Cyanocobalamin + Folic Acid + Levocarnitine Tablets

Mechanism

• Cyanocobalamin: Acts as a cofactor in DNA synthesis and myelin sheath formation.
• Folic Acid: Converts to tetrahydrofolate, essential for nucleotide biosynthesis.
• Levocarnitine: Transports long-chain fatty acids into mitochondria for β-oxidation and ATP generation.

Pharmacokinetics

• Absorption: Cyanocobalamin absorbed in ileum; folic acid absorbed in jejunum; levocarnitine absorbed in small intestine.
• Distribution: B12 stored in liver; folate distributed in plasma and tissues; levocarnitine concentrated in muscle.
• Metabolism: B12 and folate metabolized in liver; levocarnitine metabolized minimally.
• Excretion: B12 via bile; folate via urine; levocarnitine via urine.

Side Effects

• Mild gastrointestinal upset
• Headache
• Fatigue
• Allergic reaction (rare)

Contraindication

• Hypersensitivity to cephalosporins or fluoroquinolones
• History of tendon disorders related to fluoroquinolone use
• Pregnancy and lactation (unless prescribed)

Interaction

• Chloramphenicol: May antagonize hematologic response to B12.
• Phenytoin: May reduce folate levels.
• Valproic acid: May lower carnitine levels.

Warning and Precautions

• Monitor hematologic response during therapy.
• Use with caution in patients with renal disease.
• Pregnancy/lactation: Supplementation only under medical supervision.

Dosage

As directed by the Physician.