Duovit

Duovit is a combination drug containing a wide range of vitamins necessary to maintain overall health and body function. The drug is aimed at replenishing vitamin deficiencies and improving the overall condition of the body. It includes the following vitamins:

1. Retinyl Palmitate (Vitamin A):

   • Functions: Improves vision, maintains healthy skin, immune system and mucous membranes.
   • Deficiency: May cause night blindness and skin problems.

2. α-Tocopherol Acetate (Vitamin E):

   • Functions: Antioxidant, protection of cell membranes from damage by free radicals, support of the immune system.
   • Deficiency: May cause neuromuscular problems and anemia.

3. Cholecalciferol (Vitamin D3):

   • Functions: Regulation of calcium-phosphorus metabolism, maintaining healthy bones and teeth.
   • Deficiency: May lead to rickets in children and osteomalacia in adults.

4. Ascorbic acid (Vitamin C):

   • Functions: Antioxidant, collagen synthesis, wound healing, improved iron absorption.
   • Deficiency: Leads to scurvy, weakness and bleeding gums.

5. Thiamine mononitrate (Vitamin B1):

   • Functions: Carbohydrate metabolism, normal functioning of the nervous system.
   • Deficiency: May cause beriberi and nervous disorders.

6. Riboflavin (Vitamin B2):

   • Functions: Energy metabolism, health of skin and mucous membranes.
   • Deficiency: May cause cracks in the lips and corners of the mouth, inflammation of the tongue.

7. Calcium pantothenate (Vitamin B5):

   • Functions: Metabolism of carbohydrates, fats and proteins, synthesis of coenzyme A.
   • Deficiency: Rare, may cause fatigue and irritability.

8. Pyridoxine hydrochloride (Vitamin B6):

   • Functions: Metabolism of amino acids, synthesis of neurotransmitters.
   • Deficiency: May cause anemia and depression.

9. Folic acid (Vitamin Bc):

   • Functions: DNA synthesis, cell division, nervous system health.
   • Deficiency: Causes megaloblastic anemia and neural tube defects in the fetus.

10. Cyanocobalamin (Vitamin B12):

    • Functions: Formation of red blood cells, support of the nervous system.
    • Deficiency: May cause megaloblastic anemia and nervous disorders.

11. Nicotinamide (Vitamin PP):

    • Functions: Energy metabolism, health of the skin, nervous system and digestive system.
    • Deficiency: Leads to pellagra, characterized by dermatitis, diarrhea and dementia.

Indications Duovita

• Replenishment of vitamin deficiency.
• Support for the body during periods of increased physical and mental stress.
• Improving the general condition with inadequate and unbalanced nutrition.
• Recovery after illnesses and surgeries.
• Supports the immune system.

Release form

Tablets containing a combination of the above vitamins in an easy-to-take form.

Pharmacodynamics

1. Retinyl Palmitate (Vitamin A):

   • Action: Participates in the synthesis of rhodopsin, necessary for night vision, maintains the health of the skin and mucous membranes, promotes the normal functioning of the immune system.
   • Mechanism of action: Regulates gene expression, participates in cell growth and differentiation.

2. α-Tocopherol Acetate (Vitamin E):

   • Action: It is a powerful antioxidant, protects cell membranes from oxidative damage, supports immune function.
   • Mechanism of action: Inhibits lipid peroxidation, neutralizes free radicals.

3. Cholecalciferol (Vitamin D3):

   • Action: Regulates calcium and phosphorus metabolism, promotes mineralization of bones and teeth.
   • Mechanism of action: Increases calcium absorption in the intestine, stimulates calcium reabsorption in the kidneys, maintains normal levels of calcium and phosphates in the blood.

4. Ascorbic acid (Vitamin C):

   • Action: An important antioxidant, promotes collagen synthesis, improves wound healing, enhances the absorption of iron from food.
   • Mechanism of action: Neutralizes free radicals, participates in the hydroxylation of proline and lysine in the process of collagen synthesis.

5. Thiamine mononitrate (Vitamin B1):

   • Action: Participates in carbohydrate metabolism, maintains normal function of the nervous system.
   • Mechanism of action: It is part of the coenzyme thiamine pyrophosphate, which is necessary for the decarboxylation of α-keto acids.

6. Riboflavin (Vitamin B2):

   • Action: Important for energy metabolism, skin health and mucous membranes.
   • Mechanism of action: Converts into coenzymes FAD and FMN, which participate in oxidation-reduction reactions.

7. Calcium pantothenate (Vitamin B5):

   • Action: Necessary for the synthesis of coenzyme A, participates in the metabolism of carbohydrates, fats and proteins.
   • Mechanism of action: Converts into coenzyme A, which is involved in acetylation and energy metabolism.

8. Pyridoxine hydrochloride (Vitamin B6):

   • Action: Participates in the metabolism of amino acids and the synthesis of neurotransmitters.
   • Mechanism of action: Converts into active forms pyridoxal phosphate and pyridoxamine phosphate, which serve as coenzymes in amino acid metabolism.

9. Folic acid (Vitamin Bc):

   • Action: Participates in DNA synthesis, cell division, and the health of the nervous system.
   • Mechanism of action: Converts to tetrahydrofolic acid, which is necessary for nucleic acid synthesis and methylation.

10. Cyanocobalamin (Vitamin B12):

    • Action: Important for the formation of red blood cells, maintenance of the nervous system.
    • Mechanism of action: Participates in the synthesis of methionine and metabolism of fatty acids.

11. Nicotinamide (Vitamin PP):

    • Action: Participates in energy metabolism, maintains the health of the skin, nervous system and digestive system.
    • Mechanism of action: It is part of the coenzymes NAD and NADP, which participate in oxidation-reduction reactions.

Pharmacokinetics

1. Retinyl Palmitate (Vitamin A):

   • Absorption: Well absorbed from the intestine, especially in the presence of fats.
   • Distribution: Accumulates in the liver, also present in the retina of the eye, adipose tissue.
   • Metabolism: Metabolized in the liver to active forms (retinal and retinoic acid).
   • Excretion: Excreted in bile and urine as metabolites.

2. α-Tocopherol Acetate (Vitamin E):

   • Absorption: Absorbed from the intestine in the presence of fats.
   • Distribution: Distributed in lipoproteins, accumulates in adipose tissue.
   • Metabolism: Metabolized in the liver.
   • Excretion: Excreted in bile and urine.

3. Cholecalciferol (Vitamin D3):

   • Absorption: Absorbed from the intestine in the presence of fats.
   • Distribution: Converted in the liver to 25-hydroxycholecalciferol, then in the kidneys to the active form 1,25-dihydroxycholecalciferol.
   • Metabolism: Metabolized in the liver and kidneys.
   • Excretion: Excreted in bile and urine.

4. Ascorbic acid (Vitamin C):

   • Absorption: Well absorbed from the intestine.
   • Distribution: Widely distributed in tissues, high concentration in the adrenal glands, pituitary gland, liver and spleen.
   • Metabolism: Partially metabolized to oxalates.
   • Excretion: Excreted in urine both unchanged and as metabolites.

5. Thiamine mononitrate (Vitamin B1):

   • Absorption: Absorbed in the small intestine.
   • Distribution: Distributed into tissues, especially skeletal muscle, liver, kidneys and brain.
   • Metabolism: Metabolized in the liver.
   • Excretion: Excreted in urine.

6. Riboflavin (Vitamin B2):

   • Absorption: Absorbed in the small intestine.
   • Distribution: Converted into coenzymes FAD and FMN, which actively participate in cellular processes.
   • Metabolism: Metabolized in the liver.
   • Excretion: Excreted in urine, which may turn yellow.

7. Calcium pantothenate (Vitamin B5):

   • Absorption: Absorbed in the small intestine.
   • Distribution: Widely distributed in tissues, especially in the liver, kidneys, and heart.
   • Metabolism: Converted to coenzyme A.
   • Excretion: Excreted in urine and feces.

8. Pyridoxine hydrochloride (Vitamin B6):

   • Absorption: Absorbed in the small intestine.
   • Distribution: Converted to the active form pyridoxal phosphate, which accumulates in the liver and muscles.
   • Metabolism: Metabolized in the liver.
   • Excretion: Excreted in urine.

9. Folic acid (Vitamin Bc):

   • Absorption: Absorbed in the small intestine.
   • Distribution: Converted into tetrahydrofolic acid, distributed in tissues, accumulates in the liver.
   • Metabolism: Metabolized in the liver.
   • Excretion: Excreted in urine.

10. Cyanocobalamin (Vitamin B12):

    • Absorption: Absorbed in the small intestine with the help of Castle's intrinsic factor.
    • Distribution: Accumulates in the liver, distributed in tissues.
    • Metabolism: Metabolized in the liver.
    • Excretion: Excreted in bile, reabsorbed in the intestine (enteric circulation), small amounts excreted in urine.

11. Nicotinamide (Vitamin PP):

    • Absorption: Absorbed in the small intestine.
    • Distribution: Converted to NAD and NADP, distributed in tissues.
    • Metabolism: Metabolized in the liver.
    • Excretion: Excreted in urine.

Dosing and administration

1. Adults: Usually one tablet once daily.
2. Children: For children, it is recommended to use a dosage that corresponds to their age and individual vitamin needs. Children under 12 years of age are usually prescribed half the adult dose.

Use Duovita during pregnancy

Efficiency and safety

1. Vitamin A (retinyl palmitate): Vitamin A plays a key role in vision, growth, and immune function. However, high doses of retinol may be teratogenic and cause birth defects, so it is recommended to avoid exceeding the recommended daily allowance during pregnancy (Edenharder et al., 1999).
2. Vitamin E (α-tocopherol acetate): Vitamin E is a powerful antioxidant that protects cells from oxidative damage. It is considered safe for use during pregnancy when taken at recommended doses (Garcia et al., 2010).
3. Vitamin D3 (cholecalciferol): Vitamin D3 is necessary to maintain calcium and phosphate levels in the blood, which is important for fetal bone development. Adequate vitamin D3 intake prevents deficiency that can lead to rickets in the newborn (Ma et al., 2008).
4. Vitamin C (ascorbic acid): Vitamin C supports the immune system and improves the absorption of iron from food, which helps prevent anemia. It is considered safe for pregnant women when taken in recommended doses (Jin et al., 2012).
5. B vitamins (B1, B2, B5, B6, B12): B vitamins are important for metabolism, the nervous system, and red blood cell formation. They are considered safe and essential for maternal health and normal fetal development (Ahmed & Bamji, 1976).
6. Folic acid (vitamin Bc): Folic acid is critical to preventing neural tube defects in the fetus. It is recommended to start taking folic acid before conception and continue it through the first trimester of pregnancy (Christen et al., 2009).
7. Nicotinamide (vitamin PP): Nicotinamide is involved in metabolism and regenerative processes. It is considered safe for use during pregnancy (Amin & Reusch, 1987).

Duovit, containing vitamins A, E, D3, C, B1, B2, B5, B6, B12 and PP, can be useful for maintaining the health of the mother and normal development of the fetus, provided that the recommended doses are observed.

Contraindications

1. Individual intolerance: People with known allergy or sensitivity to one or more components of the drug should avoid using it.
2. Hypervitaminosis: Before starting to take Duovit, you should make sure that there is no excess of vitamins in the body to avoid the risk of hypervitaminosis.
3. Increased calcium levels in the blood (hypercalcemia): The drug contains vitamin D3, which helps absorb calcium. Patients with hypercalcemia should avoid using Duovit.
4. Serious kidney disease: Vitamin D3 can affect calcium levels in the body, which can be dangerous for people with impaired kidney function.
5. Hemophilia and other bleeding disorders: Vitamin K contained in the preparation may increase blood clotting, which is undesirable for people with bleeding disorders.
6. Heart failure: Some vitamins in this product may be contraindicated in heart failure because they may increase the strain on the heart.

Side effects Duovita

1. Dyspeptic disorders: Stomach discomfort, nausea, vomiting or diarrhea may occur.
2. Allergic reactions: Rarely, allergic reactions such as itching, rash, swelling or difficulty breathing may occur.
3. Hypervitaminosis: It is possible to consume too many vitamins, which can lead to hypervitaminosis. For example, too much vitamin A can cause headaches, drowsiness, flushed skin, and even liver damage.
4. Changes in blood counts: Some components of Duovit, such as vitamin K, may affect blood clotting.
5. Hypercalcemia: Using this medication may cause too much calcium in the body, which can cause fatigue, constipation, abdominal rumbling, and other symptoms.
6. Changes in blood pressure: Some vitamins can affect blood pressure, which can cause it to increase or decrease.
7. Other rare side effects: Dizziness, insomnia, anemia, or other unusual symptoms may occur.

Overdose

1. Vitamin A (Retinyl Palmitate):

   • Nausea, vomiting
   • Headache, dizziness
   • Irritability
   • Dryness and flaking of the skin
   • Pain in bones and joints
   • In severe cases – osteoporosis, hypercalcemia

2. Vitamin D3 (Cholecalciferol):

   • Nausea, vomiting
   • Weakness, fatigue
   • Loss of appetite
   • Thirst, frequent urination
   • Increased levels of calcium in the blood (hypercalcemia), which can lead to kidney damage

3. Vitamin E (α-Tocopherol acetate):

   • Fatigue, weakness
   • Headache
   • Nausea, diarrhea
   • In rare cases – blood clotting disorders

4. Vitamin C (Ascorbic Acid):

   • Nausea, diarrhea
   • Stomach cramps
   • Urolithiasis with prolonged use of high doses

5. B vitamins (B1, B2, B5, B6, B9, B12):

   • Vitamin B6 (pyridoxine): neurological disorders such as sensory neuropathy
   • Vitamin B3 (niacin): skin redness, itching, digestive disorders

Interactions with other drugs

1. Iron-containing preparations: Duovit may reduce the absorption of iron from iron-containing preparations.
2. Calcium-containing preparations: Calcium may reduce the absorption of some components of Duovit, such as iron and zinc.
3. Products containing magnesium: Magnesium may reduce the absorption of iron.
4. Zinc-containing drugs: Zinc may decrease the absorption of antibiotics such as tetracyclines.
5. Vitamin K-containing medications: Vitamin K may interfere with the effectiveness of anticoagulants (medicines that reduce blood clotting) such as warfarin.