Cernevit

Carnevit is a balanced mixture of fat and water-soluble vitamins, which helps to supply the patient's body with all the necessary trace elements in the process of parenteral nutrition.

[1], [2], [3]

Indications of the cernevit

The main goal of this drug is the prevention of vitamin deficiency and hypovitaminosis in children (from 11 years old) and adults. It is complementary to parenteral nutrition.

[4], [5], [6]

Release form

The product is available in the form of a lyophilizate, which is used to create a solution for intravenous administration. It looks like a loose solid yellowish-orange mass without an unpleasant odor.

The following active ingredients are in the medicine:

1. Vitamin A (retinol palmitate).
2. Vitamin E.
3. Vitamin D3 (cholecalciferol).
4. Vitamin C (ascorbic acid).
5. Vitamin B1 (thiamine).
6. Vitamin B2 (riboflavin).
7. Vitamin B5 (pantothenic acid).
8. Vitamin B6 (pyridoxine).
9. Vitamin B12.
10. Vitamin B9 (folic acid).
11. Vitamin H (biotin).

Also in addition to the preparation are: glycine, soy beans phosphatides, glycocholic acid, hydrochloric acid, sodium hydroxide.

[7], [8]

Pharmacodynamics

Since this mixture of vitamins is used during parenteral nutrition to improve the general condition of the patient's body, its pharmacodynamics is determined by those substances that make up the drug.

Thanks to vitamin A, cell differentiation and growth are improving. Vision becomes clearer because of the improvement of its physiological mechanisms.

 The processes associated with the exchange of phosphorus and calcium in the kidneys and bones are regulated in the body by vitamin D3.

Vitamin E is a popular antioxidant, therefore toxic products are not formed in the patient's body, which helps protect the components of cells.

Thiamin or vitamin B1 takes part in the process of the formation of coenzymes, which, in turn, are associated with the metabolism of carbohydrates.

Riboflavin is one of the most important coenzymes in the human body. Vitamin B2 is associated with energy metabolism in cells, with the respiration of tissues and the metabolism of macroelements.

Vitamin B3 takes part in all the restorative and oxidative processes that are important in the respiration of tissues and the exchange of macroelements.

Pantothenic acid or vitamin B5 is closely associated with such processes in the body as gluconeogenesis, oxidative metabolism of carbohydrates, the synthesis of fatty acids, steroid hormones, sterols, porphyrins.

Pyridoxine is considered an important coenzyme, which is involved in the metabolism of carbohydrates, proteins and fats in the body.

Vitamin C is a very important antioxidant, without which collagen and intercellular substance are not formed in the body in sufficient quantities. Also ascorbic acid takes part in the synthesis of steroids and carnitine, in the biosynthesis of catecholamine, the metabolism of tyrosine and folic acid.

Vitamin B12 has an exogenous origin and is important in the synthesis of myelin and nucleoprotein. It takes part during the multiplication of cells, and is also necessary to maintain erythropoiesis and the development of the body.

Biotin binds to the main four enzymes and takes part in metabolism.

Folic acid is an important part in the process of normal erythropoiesis and the synthesis of the nucleoprotein.

[9], [10], [11]

Pharmacokinetics

During parenteral nutrition, even for many months, patients who take Carnevit have a normal concentration of all the necessary vitamins (B, A, D) in the plasma.

The pharmacokinetics of the drug is based on those substances that make up its composition.

Vitamin A is excreted by the kidneys, as well as in the bile, is associated with proteins. Most of the vitamin D is concentrated in the kidneys and liver, is excreted through the kidneys. With lipoproteins, vitamin E enters the patient's blood. There, it can bind to albumin and is excreted by the kidneys.

Thiamine remains 90% in red blood cells and is excreted from the body through the kidneys. Riboflavin binds to proteins, can be excreted by the kidneys, both in the form of metabolite, and in unbound form. In the human body, vitamin B3 has the appearance of an amide or acid, when it enters the blood, it is mainly excreted through the kidneys.

The metabolism of pyridoxine occurs in the liver, and this substance is excreted from the body with the help of kidneys. Pantothenic acid can be present in the body in two forms (unbound form or in the form of vitamin A). From plasma and erythrocytes, it is excreted by the kidneys.

Vitamin B12 can be found in milk, and also its high concentration is accumulated in the liver. Can bind to proteins, is excreted through the kidneys. At normal concentration, ascorbic acid is absorbed into the kidneys in the entire amount, can be excreted by the kidneys. Folic acid can accumulate in the liver, but it is distributed equally in all tissues. To be excreted through the kidneys. Biotin can exist in plasma in a form that is bound to proteins, or in free. Removed in the unaltered form with the help of kidneys.

[12], [13], [14], [15]

Use of the cernevit during pregnancy

To date, clinical studies on the use of the drug Zernevit in the treatment of pregnant women have not been conducted. Therefore, the remedy is not recommended for use during this period.

Since vitamins can concentrate in breast milk and enter through it into the body of a child, it is forbidden to apply Carnevit during lactation.

Contraindications

The drug Carnevit is not recommended for use during treatment of children under 11 years of age, as well as patients with intolerance to its components, in particular vitamin B1.

[16], [17], [18]

Side effects of the cernevit

Since this remedy is a mixture of vitamins, the only negative symptoms in its use can be allergies (itching, redness, hives, burning, swelling). When these unpleasant sensations occur, you should immediately stop taking the drug.

[19]

Dosing and administration

This mixture is used only for the preparation of a special solution, which is administered intravenously. The standard dose during parenteral nutrition is one bottle once every 24 hours. The duration of therapy is determined by a specialist.

In a 5 ml bottle, 5 ml of water, 5% glucose solution or sodium chloride solution (0.9%) must be injected with a syringe. Slowly stir until all the lyophilizate has dissolved. The solution should turn out to be bright yellow or orange.

Enter into the vein for at least 10 minutes. It can be added to three- or two-component solutions, if the substances are compatible with each other.

When you take it, follow the aseptic conditions.

[20]

Overdose

Overdosage with the drug Zernevit is possible mainly because it includes vitamin A. In this case, the patient may have the following symptoms: headaches, stomach upsets, increased intracranial pressure, edema of the optic nerves, mental disorders, convulsions, emotional excitability, swelling of the skin, which are characterized by increased morbidity.

For treatment, the drug is stopped and symptomatic therapy is administered (calcium is reduced, rehydration is performed, diuresis is intensified).

[21], [22]

Interactions with other drugs

The active ingredient is vitamin B6 (pyridoxine), which is not allowed to be taken concomitantly with levodopa, as this can speed up the metabolism. To prevent this interaction in some cases, you can additionally take carbidopa.

The preparation also contains folic acid, so it should be carefully used together with drugs against epilepsy, which contain primidon, phenobarbital or phenytoin.

Before using Zernevir, tell your doctor about all the medicines you took earlier.

[23], [24]

Storage conditions

It is very important to store the medicine in a place that is inaccessible to young children. The air temperature should not exceed +25 degrees. 

[25], [26]

Shelf life

The medicine can be used for two years after release. Do not take the drug after the expiration date. 

[27], [28]