Drug Interaction:
Interacting drugs- summary
Niacin+
Lovastatin
coadmin of niacon have resulted in rhabdomyolysis
Sulfinpyrazone
uricosuric effect inhibited by nicotinic acid
Pyridoine +
Levodopa
pyridone reduces levodopas efficacy by increasing its peripheral metabolism
therefore, lower levels are available for CNS penetration .
Avoid vitamin supplementation that contains > 5mg pyridoxine per daily dose
Phenobarbital
phenobarbital serum levels decreased
Phenytoin
phenytoin serum levels decreased
Indication:
Refer B- complex
Adverse Reaction:
Refer Vitamin B complex
Contra-Indications:
Refer Vitamin B complex
Special precautions: Refer Vitamin B complex
Dosages/ Overdosage Etc:
Indications: Pyridoxine deficiency
Dosage: Dietary deficiency- 10 to 20 mg daily for 3 weeks.
Other Information:
For Availability/supplies
Contact -
1.Indian Drug Manufacturers Association (IDMA)
Phone- 022- 24944624/ 24974308
Fax- 022- 24950723
Email- idma@vsnl.com
Website: www.idma-assn.org
2.Bulk Drug Manufacturers Association (India)(BDMA)
Phone - 040-23703910/ 23706718
Fax- 040-23704804
Email- info@bdmai.org
Website: www.info@bdmai.org
EVIDENCE BASED MEDICINE (April 2003)
Premenstrual sydrome
Comparative effectiveness of various intreventions
Beneficial
Overall Premenstrual Syndrome Symptoms
1. Prostagalndin inhibitors (e.g. Indomethicin)
2. Selective serotonin Reuptake Inhibitors (e.g. Fluoxetine, Seratinine, Fluvoxamine)
Breast symptoms only
1. Leuteal phase control
2. Bromocriptine
Bloatedness and Swelling
1. Spironolactone/ diuretics
Likely to be beneficial
1. Tobolone
2. Oestrogen
3. Vitamin B-6
4. Evening primrose B-6
Trade-off between Benefits and Harms
1. Danazol
2. Gonodotropin-releasing hormone (GnRH analogues)
3. Non-SSRI antidepressants/ anxiolytics
4. Hysterectomy with/without oophorectomy
Unknown effectiveness
1. Progesterone
2. Progestogens
3. Oral contraceptives
4. Cognitive behaviour treatment
5. Dietary supplements
6. Relaxation treatment
7. Endometrial ablation
8. Laproscipic bilateral oophorectomy
KEY POINTS
1. Trials have found that SSRIs and prostagalndin inhibitors relieve premenstrual symptoms. Antidepressants and ovulation suppression with danazol and GnRH analoges are also effective but have significant adverse effects, including the masculanising effects of danazol and the menopausal effects of GnHR analogues.
2. There is a limited evidence suggesting that oestrogen, viatmin-B6 , evening Primrose Oil and excercise may also be beneficoial
3. Trials have found that bromocriptine is effective for breast symptoms and diuretics are effective for bloatedness and swelling. Both can have adverse efects.
4. There is no good evidence to support the use of progesterone or oral contraceptives
5. Few treatments have been adequately validated in trials.
Patient Information:
Ref - USP PDI Vol II 17th Edition (1997)
NIACIN- Vitamin B6 - systemic
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
niacinamide. Also tell your healthcare care professional if you are allergic
to any other substances such as foods. preservatives or dyes.
2.Pregnancy-
It is especially important that you are receiving enough vitamins when you
become pregnant and that you continue to receive the right amount of
vitamins throughout your pregnancy.
However, taking large amounts of dietary supplements in pregnancy may
be harmful to the mother and /or fetus and should be avoided
3. Breast-feeding-
It is especially important that you receive the right amonts of vitamins
somthat your baby will also get the right amount of viatamins to grow
properly. However, taking large amounts of dietary supplements
may be harmful to the mother and/or baby and should be avoided
4.Children-
Problems in children have not been reported with intake of normal
daily recommended amounts
5.Older adults-
Problems in older adults have not been reported with intake of normal
daily recommended amounts
6. Other medicines-
Tell your doctor if you are using any other dietary supplements or
any other prescription or non-prescription (Over-the counter)
OTC medicine.
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Bleeding problems or
Diabetes mellitus or
Glaucoma or
Gout or
Liver disease or
Low blood pressure or
Stomach ulcer - niacin or nacinamide may make the conditions worse
Manufacturer Details