficiency impairs production of energy on which the activity of the smooth muscle of the heart and blood vessel is highly dependent.
Independent of its coenzyme function, thiamine acts as modulator in the transmission of neural impulses. Thiamine deficiency results in symptoms of cardiovascular, gastrointestinal and neurologic disturbances. Thiamine deficiency can also cause degeneration of myelin sheaths in the peripheral nerves and in the CNS.
Thiamine as coenzyme ensures that energy is available for the vital organs of the body to do their work. The smooth muscle cells of the heart, blood vessels, and the secretory glands of the gastrointestinal tract depend on the energy derived from metabolism of glucose.
Thiamine helps improve muscle tone of the intestine, stomach, heart and blood vessels. Without sufficient energy, the muscles of the heart and blood vessels walls dilate leading to fluid accumulation.
Pyridoxine (Vitamin B₆) participates in many cellular reactions of lipid and amino acid metabolism (i.e. transaminations, decarboxylation).
Vitamins B₁, B₆, B₁₂ (POLYNERV 500) tablet is coated with a soluble film integument which masks the unpleasant tastes of its constituted ingredients. Moreover, this film coat protects its active components from possible loss of potency caused by light and other degrading factors in the atmosphere.
The active form of B₆, pyridoxal phosphate, acts as coenzyme in several metabolic transformations of amino acids which are in turn needed for tissue building and in the synthesis of certain compounds and blood elements. Pyridoxine is required in the synthesis of delta-aminolevulnic acid, the heme precursor necessary for the formation of hemoglobin molecule.
Vitamin B₁, B₆ and B₁₂ (POLYNERV 250) tablet contains high amount of Cyanocobalamin (Vitamin B₁₂) a coenzyme involved in several metabolic pathways (i.e. conversion of methyl moionyl CoA to succinyl CoA, fatty acid synthesis). The most important action of cyanocobalamin is to act as a coenzyme of nucleic acid metabolism, reducing ribonucleotides to deoxyribonucleotides, a step that is essential in the replication of genes and formation of new cells. Cyanocobalamin is also an important cofactor in the formation and maturation of red blood cells in the bone marrow. Deficiency of B₁₂ results in megaloblastic anemia.
The inhibition of normal fatty acid synthesis in the brain and nerve tissues leads to faulty structure and impaired functions manifested as neurological symptoms. Deficiency of vitamin B₁₂ also results in demyelination of the large nerve fibers of the spinal cord.
As the well known actions of B₁, B₆ and B₁₂ are directed towards the CNS, the purported action of high doses of these B vitamins evolve around the central nervous system.
Pharmacokinetics: Following oral administration, thiamine is absorbed from the gastrointestinal tract and is widely distributed into most body tissues. Thiamine is mostly present within the cells as diphosphate. It is not stored in the body and amounts in excess of the body's requirements are excreted in the urine as unchanged thiamine or as metabolites.
Pyridoxine is really absorbed from the gastrointestinal tract. It is converted to the active form pyridoxal phosphate and is stored mainly in the liver. Amounts in excess of the body's requirements are excreted unchanged in the urine.
Pyridoxal diffuses across the placenta and appears in breast milk.
Vitamin B₁₂ compounds which bind to intrinsic factor, a glycoprotein secreted by the gastric mucosa are then actively absorbed from the gastrointestinal tract. Little amount is absorbed by passive diffusion but the process becomes increasingly important with larger amounts.
Vitamin B₁₂ is extensively bound to transcobalamin, a plasma protein. Vitamin B₁₂ is stored in the liver and excreted in the bile. Part of a dose is excreted in the urine. Vitamin B₁₂ diffuses across placenta and is also distributed into breast milk.
Polynerv 500: Thiamine (Vitamin B₁) functions as a coenzyme, operating as a cocarboxylase in various reactions of glucose metabolism (i.e. decarboxylation of pyruvic acid and other alpha-keto acids, leading to synthesis of ATP).
Thiamine enhances production of energy from glucose and storage of energy as fat, making energy available to support normal cellular processes.
Thiamine as coenzyme of glucose metabolism ensures that energy is available for the vital organs of the body to do their work. The smooth muscle cells of the heart, blood vessels, and the secretory glands of the gastrointestinal tract depend on the energy derived from metabolism of glucose. Vitamin B₁ helps improve muscle tone of the intestine, stomach, heart and blood vessels. Without sufficient energy, the muscles of the abnormalities affecting the cardiovascular, gastrointestinal and nervous systems of the body.
Pyridoxine (Vitamin B₆) participates in many cellular reactions of lipid and amino acid metabolism (i.e. transaminations, decarboxylation). The active form of B₆, pyridoxal phosphate, acts as a coenzyme in several metabolic transformations of amino acids which are in turn needed for tissue building and in the synthesis of certain compounds and blood elements. Vitamin B₆ is required in the synthesis of delta-aminolevulnic acid, the heme precursor necessary for the formation of hemoglobin molecule.
Vitamins B₁, B₆, B₁₂ (POLYNERV 500) tablet contains high amounts of Cyanocobalamin (Vitamin B₁₂), as coenzyme involved in several metabolic pathways (i.e. conversion of methyl malonyl coA to succinyl coA, fatty acid synthesis). The most important action of vitamin B₁₂ is to act as a coenzyme of nucleic acid metabolism, reducing ribonucleotides to deoxyribonucleotides, a step that is essential in the replication of genes and formation of new cells. Vitamin B₁₂ is also an important cofactor in the formation and maturation of red blood cells in the bone marrow. Deficiency of B₁₂ results in megaloblastic anemia.

For the treatment of Vitamin B deficiencies.
Polynerv 500: As nutritional support in the management of the following conditions: Painful neurological manifestations of neuritis and neuropathy such as cervical and shoulder-arm syndrome, lumbago, ischialgia and sciatica; neuropathies caused by certain disease states such as diabetes, rheumatoid arthritis, tuberculosis, leprosy, cardiac disorders; alcoholic neuropathy and other neuropathies due to intoxication from drugs (i.e. INH, phenothiazine); neuropathic changes during pregnancy and neuropathies due to hyperemesis gravidarum.

For therapeutic use, 2-4 tablets of Vitamins B₁+B₆+B₁₂ (POLYNERV 250) & (POLYNERV 500) should be administered daily until acute symptoms subside. Chronic cases may require longer therapy.
For prophylactic administration when disease or drugs are likely to lead to neurological complications, the recommended dosage is 1-2 tablets daily. Or as prescribed by the physician.

Contraindicated in patients with history of hypersensitivity to the components. Cyanocobalamin should not be given to patients with suspected vitamin B₁₂ deficiency without confirmation of the diagnosis.

Cyanocobalamin (Vitamin B₁₂) should not be used to treat megaloblastic anemia of pregnancy. Administration of doses greater than 10 mcg of Vitamin B₁₂ daily may produce a haematological response in patients with folate deficiency; indiscriminate use may mask the precise diagnosis. Cyanocobalamin or hydroxocobalamin should, if possible, not be given to patients with suspected vitamin B₁₂ deficiency without first confirming the diagnosis. Regular monitoring of the blood is advisable.

Use in Pregnancy: Cyanocobalamin (Vitamin B₁₂) should not be used to treat megaloblastic anemia of pregnancy.

Adverse effects seldom occur after oral administration of thiamine and cyanocobalamin, but hypersensitivity reactions have been reported after parenteral administration. Hypersensitivity reactions to thiamine ranged from very mild to very rarely, anaphylactic shock. Hypersensitivity reactions have occurred rarely following oral administration of cyanocobalamin.
Long-term administration of large doses of pyridoxine is associated with the development of severe peripheral neuropathies.

Drugs that increase the requirements for pyridoxine include hydralazine, isoniazid, penicillamine and oral contraceptives, neomycin, aminosalicylic acid, histamine H₂-antagonists and colchicine may reduce the absorption of vitamin B₁₂ from the gastrointestinal tract. Oral contraceptives may reduce serum concentrations of vitamin B₁₂. Though unlikely to be of clinical significance, many interactions of vitamin B₁₂ should be taken into account when performing assays for blood concentration.

Store at temperatures not exceeding 30°C. Protect from light.

Vitamin B-Complex / with C

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

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