Nicotinamide + Pantothenic Acid + Pyridoxine Hydrochloride + Riboflavin + Vitamin A + Vitamin B1 + Vitamin C + Vitamin D

Nicotinamide + Pantothenic Acid + Pyridoxine Hydrochloride + Riboflavin + Vitamin A + Vitamin B1 + Vitamin C + Vitamin D is a multivitamin supplement medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Prevention and treatment of deficiency of the included vitamins when diagnosed or suspected by a healthcare professional.
• Vitamin supplementation when usual dietary intake is inadequate or during periods of increased nutritional need as advised by a doctor.
• Supportive supplementation during recovery from illness or poor feeding when recommended by a healthcare professional.

The dose depends on age, diet, nutritional status, and the exact strength of the preparation. Paediatric drops should be given only in the amount directed on the product label or prescribed by a doctor. Adults should not use paediatric drops as a substitute for an appropriate adult vitamin preparation unless advised by a healthcare professional. Do not exceed the recommended daily intake; ask the prescribing doctor or pharmacist for the correct dose.

• Usually well tolerated when taken at recommended doses.
• Possible mild effects include nausea, vomiting, stomach discomfort, diarrhoea, constipation, or unpleasant taste.
• Riboflavin may cause bright yellow urine; this is harmless.
• Allergic reactions such as rash, itching, swelling, or breathing difficulty are rare but require urgent medical attention.
• Excess intake may cause vitamin A toxicity, vitamin D toxicity, high calcium levels, headache, dizziness, irritability, poor appetite, bone pain, or kidney problems.

Use with caution in people with kidney disease, high blood calcium, sarcoidosis or other granulomatous disease, liver disease, a history of kidney stones, or those already taking other multivitamins, vitamin A, vitamin D, or cod liver oil. Keep out of reach of children to avoid accidental overdose. Use under the guidance of a registered doctor or pharmacist.

• Do not combine with other vitamin A or vitamin D products unless advised, as toxicity may occur.
• Retinoid medicines such as isotretinoin or acitretin may increase the risk of vitamin A toxicity.
• Vitamin D may increase the risk of high calcium or heart rhythm problems in patients taking digoxin, especially if calcium levels rise.
• Thiazide diuretics may increase the risk of high calcium when used with vitamin D.
• Cholestyramine, colestipol, orlistat, and mineral oil may reduce absorption of fat-soluble vitamins A and D.
• Some anti-seizure medicines and corticosteroids may reduce vitamin D effect.
• Pyridoxine can reduce the effect of levodopa if levodopa is taken without carbidopa.

• Known allergy or hypersensitivity to any ingredient of the preparation.
• Existing hypervitaminosis A or hypervitaminosis D.
• High blood calcium or conditions causing excessive vitamin D sensitivity, unless specifically supervised by a doctor.

During pregnancy or breastfeeding, vitamin supplements should be used only as advised by a healthcare professional. Avoid taking extra vitamin A or vitamin D from multiple products unless prescribed, because excessive intake can harm the mother or baby. Pregnant women should use an appropriate prenatal supplement recommended by their doctor.

Store in a cool, dry place away from direct sunlight and heat. Keep the bottle tightly closed and out of the reach of children. Do not use after the expiry date, and follow any storage instructions on the product label.