For the treatment and prophylaxis of folic acid and vitamin B12 deficiencies
VITAMIN B12, PLUS, folic acid, Cyanocobalamin, ampoules Composition:
1 ampoule of 2 ml of Vitamin B12-Hevert contains: Cyanocobalamin (vitamin B12 cyano complex) 3000 µg (3 mg)
1 ampoule of 2 ml of Folsäure-Hevert contains: folic acid 20 mg
Excipients: Vitamin B12-Hevert: ammonium sulfate, sodium chloride, hydrochloric acid solution, water for injections. , Folic acid Hevert: sodium chloride, sodium hydroxide solution, water for injections.
Areas of application VITAMIN B12, PLUS, folic acid, Cyanocobalamin, ampoules:
For the therapy and prophylaxis of isolated and combined folic acid and vitamin B12 deficiencies, which can manifest themselves clinically in megaloblastic anemia and/or neurological or psychiatric disorders.
Dosage VITAMIN B12, PLUS, folic acid, Cyanocobalamin, ampoules:
Unless otherwise prescribed, for initial treatment, inject 20 mg folic acid and 1500 µg vitamin B12 intramuscularly or intravenously twice a week.
After the tissue stores have been replenished, in the case of intestinal absorption disorders, 20 mg folic acid and 1500 µg vitamin B12 should be administered intramuscularly at intervals of 4 weeks.
Folic acid should be taken orally every day between the injections (eg "Folic Acid Hevert" tablets).
Intolerance to any of the components. "Vitamin B12-Hevert plus Folsäure-Hevert" must not be used in the case of megaloblastic anemia as a result of an isolated vitamin B12 deficiency (e.g. due to a lack of intrinsic factor) or an isolated folic acid deficiency. "Vitamin B12 forte-Hevert injekt" or "Vitamin B12 Depot Hevert" are available for the treatment of isolated vitamin B12 deficiency. "Folic acid forte-Hevert" and "Folic acid Hevert 5 mg" injection solutions as well as "Folic acid Hevert" tablets are available for the treatment of an isolated folic acid deficiency.
There are no known risks for doses of up to 5 mg folic acid per day during pregnancy and breastfeeding. Since the safety of a higher dosage cannot be guaranteed, no more than 5 mg folic acid per day may be administered during pregnancy and breastfeeding. Folic acid supplementation during pregnancy can reduce the risk of neural tube defects in the unborn child.
VITAMIN B12, PLUS, folic acid, Cyanocobalamin, ampoules Side effects:
Vitamin B12: There have been isolated reports of acne, eczematous or urticarial drug reactions, and anaphylactic or anaphylactoid reactions.
Folic acid: In high doses, rarely gastrointestinal disorders, sleep disorders, excitement, depression. An increase in the frequency and severity of seizures has been observed in epileptics after folic acid substitution.
Since folic acid is sensitive to heat, it is often destroyed if the food is prepared incorrectly, which means that the organism is not supplied with enough folic acid. But increased alcohol intake also leads to folic acid deficiency symptoms. Therapy with some allopathic anticonvulsants and with hormones such as ovulation inhibitors can also lead to a folic acid deficiency. As a result of diseases of the small intestine, after gastric surgery and in the case of chronic diarrhea, folic acid is not absorbed enough and the organism is undersupplied with folic acid (malabsorption syndrome). During pregnancy and particularly in the case of hyperthyroidism, an increased need for folic acid can be observed.
Since folic acid is a co-enzyme in nucleic acid metabolism, the blood-forming cells are affected first in the event of a folic acid deficiency. Hyperchromic macrocytic anemia occurs. But the formation of antibodies is also affected. The folic acid deficiency syndrome usually manifests itself in neurological and psychiatric disorders (organic brain syndrome, disturbance of the pyramidal tracts, neuropathies) with general weakness, paresthesia and tingling, as well as pale complexion, painful, swollen and shiny tongue. Other symptoms of folic acid deficiency are mucosal changes in the oral cavity and gastrointestinal disorders that lead to diarrhea.
In the case of chronic liver disease, vitamin B12 and folic acid deficiency can often be determined, which explains anemia, for example in cirrhosis of the liver. The high-dose therapy with "Vitamin B12-Hevert plus folic acid Hevert" is the drug of choice for liver diseases with accompanying megaloblastenemia, especially if it is caused by alcohol abuse.
The side effects of pernicious anemia with vitamin B12 deficiency are neurological diseases that can be accompanied by paralysis (funicular myelosis). The nucleic acid metabolism, which is the basis of protein build-up, especially in the liver, requires vitamin B12. "Vitamin B12-Hevert plus folic acid Hevert" solution for injection quickly and permanently eliminates the haematological and neurological symptoms.
In the treatment of acute and chronic liver diseases and macrocytic anemia, eg megaloblastic anemia, in pregnant women, children and alcoholics and in dialysis treatment, the simultaneous administration of "Vitamin B12 Hevert plus Folic Acid Hevert" offers better therapeutic success.