Duovit

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

1. Retinol palmitate (Vitamin A):

   • Functions: Improving vision, maintaining healthy skin, immune system and mucous membranes.
   • Deficiency: May cause night blindness and skin deterioration.

2. Α-Tocopherol Acetate (Vitamin E):

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

3. Cholecalciferol (Vitamin D3):

   • Functions: Regulation of calcium-phosphorus metabolism, maintenance of healthy bones and teeth.
   • Deficient: May cause rickets in children and osteomalacia in adults.

4. Ascorbic Acid (Vitamin C):

   • Functions: Antioxidant, collagen synthesis, wound healing, improved absorption iron.
   • 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, healthy skin and mucous membranes.
   • Deficiency: May lead to cracked 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.
   • Deficient: Rare, may cause fatigue and irritability.

8. Pyridoxine hydrochloride (Vitamin B6):

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

9. Folic acid (Vitamin Bc):

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

10. Cyanocobalamin (Vitamin B12):

    • Functions: Red blood cell formation, nervous system support.
    • Deficient: May cause megaloblastic anemia and nervous disorders.

11. Nicotinamide (Vitamin PP):

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

Indications Duovita

• Replenishment of vitamin deficiency.
• Support the body during periods of increased physical and mental stress.
• Improvement of general condition in case of poor and unbalanced nutrition.
• Recovery after illness and surgery.
• Immune system support.

Release form

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

Pharmacodynamics

1. Retinol palmitate (Vitamin A):

   • Action: Participates in the synthesis of rhodopsin, necessary for night vision, maintains the health of the skin and mucous membranes, and 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. Colecalciferol (Vitamin D3):

   • Action: Regulates the exchange of calcium and phosphorus, promotes the mineralization of bones and teeth.
   • Mechanism of action: Increases the absorption of calcium in the intestines, stimulates the reabsorption of calcium in the kidneys, maintains normal levels of calcium and phosphate 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. Thiamin mononitrate (Vitamin B1):

   • Action: Participates in the metabolism of carbohydrates, supports normal function of the nervous system.
   • Mechanism of action: Part of the coenzyme thiamine pyrophosphate, necessary for the decarboxylation of α-keto acids.

6. Riboflavin (Vitamin B2):

   • Action: Important for energy metabolism, health of the skin and mucous membranes.
   • Mechanism of action: Converted into coenzymes FAD and FMN, which participate in redox 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 to 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 the active forms pyridoxal phosphate and pyridoxamine phosphate, which serve as coenzymes in the metabolism of amino acids.

9. Folic acid (Vitamin Bc):

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

10. Cyanocobalamin (Vitamin B12):

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

11. Nicotinamide (Vitamin PP):

    • Action: Participates in energy metabolism, supports the health of the skin, nervous system and digestive system.
    • Mechanism of action: Part of the coenzymes NAD and NADP involved in redox reactions.

Pharmacokinetics

1. Retinol palmitate (Vitamin A):

   • Absorption: Well absorbed from the intestine, especially in the presence of fat.
   • Distribution: Accumulates in the liver, also present in the retina of the eyes, adipose tissue.
   • Metabolism: Metabolized in the liver to active forms (retinal and retinoic acid).
   • Excretion: Excreted in bile and urine in the form of 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. Colecalciferol (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 intestines.
   • Distribution: Widely distributed in tissues, high concentrations in the adrenal glands, pituitary gland, liver and spleen.
   • Metabolism: Partially metabolized to oxalates.
   • Excretion: Excreted in the urine both unchanged and in the form of metabolites.

5. Thiamin mononitrate (Vitamin B1):

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

7. Calcium pantothenate (Vitamin B5):

   • Absorption: Absorbed in the small intestine.
   • Distribution: Widely distributed in tissues, especially in the liver, kidneys, 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 to 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 intrinsic factor.
    • Distribution: Accumulates in the liver, distributed in tissues.
    • Metabolism: Metabolized in the liver.
    • Excretion: Excreted in bile, reabsorbed in the intestines (enteric circulation), small amounts are 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 a day.
2. Children: For children, it is recommended to use a dosage that is appropriate to their age and individual vitamin needs. Children under 12 years of age are usually prescribed half the adult dose.

Use Duovita during pregnancy

Efficacy 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 potent antioxidant that protects cells from oxidative damage. It is considered safe for use during pregnancy when used in recommended doses (Garcia et al., 2010).
3. Vitamin D3 (cholecalciferol): Vitamin D3 is necessary for maintaining calcium and phosphate levels in the blood, which is important for fetal bone development. Adequate vitamin D3 intake prevents deficiency, which 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 the formation of red blood cells. They are considered safe and necessary for maternal health and normal fetal development (Ahmed & Bamji, 1976).
6. Folic Acid (Vitamin Bc): Folic acid is critical for preventing neural tube defects in the fetus. It is recommended to start taking folic acid before conception and continue it throughout 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, may 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 a known allergy or sensitivity to one or more components of the drug should avoid its use.
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. Elevated levels of calcium in the blood (hypercalcemia): This medicine 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 this product may increase blood clotting, which is undesirable in individuals with bleeding disorders.
6. Heart failure: Some vitamins in the drug may be contraindicated in heart failure, as they may increase the load on the heart.

Side effects Duovita

1. Dyspeptic disorders: Stomach discomfort, nausea, vomiting or diarrhea may occur.
2. Allergic reactions: Rare, but allergic reactions such as itching, rash, swelling or difficulty breathing may occur.
3. Hypervitaminosis: Excessive intake of vitamins is possible, 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 parameters: Some components of Duovit, such as vitamin K, may affect blood clotting.
5. Hypercalcemia: Use of the drug may lead to excess calcium in the body, which can cause fatigue, constipation, rumbling in the stomach and other symptoms.
6. Changes in blood pressure: Some vitamins may affect blood pressure, causing it to increase or decrease.
7. Other rare adverse reactions: Dizziness, insomnia, anemia or other unusual symptoms may occur.

Overdose

1. Vitamin A (Retinol palmitate):

   • Nausea, vomiting
   • Headache, dizziness
   • Irritability
   • Dry and flaky skin
   • Pain in bones and joints
   • In severe cases – osteoporosis, hypercalcemia

2. Vitamin D3 (Colecalciferol):

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

3. Vitamin E (α-Tocopherol acetate):

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

4. Vitamin C (Ascorbic acid):

   • Nausea, diarrhea
   • Stomach cramps
   • Uurolithiasis with long-term 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. Preparations containing iron: Duovit may reduce the absorption of iron from iron-containing preparations.
2. Medicines containing calcium: Calcium may reduce the absorption of some components of Duovit, such as iron and zinc.
3. Medicines containing magnesium: Magnesium may reduce the absorption of iron.
4. Medicines containing zinc: Zinc may reduce the absorption of antibiotics such as tetracyclines.
5. Medicines containing vitamin K: Vitamin K may interfere with the effectiveness of anticoagulants (drugs that reduce blood clotting) such as warfarin.