Ribomin Hasan nuggets supplement vitamins (30 packs x 2g)

Dosage form 30 package box
Specifications Vitamin A, Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B5, Vitamin B6, Vitamin B12, Vitamin D3, Vitamin E, Vitamin C

Ingredient

Composition informationContent
Vitamin A2000iu
Vitamin B11.2mg
Vitamin B21.2mg
Vitamin B312.0mg
Vitamin B55.0mg
Vitamin B61.4mg
Vitamin B120.032mg
Vitamin D3400iu
Vitamin E8mg
Vitamin C

Uses

Indications

ribomin indicated to use the vitamins necessary for the body of the child's development age.

Supplement and prevent vitamin deficiency when diet is not enough nutrients, recovery stage after illness.

Vitamin supplements in the period of the body have more vitamins, especially at the time of changing seasons.

Pharmacological

Classification is reasonable: combined vitamins.

Matc: Alija

Mechanism of action

Vitamin A

Vitamin A is needed for vision, growth, development and maintenance of epithelium.

thiamin hydrochloride (vitamin B1)

Vitamin B1 is the role of a carbohydrate metabolism that reduces carboxyl of alpha-cetoacids in using pentose in the Hexose Monohydrate cycle.

riboflavin (vitamin B2)

riboflavin is transformed into 2 operating coenzymes needed for the respiration of tissue: Flavin Mononucleotid (FMN) and Flavin Adenin Dinucleotid (FAD), helping to activate pyridoxin, the metabolism of tryptophan into niacin and relate to the integrity of red blood cells, needed for electronic transport system.

Niacinamid (vitamin B3)

Niacinamid transforms into nicotinamid adenin dinucleotid (NAD) or Nicotinamid adenin Dinucleotid phosphate (NADP), acting as a hydrogen transportation in the catalyst of oxidation reactions needed for cell respiration, glycogen resolution, lipid transformation.

calcium d-pantothenate (vitamin B5)

Pantothenic acid is the precursor of coenzyme A needed for acetylation reactions in the process of glucose creation, release energy from carbohydrates, synthesized and degenerated fatty acids, sterol synthesis and steroid hormones, porphyrin, acetylcholine and other substances.

pyridoxinhydrocrocrochid (vitamin B6)

Pyridoxin monkeys into the body transformed into pyridoxal phosphate and partly into pyridoxamin phosphate, acting as coenzymes in conversion of protein, glucid and lipid.

pyridoxin participates in the synthesis of gamma-aminobutyric acid (GABA) in the central nervous system and participates in hemoglobin synthesis.

cyanocobalamin (vitamin B12)

Cyanocobalamin forms active coenzymes, methylcobalamin and 5-damtoxadenosylcobalamin, which is essential for copying and growth cells. Cyanocobalamin is essential for tissues with strong cell growth such as hematuria, small intestine, and uterus, cyanocobalamin lacks nerve cancellation.

acid ascorbic (vitamin C)

Vitamin C is essential for collagen formation, tissue regeneration in the body and participate in some oxidation - reduction reactions. Vitamin C participates in amino acid metabolism, iron and some drug metabolic enzymes, in carbonate use, lipid and protein synthesis, in immune function, in resistance to bacterial infections, in preserving the integrity of blood vessels and cell respiration.

cholecalciferol (vitamin D3)

Vitamin D3 helps maintain normal calcium and phosphorus concentrations in plasma by enhancing food absorption and increasing mobilization from bones to blood.

Vitamin E

Vitamin E is an antioxidant due to the oxidation of essential ingredients in cells, preventing toxic oxidation products.

pharmacokinetics

vitamin A

Absorption: Vitamin A is absorbed in the digestive tract. In the form of oral powder powder, the highest concentration of retinolester achieved in plasma after 3-4 hours.

DISTRIBUTION: Vitamin A is mostly stored in the liver, in addition to the kidneys, adrenal glands, retina, unable to pass the placenta, allocate into milk.

Metabolism and elimination. Retinyl acetate is hydrolyzed by enzymes in the pancreas. The free retinol part is glucuronic and oxidized into retinal and retinoic acid and then excreted through urine and feces.

thiamin hydrochloride (vitamin B1)

absorption: Vitamin B1 absorbed through the gastrointestinal tract.

Distribution: Thiamin allocated into most tissues in the body, reaching the highest concentration in the liver, brain, kidney and heart.

Metabolism and elimination: When absorbed at a low level, there are very few or no thiamin excreted through the urine. When absorbed beyond the minimum demand for thiamin warehouses in the first saturated tissues, then the excess amount will be eliminated through the urine in the form of intact thiamin molecules.

riboflavin sodium phosphate (vitamin B2)

absorption: riboflavin is absorbed mainly in the duodenum.

Distribution: Riboflavin is distributed throughout the tissues in the body such as the cells of the gastrointestinal mucosa, red blood cells, and liver. In addition, it is also stored in the spleen, kidneys and deeply. The free riboflavin form is found in the retina. Riboflavin can be placed with placenta and allocated into milk. After drinking, about 60% FAD and FMN attached to plasma proteins.

Metabolism: Riboflavin is phosphoryl turned into FMN form in the cells of the gastrointestinal mucosa, red blood cells, liver. FMN form is converted to fad at the liver.

Elimination: riboflavin eliminates urine and feces.

Niacinamid (vitamin B3)

absorption: Niacinamid is quickly absorbed by the digestive tract.

allocating niacinamid is distributed mainly in the liver, kidney, fat tissue, milk.

Metabolism: Niacinamid metabolized mainly in the liver into n-methylnicotinamid, 2-pyridon and 4-pyridon derivatives.

Eliminate niacinamid excreted into urine in constant form.

calcium d-pantothenate (vitamin B5)

absorption: Vitamin B5 absorbed through the gastrointestinal tract.

Distribution: Vitamin B5 is distributed in body tissues, the highest in the liver, adrenal glands, heart and kidneys, allocated into breast milk.

Metabolism and excretion: About 70% of the dosage of pantothenic acid oral deduction in the form of unchanged urine and 30% excreted in feces.

Pridoxin hydrochloride (vitamin B6)

absorption: Bridoxin is quickly absorbed through the gastrointestinal tract except for malabsorption syndrome.

Distribution: After drinking, the drug is mostly stored in the liver and part of the muscles and brain, through the placenta, distributed into breast milk.

Metabolism: pyridoxin converts into 4-pyridoxic acid in the liver.

Elimination: pyridoxin excreted mainly through the kidneys in the form of metabolism. If the amount is put in exceeding the daily demand, most pyridoxin is eliminated in the form of unprocessed.

cyanocobalamin (vitamin B12)

Absorption: Cyanocobalamin absorbs mainly in the ileum.

Distribution: Cyanocobalamin is linked to Transcobalamin II and is quickly removed from plasma to distribute priority to the liver parenchyma, through the placenta and allocate into breast milk ..

Metabolism and elimination: About 3 micrograms of cyanocobalamin eliminate daily bile, of which 50-60% are the derivatives of cobalamin that cannot be reabsorbed.

acid ascorbic (vitamin C)

Absorption: Vitamin C absorbs easily after taken, the absorption process can be reduced in diarrhea or stomach disease.

Distribution: Vitamin C is widely distributed in body tissue, about 25% of vitamin C in plasma combined with protein.

Metabolism and elimination: Vitamin C is reversible to dehydrooscorbic acid, a little transformed into non-activity compounds including ascorbic-2-Sulfate and oxalic acid excreted in the urine.

cholecalciferol (vitamin D3)

Absorption: Vitamin D3 is well absorbed through the gastrointestinal tract, because vitamin D is soluble in lipid should be concentrated in the body of the body, and is absorbed in the lymphatic system.

Drug allocation is kept for a long time in adipose tissue.

Metabolism: Cholecalciferol is hydroxylation in the liver and kidneys forming metabolites active as calcitriol and deductors of 1,24,25-trihydroxy.

Elimination. Vitamin D and metabolites are excreted mainly through bile and feces, small amounts appear in urine.

alphatocopheryl acetate (vitamin E)

absorption: Vitamin E is absorbed through the gastrointestinal tract.

Allocate drugs into blood through the microorganisms in the lymph and widely distribute to all tissues, accumulating in fat tissue.

Metabolism and elimination. Small amounts are metabolized with glucuronic in the liver and then discharged through the urine, mostly eliminate slowly into the bile, very little through the placenta, allocated into milk.

Before taking Ribomin Hasan nuggets supplement vitamins (30 packs x 2g)

How to use

Dissolve the drug package in 30 ml of boiled warm water.

Used while eating, or as directed by the doctor depending on the case.

Dosage

infant: Use from 1/2 to 1 pack/1 day.

Children and adults: Use 1-2 packs/day.

What do

do when overdose?

Vitamin A

Symptoms

Vitamin A chronic poisoning: Fatigue, irritability, anorexia, weight loss, vomiting, fire disorders, fever, liver - Spleen, changing skin, hair loss, crispy dry hair, chapped lips and bleeding, anemia, headache, high blood calam, subcutaneous edema, bone and joint pain. In children, the symptoms of chronic poisoning also include increased skull pressure (stretching), covered with eyes, tinnitus, visual disorders, pain along the long bones.

When stopping vitamin A, the symptoms also gradually disappear, but the bone may stop growing due to the long -term bone heads that have been reinforced too early.

Vitamin A poisoning: Drowsiness, dizziness, dizziness, nausea, vomiting, prone to stimulation, headache, delirium and convulsions, diarrhea, ... Symptoms appear after taking very high doses of vitamin A from 6-24 hours.

How to handle: Stop taking symptoms and supportive treatment.

Niacinamid (vitamin B3)

When an overdose occurs, there is no specific detoxification measure. Use common measures such as vomiting, gastric lavage, symptomatic treatment and support.

pyridoxinhydrocrocrochid (vitamin B6)

Pyridoxine symptoms (vitamin B6) are often considered non -toxic, but when taking high doses (such as 2 g/day or more) lasts (over 30 days) can cause sensory neurological syndrome, loss of coordination. The manifestation of the sense of the position and tremor of the heads and the loss of the sensory movement gradually the tactile, distinguishing the hot and cold and less pain.

How to handle: Stop taking the drug. After stopping, neurological dysfunction gradually improves and long -term monitoring is good, can stop the drug for up to 6 months for the nervous system to feel normal.

cholecalciferol (vitamin D3)

Symptoms: Early symptoms of blood calcium hypercalcemia include muscle weakness, fatigue, sleeping, headache, anorexia, dry mouth, metal flavor, nausea, vomiting, abdominal pain, constipation, dizziness, tinnitus, loss of coordination, rash, muscle tone, muscle pain, bone symptoms as a result of hypercalcemia including kidney calcium, urination, urination, urination, urination, urination, urination, urination, urination, urination, urination. Special).

Management: Regularly quantifying blood calcium concentration and maintenance of blood calcium at 9 - 10 mg/dl must not exceed 11 mg/dL. It must be given plenty of water, stop immediately medication and calcium supplement, maintain a poor calcium measurement regime, drink or intravenously. If necessary, use corticosteroids or calcium diuretics such as Furosemid and ethacrynic acid. Can hemorrhage or peritoneal. If newly taken for gastric lavage or vomiting. If the drug has passed the stomach, drink mineral oil to promote fecal elimination.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

Side effects and harmful effects will appear when taking high doses of vitamin A, long -term or taking a very high dose of vitamin A (see also the item "overdose and management").

thiamin hydrochloride (vitamin B1)

The harmful reactions of Thiamin are very rare and often allergic. Hypersensitivity reactions occur mainly when injecting.

Rare (ADR 1 000):

The whole body has a lot of sweat, too hypersensory.

Circulation: acute hypertension. Skin skin, itching, urticaria.

Respiratory: Difficulty breathing.

Other reactions stimulated at the injection site.

riboflavin (vitamin B2)

There is no unwanted effect when using riboflavin. Using high doses of riboflavin, urine will turn light yellow, causing deviations for some laboratory water tests.

Niacinamid (vitamin B3)

Low dose niacinamid is not toxic, but if high doses, some unwanted effects may occur (these effects will end after stopping the drug).

Common (ADR2 /100):

Digestive: nausea.

Less (1/1000

Digestive, progressive stomach ulcers, vomiting, anorexia, pain when hungry, flatulence, diarrhea.

Dry skin, hyperpigmentation, jaundice, rash.

Metabolism: liver failure, reducing glucose tolerance, increased sebaceous secretion, gout worse.

Other: hyperglycemia, hyperuricemia, blood vagus attack, headache and blurred vision, dry eyes, swelling of the eyelids, dizziness, heart beating fast, fainting, wheezing.

Rare (ADR

Instructions on how to handle ADR: Patients who use high doses should take the medicine with food, increase the dose slowly or use the type of release drugs that are prolonged. Stop taking the medication and immediately ask your doctor if there is any symptoms such as the symptom of the flu (nausea, vomiting, not healthy), reducing the amount of urine and urine with dark color, discomfort in muscle, abnormal heart rate, or blurred, gloomy look.

calcium d-pantothenate (vitamin B5)

Pantothenate is reported often without toxicity.

pyridoxin hydrochloride (vitamin B6)

pyridoxin is usually not toxic. Using pyridoxin lasts for 10 mg/day is said to be safe but using pyridoxin for a long time with a dose of ≥ 200 mg/day can cause neurological diseases.

Central nerve: headache, convulsions (after high -dose intravenous injection); Dreaming, sleepy. Endocrine and metabolism of acid contamination, folic acid decreased. Gastrointestinal: Nausea, vomiting. Liver: AST increases.

Other: allergies, burning sensation, itching can occur when intramuscularly or subcutaneously.

Neuromuscular: Taking a dose of 200 mg/day and over 2 months can cause severe peripheral neuritis, progressing from unstable appearance and numbness to numbness and clumsy hands. This condition can recover when stopping the drug, although there is still more or less sequelae.

cyanocobalamin (vitamin B12)

Rare (ADR

Instructions on how to handle ADR: Unwanted effects are usually mild, self -recovery, except for anaphylactic reaction. Emergency treatment must be treated by adrenalin injection, artificial respiration, oxygen breathing.

acid ascorbic (vitamin C)

Common (ADR> 1/100):

Kidney: Increase oxalate.

Uncommon (1/1000

Instructions on how to handle ADR: Do not stop suddenly after using high doses of vitamin C for a long time to prevent the corresponding corbut due to the induction in the process of specializing in vitamin C because it is a physiological response and the consequences of the previous doses of vitamin C.

cholecalciferol (vitamin D3)

Use vitamin D at a dose not exceeding the physiological needs are often non -toxic. However, vitamin D overdose may occur when treated with high or prolonged doses or when increased sensitivity to drugs similar to vitamin D, and will lead to clinical manifestations of blood calcium hypercalcemia.

Risk of hypercalcemia and hyperactive blood phosphorus:

Symptoms: Anorexia, headache, nausea, vomiting, abdominal pain, constipation.

Symptoms: Calciumization of soft tissue, calcification, sensory neurological disorders.

Instructions on how to handle ADR:

Should avoid excessive treatment of hypocc calcium, because converting into hypercalcemia is even more dangerous.

Regularly determine serum calcium concentration, should be maintained at 9 - 10 mg/dL (4.5 - 5 MEQ/L). Serum calcium concentration usually does not exceed 11 mg/dl.

While treating with vitamin D, it is necessary to periodically measure calcium, phosphate, serum magnesium, blood urea nitrogen, blood alkaline phosphatase, calcium and phosphate in urine 24 hours. Reducing alkaline phosphatase concentration often appears before hypercalcemia in bone puree or kidney bone dysplasma.

Give plenty of water or infusion to increase the volume of pepper water, in order to avoid creating kidney stones in people with hypercalcium.

alpha tocopheryl (vitamin E)

Vitamin E is usually well tolerated. Unwanted effects can occur when high doses, prolonged, intravenous injection, especially when used for premature babies, light weight at birth.

Central nervous, dizziness. Blurred vision. Gastrointestinal: Nausea, diarrhea, abdominal pain, digestive disorders, necrotic bowelitis. Endocrine and metabolism: abnormalities in sex, breast aches, cholesterol and serum triglycerides, reduced thyroxin and serum tripodothinin. Kidney: Creatininuria, increased serum kinase, increased estrogen and androgen in urine. Other: rash, dermatitis, fatigue, thrombosis.

Warnings

contraindicated

ribomin contraindicated in the following cases:

  • Hypersensitivity to any component of the drug.

    Be cautious when using

    need to be very careful when taking the drug in the case:

    Used with high doses of vitamin A or isotretionin.

    When using high doses of niacinamid in the following cases: History of stomach ulcer, gallbladder disease, history of jaundice or liver disease, gout, gout arthritis, and diabetes.

    Increased sarcoidosis or parathyroid defect can cause increased sensitivity to vitamin D.

    Children with high calcium content in the blood, kidney stones, kidney dysfunction.

    affects the ability to drive and operate machinery

    The drug does not affect the ability to drive, operate machinery, work on high or other cases.

    Pregnant and lactating women

    Pregnant women

    Avoid using vitamin A or synthetic preparations of the same type with high doses for pregnant women because vitamin A is high doses (10 000 IU/day) capable of monitoring.

    Hypercalcemia during pregnancy can cause aortic valve stenosis, retinopathy, miraculous and physical retardation, and hypothyroidism for the fetus. Safety of using vitamin D during pregnancy has not been determined, however, the risk for mothers and fetuses due to not treating hypothyroidism or reducing blood phosphate may be even greater than the risk of the use of medications similar to vitamin D, the recommended diet of Vitamin D (RDA) is currently 600 IU (15 mg).

    If the diet is not enough vitamin D or lack of exposure to ultraviolet radiation, vitamin D should be supplemented to the dose of RDA during pregnancy.

    During pregnancy, missing or excess vitamin E are no complications for the mother or fetus. The daily need for vitamin E in pregnant women and normal women is not different. In a good nutrition, the amount of vitamin E in food is sufficient and does not need to be supplemented. If the diet is poor, so dad is enough to meet daily needs.

    Additional dose according to the daily needs of Thiamin, Riboflavin, Niacinamid, Pyridoxin, Cyanocobalamin, Calci Pantothenate, Ascorbic acid does not cause harmful effects on the fetus.

    Do not determine safety, ribomin should only be used in pregnant women when really necessary

    breastfeeding women

    vitamin A excreted into breast milk. When breastfeeding, mothers need daily use at a dose of 4000 - 4330 IU vitamin A.

    Vitamin D secretes breast milk and the concentration of milk is correlated with the amount of vitamin D in the serum of the breastfeeding. Therefore, Vitamin D should not be used at a larger doses than the dose of nursing women (600 IU or 15 kg). Vitamin D should be added if the diet is not enough or lacks exposure to ultraviolet radiation. If the mother uses vitamin D with pharmacological doses, it is necessary to closely monitor blood calcium hypercalcemia and the signs of vitamin D poisoning in breastfeeding children.

    vitamin E excreted into breast milk. The human milk has 5 times the amount of vitamin E and is more effective in maintaining the sufficient amount of vitamin E in the serum for children up to 1 year old. The daily demand for vitamin E during breastfeeding is 19 mg. Just supplement the mother when the menu does not provide enough vitamin E for daily needs.

    Due to the unsafe determination, Ribon should only be used in breastfeeding women when necessary.

    Interactive drug

    neomycin, cholestyramin, liquid paraffin: reducing vitamin A.

    Isotretionin: Concomitance of vitamin A and isotretinoin can lead to an overdose of vitamin A, which should be avoided simultaneously.

    orlistat: can reduce the absorption of vitamin A, hindering vitamin E absorption.

    warfarin: high doses of vitamin A can increase the effect of reducing blood prothrombin. A few vitamin C reports reduce Warfarin's anticoagulant effect.

    Neuromomia: Thiamin can increase the effects of neurotransmitter.

    There have been some cases of "lack of riboflavin" in humans who used clepopromazin, imipramin, amitriptylin and adriamycin.

    Alcohol: can hinder the absorption of riboflavin in the intestine.

    Isoniazid treats isoniazid for a long time can affect the conversion of tryptophan into niacin and increase Niacin demand.

    Levodopa: Pyridoxin reduces the effect of levodopa in the treatment of Parkinson's disease, this does not happen with preparations as a mixera-carbidopa or levodopa-benseraid.

    Phenytoin and Phenobarbiton: The dose of pyridoxin hydrochloride 200 mg/day may cause 40-50% reduction in the concentration of phenytoin and phenobarbiton in the blood in some patients. The liver enzyme, phenytoin, phenobarbital induction drugs can reduce the concentration of the 25-hydroxy metabolites of vitamin D and increase metabolism into non-active substances.

    contraceptive pills: Increasing plasma vitamin A concentration, increasing pyridoxin demand and may reduce the serum concentration of cyanocobalamin. Pyridoxin can lighten depression in women who take birth control pills.

    hydralazin, isoniazid, penicilamin: increasing the demand for pyridoxin.

    Colchicin, aminosalicylic acid and salt, neomycin, Histamine anti -anti -receptor drugs, excessive alcohol lasting more than 2 weeks: can reduce the absorption of cyanocobalamin through the gastric - intestine.

    chloramphenicol: can reduce the effectiveness of cyanocobalamin in treating anemia.

    omeprazol: Reducing gastric juice should reduce the absorption of oral vitamin B12

    Probenecid: Reducing Riboflavin absorption in the stomach, intestines.

    Concomitance ascorbic acid with elemental iron, aspirin, salicylate, fluhenazin, selenium, aluminum hydroxyd, amphetamine, drugs affected by urine acidification and some tests.

    cholestylamin, colestipol: Reduce the absorption of vitamins A, D3, E.

    Excessive use of mineral oil can hinder the absorption of vitamin D and vitamin E in the intestine.

    Dicid diuretic: Increased risk of hypercalcemia in people with hypothyroidism use simultaneously vitamin D and thiazid diuretics.

    corticosteroids: Should not be used with vitamin D with corticosteroids because corticosteroids hinder the effects of vitamin D.

    cardiac glycosides: Do not simultaneously use vitamin D with cardiac glycosides because of the toxicity of glycosides that support cardiac growth due to hypercalcemia, leading to arrhythmia.

    Use niacinamid simultaneously with HGM-CoA reducing enzyme inhibitors, medications for hypertension alpha receptor blockers, hypoglycemic drugs or insulin, carbamazepine, toxic drugs with the liver.

    Sucinylcholin: Pantothenate can extend the muscle stretching effect of Suc Inylcholin.

    Vitamin E and metabolic form reduce the effectiveness of vitamin K and increase the effectiveness of anticoagulant drugs.

    Simultaneous use of vitamin E and acetylsalicylic acid are at risk of bleeding.

    • Storage

    In a dry place, under 30 ° C, avoid light.

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