Avina

Each tablet contains Ascorbic acid (Avina) 500 mg.

Ascorbic acid (Avina) (Ascorbic acid (Avina)) is a vitamin that is freely soluble in water. The superior formulation of Ascorbic acid (Avina) (Ascorbic acid (Avina)) assures substantial amounts per dose for prophylaxis and treatment of Ascorbic acid (Avina) deficiencies. This preparation has a very delectable grape (Ascorbic acid (Avina) Tablet) flavors.

A dibenzoxepin tricyclic compound. It displays a range of pharmacological actions including maintaining adrenergic innervation. Its mechanism of action is not fully understood, but it appears to block reuptake of monoaminergic neurotransmitters into presynaptic terminals. It also possesses anticholinergic activity and modulates antagonism of histamine H(1)- and H(2)-receptors.

Mecobalamin (Avina)-500/Mecobalamin (Avina)-1500 also contains the following inactive ingredients: Lactose, maize starch, microcrystalline cellulose, povidone (K-30), purified talc, anhydrous colloidal silica, hypromellose, macrogol, titanium dioxide, isopropyl alcohol, dicholoromethane, red iron oxide and yellow iron oxide.

Niacinamide (Avina), also called as nicotinamide (vitamin B3), is prescribed for the treatment of niacin deficiency disorders including pellagra. Niacinamide (Avina) should not be used for treatment of hyperlipidemia.

For systemic use of Ascorbic acid (Avina) Atlantic Laboratories: prevention and treatment of hypo- and avitaminosis of Ascorbic acid (Avina); providing increased need for Ascorbic acid (Avina) during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.

For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.

skin disorders, Biotin (Avina) deficiency, digestive disorders

Mecobalamin (Avina) (doxacurium chloride) is a long-acting neuromuscular blocking agent, indicated to provide skeletal muscle relaxation as an adjunct to general anesthesia, for endotracheal intubation or to facilitate mechanical ventilation.

Ascorbic acid (Avina) (Ascorbic acid (Avina)) occurs naturally in foods such as citrus fruit, tomatoes, potatoes, and leafy vegetables. Ascorbic acid (Avina) is important for bones and connective tissues, muscles, and blood vessels. Ascorbic acid (Avina) also helps the body absorb iron, which is needed for red blood cell production.

Ascorbic acid (Avina) is used to treat and prevent Ascorbic acid (Avina) deficiency.

Ascorbic acid (Avina) may also be used for purposes not listed in this medication guide.

Biotin (Avina) is a form of vitamin B found in foods. Biotin (Avina) helps the body break down fats, carbohydrates, and other substances.

Biotin (Avina) has been used in alternative medicine as a likely effective aid in treating or preventing Biotin (Avina) deficiency. Biotin (Avina) deficiency can be caused by malnutrition, rapid weight loss, long-term tube feeding, and other medical conditions.

Biotin (Avina) has also been used to treat seborrhea (skin rash) in babies. However, research has shown that Biotin (Avina) may not be effective in treating this condition.

Other uses not proven with research have included treating brittle nails or thinning hair, diabetes, nerve pain, and other conditions.

It is not certain whether Biotin (Avina) is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Biotin (Avina) should not be used in place of medication prescribed for you by your doctor.

Biotin (Avina) is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Biotin (Avina) may also be used for purposes not listed in this product guide.

Treating acne.

Niacinamide (Avina) gel is a vitamin B supplement. Exactly how Niacinamide (Avina) gel works is unknown.

• Niacinamide (Avina) gel is for external use only. Avoid getting Niacinamide (Avina) gel in your eyes. If you get Niacinamide (Avina) gel in your eyes, rinse thoroughly with cool tap water.
• Follow up with your doctor after 8 to 12 weeks to monitor your progress.
• Do not use any other medicines or special cleansers on your skin unless your doctor instructs you otherwise. Makeup and other acne medicines may be applied over Niacinamide (Avina) gel as directed by your doctor.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Niacinamide (Avina) gel while you are pregnant. It is not known if Niacinamide (Avina) gel is found in breast milk after topical use. If you are or will be breast-feeding while you use Niacinamide (Avina) gel, check with your doctor. Discuss any possible risks to your baby.

Important Preparation and Administration Instructions

• Ascorbic acid (Avina) vials contain 25, 000 mg of Ascorbic acid (Avina) and the largest recommended single dose is 200 mg. Do not give the entire contents of the vial to a single patient.
• Do not administer Ascorbic acid (Avina) as an undiluted intravenous sensitive.
• Minimize exposure to light because Ascorbic acid (Avina) is light sensitive.
• Ascorbic acid (Avina) is supplied as a Pharmacy Bulk Package (PBP) which is intended for dispensing of single doses to multiple patients in a pharmacy admixture program and is restricted to the preparation of admixtures for infusion:

a. Use only in a suitable ISO Class 5 work area such as a laminar flow hood (or an equivalent clean air compounding area)

b. Penetrate each PBP vial closure only one time with a suitable sterile transfer device or dispensing set that allows measured dispensing of the contents. Given that pressure may develop within the vial during storage, excercise caution when withdrawing contents from the vial.

c. Once the closure system has been penetrated, complete all dispensing from the PBP vial within 4 hours. Each dose must be used immediately. Discard unused portion.

d. Prior to administration, Ascorbic acid (Avina) must be diluted in a suitable infusion solution and the final solution for infusion must be isotonic (undiluted the osmolarity of Ascorbic acid (Avina) is approximately 5,900 mOsmol/L). Prior to preparing the admixture for infusion, calculate the osmolarity of the intended admixture for infusion. Add one daily dose of Ascorbic acid (Avina) directly to an appropriate volume of a suitable infusion solution (e.g., 5% Dextrose Injection, Sterile Water for Injection) and add appropriate solutes, as necessary, to make final solution isotonic. Sterile Water for Injection is highly hypotonic; adjust solute content, as necessary, to make thet final infusion solution isotonic prior to injection. Do not mix Ascorbic acid (Avina) with solutions containing elemental compounds that can be reduced (e.g., copper). The concentration of Ascorbic acid (Avina) in the final, admixture solution for infusion is to be the range of 1 to 25 mg of Ascorbic acid (Avina) per mL. For example, for the largest recommended dose:

Add 200 mg of Ascorbic acid (Avina) (equivalent to 0.4 mL of Ascorbic acid (Avina)) to 7.5 mL of Sterile Water for Injection to produce an infusion solution having an approximate osmolarity of 290 mOsmol/L. In this specific example, addition of solute is NOT necessary because the solution is isotonic.

e. Prepare the recommended dose based on the patient population [ see Dosage and Administration (2.2), (2.3)].

f. Visually inspect for particulate matter and discoloration prior to administration (the diluted Ascorbic acid (Avina) solution should appear colorless to pale yellow).

g. Immediately administer the admixture for infusion as a slow intravenous infusion [ see Recommended Dosage, (2.2)]

Recommended Dosage

Table 1 provides recommended doses of Ascorbic acid (Avina) based on patient population and infusion rates of diluted Ascorbic acid (Avina) solution.

The recommended maximum duration of daily treatment with Ascorbic acid (Avina) is seven days. If no improvement in scorbutic symptoms is observed after one week of treatment, retreat until resolution of scorbutic symptoms is observed.

Repeat dosing is not recommended in pediatric patients less than 11 years of age.

Dosage Reductions in Specific Populations

Women who are pregnant or lactating and patients with glucose-6-dehydrogenase deficiency should not exceed the U.S. Recommended Dietary Allowance (RDA) or daily Adequate Intake (AI) level for Ascorbic acid (Avina) for their age group and condition [ ​ see Warnings and Precautions (5.2) and Use in Specific Populations (8.1, 8.2)].

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule,

Oral:

Meribin: 5 mg

Capsule,

Oral [preservative free]:

Biotin (Avina) Extra Strength: 10 mg [gluten free; contains soybean lecithin, soybean oil]

Generic: 5000 mcg

Tablet,

Oral:

Generic: 1000 mcg, 5 mg, 10 mg

Tablet,

Oral [preservative free]:

Generic: 300 mcg [DSC], 1000 mcg

Dosing: Adult

Dietary supplementation (OTC labeling):

Oral: Usual

Dosage: One tablet or capsule daily; also see specific product labeling

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Biotinidase deficiency, symptomatic: Limited data available: Infants, Children, and Adolescents:

Oral: 5 to 20

Mecobalamin (Avina) SHOULD ONLY BE ADMINISTERED INTRAVENOUSLY.

Mecobalamin (Avina), like other long-acting neuromuscular blocking agents, displays variability in the duration of its effect. The potential for a prolonged clinical duration of neuromuscular block must be considered when Mecobalamin (Avina) is selected for administration. The dosage information provided below is intended as a guide only. Doses should be individualized. Factors that may warrant dosage adjustment include: advancing age, the presence of kidney or liver disease, or obesity (patients weighing ≥ 30% more than ideal body weight for height). The use of a peripheral nerve stimulator will permit the most advantageous use of Mecobalamin (Avina), minimize the possibility of overdosage or underdosage, and assist in the evaluation of recovery.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.

Adults

Initial Doses

When administered as a component of a thiopental/narcotic induction-intubation paradigm as well as for production of long-duration neuromuscular block during surgery, 0.05 mg/kg (2 × ED95) Mecobalamin (Avina) produces good-to-excellent conditions for tracheal intubation in 5 minutes in approximately 90% of patients. Lower doses of Mecobalamin (Avina) may result in a longer time for development of satisfactory intubation conditions. Clinically effective neuromuscular block may be expected to last approximately 100 minutes on average (range: 39 to 232) following 0.05 mg/kg Mecobalamin (Avina) administered to patients receiving balanced anesthesia.

An initial Mecobalamin (Avina) dose of 0.08 mg/kg (3 × ED95) should be reserved for instances in which a need for very prolonged neuromuscular block is anticipated. In approximately 90% of patients, good-to-excellent intubation conditions may be expected in 4 minutes after this dose; however, clinically effective block may be expected to persist for as long as 160 minutes or more (range: 110 to 338).

If Mecobalamin (Avina) is administered during steady-state isoflurane, enflurane, or halothane anesthesia, reduction of the dose of Mecobalamin (Avina) by one third should be considered.

When succinylcholine is administered to facilitate tracheal intubation in patients receiving balanced anesthesia, an initial dose of 0.025 mg/kg (ED95) Mecobalamin (Avina) provides about 60 minutes (range: 9 to 145) of clinically effective neuromuscular block for surgery. For a longer duration of action, a larger initial dose may be administered.

Maintenance Doses

Maintenance dosing will generally be required about 60 minutes after an initial dose of 0.025 mg/kg Mecobalamin (Avina) or 100 minutes after an initial dose of 0.05 mg/kg Mecobalamin (Avina) during balanced anesthesia. Repeated maintenance doses administered at 25% T1 recovery may be expected to be required at relatively regular intervals in each patient. The interval may vary considerably between patients. Maintenance doses of 0.005 and 0.01 mg/kg Mecobalamin (Avina) each provide an average 30 minutes (range: 9 to 57) and 45 minutes (range: 14 to 108), respectively, of additional clinically effective neuromuscular block. For shorter or longer desired durations, smaller or larger maintenance doses may be administered.

Children

When administered during halothane anesthesia, an initial dose of 0.03 mg/kg (ED95) produces maximum neuromuscular block in about 7 minutes (range: 5 to 11) and clinically effective block for an average of 30 minutes (range: 12 to 54). Under halothane anesthesia, 0.05 mg/kg produces maximum block in about 4 minutes (range: 2 to 10) and clinically effective block for 45 minutes (range: 30 to 80). Maintenance doses are generally required more frequently in children than in adults. Because of the potentiating effect of halothane seen in adults, a higher dose of Mecobalamin (Avina) may be required in children receiving balanced anesthesia than in children receiving halothane anesthesia to achieve a comparable onset and duration of neuromuscular block. Mecobalamin (Avina) has not been studied in pediatric patients below the age of 2 years.

Compatibility

Y-site Administration

Mecobalamin (Avina) Injection may not be compatible with alkaline solutions with a pH greater than 8.5 (e.g., barbiturate solutions).

Mecobalamin (Avina) is compatible with:

• 5% Dextrose Injection, USP
• 0.9% Sodium Chloride Injection, USP
• 5% Dextrose and 0.9% Sodium Chloride Injection, USP
• Lactated Ringer's Injection, USP
• 5% Dextrose and Lactated Ringer's Injection
• Sufenta® (sufentanil citrate) Injection, diluted as directed
• Alfenta® (alfentanil hydrochloride) Injection, diluted as directed
• Sublimaze® (fentanyl citrate) Injection, diluted as directed

Mecobalamin (Avina) diluted up to 1:10 in 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP has been shown to be physically and chemically stable when stored in polypropylene syringes at 5° to 25°C (41° to 77°F), for up to 24 hours. Since dilution diminishes the preservative effectiveness of benzyl alcohol, aseptic techniques should be used to prepare the diluted product. Immediate use of the diluted product is preferred, and any unused portion of diluted Mecobalamin (Avina) should be discarded after 8 hours.

Applies to the following strengths: 100 mg; 500 mg

Usual Adult Dose for:

• Niacin Deficiency
• Pemphigus

Usual Pediatric Dose for:

• Niacin Deficiency
• Pemphigus

Additional dosage information:

• Renal Dose Adjustments
• Liver Dose Adjustments
• Dialysis
• Other Comments

Usual Adult Dose for Niacin Deficiency

Recommended Daily Allowances (RDA):

Males: 19 mg orally each day

Females: 13 mg orally each day

Initial dose: 100 mg orally 3 times a day, with or after meals

Maintenance dose: 100 to 500 mg orally up to 3 times a day, with or after meals

Niacinamide (Avina) has toxic potential at adult doses in excess of 3 g/day.

Niacinamide (Avina) may also be administered parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products. All existing parenteral vitamin products for adults contain 40 mg/vial, which is the dose recommended by the American Medical Association/Nutrition Advisory Group for patients 11 years and older requiring parenteral vitamins.

Usual Adult Dose for Pemphigus

Recommended Daily Allowances (RDA):

Males: 19 mg orally each day

Females: 13 mg orally each day

Initial dose: 100 mg orally 3 times a day, with or after meals

Maintenance dose: 100 to 500 mg orally up to 3 times a day, with or after meals

Niacinamide (Avina) has toxic potential at adult doses in excess of 3 g/day.

Niacinamide (Avina) may also be administered parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products. All existing parenteral vitamin products for adults contain 40 mg/vial, which is the dose recommended by the American Medical Association/Nutrition Advisory Group for patients 11 years and older requiring parenteral vitamins.

Usual Pediatric Dose for Niacin Deficiency

Recommended Daily Allowances (RDA):

0 to 6 months: 5 mg orally each day

6 months to 1 year: 6 mg orally each day

1 to 3 years: 9 mg orally each day

4 to 6 years: 12 mg orally each day

7 to 10 years: 13 mg orally each day

Males:

11 to 14 years: 17 mg orally each day

15 to 18 years: 20 mg orally each day

19 to 50 years: 19 mg orally each day

Females:

11 to 50 years: 13 mg orally each day

Niacinamide (Avina) may also be administered parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products. All existing parenteral vitamin products for children contain 17 mg/vial, which is the dose recommended by the American Medical Association/Nutrition Advisory Group for patients under 11 years of age.

Usual Pediatric Dose for Pemphigus

Recommended Daily Allowances (RDA):

0 to 6 months: 5 mg orally each day

6 months to 1 year: 6 mg orally each day

1 to 3 years: 9 mg orally each day

4 to 6 years: 12 mg orally each day

7 to 10 years: 13 mg orally each day

Males:

11 to 14 years: 17 mg orally each day

15 to 18 years: 20 mg orally each day

19 to 50 years: 19 mg orally each day

Females:

11 to 50 years: 13 mg orally each day

Niacinamide (Avina) may also be administered parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products. All existing parenteral vitamin products for children contain 17 mg/vial, which is the dose recommended by the American Medical Association/Nutrition Advisory Group for patients under 11 years of age.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Because Niacinamide (Avina) is primarily metabolized by the liver and because of the risk of hepatotoxicity, Niacinamide (Avina) in not recommended in patients with liver dysfunction.

Dialysis

Data not available

Other Comments

Taking Niacinamide (Avina) with food may reduce stomach upset.

Niacinamide (Avina) should not be taken with hot drinks.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

More about Niacinamide (Avina)

• Niacinamide (Avina) Side Effects
• During Pregnancy
• Drug Interactions
• Support Group
• 1 Review
• Drug class: vitamins

Consumer resources

• Niacinamide (Avina)
• Niacinamide (Avina) Extended-Release Tablets

Related treatment guides

• Niacin Deficiency
• Pemphigus

See also:
What is the most important information I should know about Ascorbic acid (Avina)?

There are no contraindications to the administration of Ascorbic acid (Avina).

See also:
What is the most important information I should know about Biotin (Avina)?

SINEQUAN is contraindicated in individuals who have shown hypersensitivity to the drug. Possibility of cross sensitivity with other dibenzoxepines should be kept in mind.

SINEQUAN is contraindicated in patients with glaucoma or a tendency to urinary retention. These disorders should be ruled out, particularly in older patients.

Mecobalamin (Avina) (doxacurium chloride) is contraindicated in patients with known hypersensitivity to the product and its components. Mecobalamin (Avina) (doxacurium chloride) is contraindicated for use in premature infants because the formulation contains benzyl alcohol.

Use Ascorbic acid (Avina) solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Ascorbic acid (Avina) solution may be taken with or without food.
• You may drop the dose of Ascorbic acid (Avina) solution directly into your mouth or mix it with cereal, milk, or water.
• Take Ascorbic acid (Avina) solution with a full glass of water (8 oz/240 mL). Do not lie down for 30 minutes after taking Ascorbic acid (Avina) solution.
• Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
• If you miss a dose of Ascorbic acid (Avina) solution, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Ascorbic acid (Avina) solution.

Use Niacinamide (Avina) gel as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Wash the affected area with a mild cleanser or other cleansing product prescribed by your doctor and completely dry.
• Apply a thin layer of the medicine to the affected area twice daily or as directed by your doctor. Gently rub the medicine in until it is evenly distributed.
• Wash your hands immediately after using Niacinamide (Avina) gel.
• If you miss a dose of Niacinamide (Avina) gel, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Niacinamide (Avina) gel.

Ascorbic acid (Avina) (Ascorbic acid (Avina)) is used to prevent or treat low levels of Ascorbic acid (Avina) in people who do not get enough of the vitamin from their diets. Most people who eat a normal diet do not need extra Ascorbic acid (Avina). Low levels of Ascorbic acid (Avina) can result in a condition called scurvy. Scurvy may cause symptoms such as rash, muscle weakness, joint pain, tiredness, or tooth loss.

Ascorbic acid (Avina) plays an important role in the body. It is needed to maintain the health of skin, cartilage, teeth, bone, and blood vessels. It is also used to protect your body's cells from damage. It is known as an antioxidant.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This vitamin may also be used with other vitamins for a certain eye condition (macular degeneration).

How to use Ascorbic acid (Avina)

Take this vitamin by mouth with or without food, usually 1 to 2 times daily. Follow all directions on the product package, or take as directed by your doctor.

If you are taking the extended-release capsules, swallow them whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Take this product with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise.

If you are taking the wafers or chewable tablets, chew them thoroughly and then swallow. If you are taking the lozenges, place the lozenge in your mouth and allow it to slowly dissolve.

If you are taking the powder, mix it thoroughly in the proper amount of liquid and stir well. Drink all of the liquid right away. Do not prepare a supply for future use. If you are using the liquid form of this vitamin, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

Dosage is based on your medical condition and response to treatment.

Use this vitamin regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

If you think you may have a serious medical problem, seek immediate medical attention.

Biotin (Avina) is a water soluble B-complex vitamin needed for normal growth and development of skin and hair and maintenance of a healthy nervous system and bone marrow. It is used to prevent and treat Biotin (Avina) deficiency associated with pregnancy, long-term tube feeding, malnutrition, and rapid weight loss. It is also used orally for hair loss, brittle nails, skin rash in infants (seborrheic dermatitis), diabetes, and mild depression.

To treat Hartnup disease (light sensitive skin rashes), inflammatory skin disease, vitamin deficiency, anxiety and Alzheimer’s disease (disorder that causes mental confusion and forgetfulness). It is also used in combination with intravenous Niacinamide (Avina) therapy for cancer.

See also:
What other drugs will affect Ascorbic acid (Avina)?

In an application with barbiturates, primidone increases the excretion of Ascorbic acid (Avina) in the urine.

With the simultaneous use of oral contraceptives reduces the concentration of Ascorbic acid (Avina) in blood plasma.

In an application of Rhea Ascorbic acid (Avina) with iron preparations Ascorbic acid (Avina), due to its regenerative properties, transforms ferric iron in the bivalent, which improves its absorption.

Ascorbic acid (Avina) in high doses can decrease urine pH that while the application reduces the tubular reabsorption of amphetamine and tricyclic antidepressants.

With the simultaneous use of aspirin reduces the absorption of Ascorbic acid (Avina) by about a third.

Rhea Ascorbic acid (Avina) in an application with warfarin may decrease effects of warfarin.

With the simultaneous application of Ascorbic acid (Avina) increases the excretion of iron in patients receiving deferoxamine. In the application of Ascorbic acid (Avina) at a dose of 500 mg / day possibly left ventricular dysfunction.

In an application with tetracycline is increased excretion of Ascorbic acid (Avina) in the urine.

There is a described case of reducing the concentration of fluphenazine in plasma in patients treated with Ascorbic acid (Avina) 500 mg 2 times / day.

May increase the concentration of ethinyl estradiol in the blood plasma in its simultaneous application in the oral contraceptives.

See also:
What other drugs will affect Biotin (Avina)?

The anticonvulsants carbamazepine, phenytoin, Phenobarbital, and primidone may accelerate Biotin (Avina) metabolism, leading to a reduction in available Biotin (Avina). Chronic use of these drugs has been associated with decreased plasma concentrations of Biotin (Avina).

The use of antibiotics may reduce the contribution of Biotin (Avina) made by bacteria within the large intestine.

Antibiotics: The use of antibiotics may alter the intestinal microflora and may decrease the possible contribution of Mecobalamin (Avina) by certain inhabitants of the microflora (eg, Lactobacillus spp) to the body's requirement for the vitamin. This may particularly be a problem for vegetarians. Garlic, onions, leeks, bananas, asparagus and artichokes, among other vegetables and fruits, contain inulins which promote the growth of certain colonic bacteria including Lactobacillus spp.

Cholestyramine:

Colchicine: Colchicine may cause decreased absorption of Mecobalamin (Avina).

Colestipol:

H₂-Blockers (Cimetidine, Famotidine, Nizatidine, Ranitidine): Chronic use of H₂-blockers may result to decreased absorption of Mecobalamin (Avina). They are unlikely to affect the absorption of supplemental B₁₂.

Metformin: Metformin may decrease the absorption of Mecobalamin (Avina). This possible effect may be reversed with oral calcium supplementation.

Nitrous Oxide: Inhalation of the anesthetic agent nitrous oxide (not to be confused with nitric oxide) can produce a functional deficiency. Nitrous oxide forms a complex with cobalt in Mecobalamin (Avina), the cofactor for methionine synthase, resulting in inactivation of the enzyme.

Para-Amino Salicylic Acid: Chronic use of the anti-tuberculosis drug may decrease the absorption of Mecobalamin (Avina).

Potassium Chloride: It has been reported that potassium chloride may decrease the absorption of Mecobalamin (Avina).

Proton Pump Inhibitors (Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole): Chronic use of proton pump inhibitors may result in decreased absorption, naturally found in food sources.

See also:
What are the possible side effects of Ascorbic acid (Avina)?

Applies to Ascorbic acid (Avina): oral capsule, oral capsule extended release, oral capsule liquid filled, oral granule, oral liquid, oral lozenge/troche, oral powder, oral powder for solution, oral powder for suspension, oral solution, oral syrup, oral tablet, oral tablet chewable, oral tablet extended release, oral wafer

In addition to its needed effects, some unwanted effects may be caused by Ascorbic acid (Avina) (the active ingredient contained in Ascorbic acid (Avina)). In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking Ascorbic acid (Avina), check with your doctor or nurse as soon as possible:

Less common or rare: - with high doses

• Side or lower back pain

Minor Side Effects

Some of the side effects that can occur with Ascorbic acid (Avina) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common or rare: - with high doses

• Diarrhea
• dizziness or faintness (with the injection only)
• flushing or redness of skin
• headache
• increase in urination (mild)
• nausea or vomiting
• stomach cramps

See also:
What are the possible side effects of Biotin (Avina)?

Adverse reactions associated with Biotin (Avina) supplementation are rare in the medical literature; however, urticaria and gastrointestinal upset have been reported. As with any oral treatment, if patients experience any adverse reactions or side effects, they should inform their physicians immediately and discontinue use.

The most frequent adverse effect of nondepolarizing blocking agents as a class consists of an extension of the pharmacological action beyond the time needed for surgery and anesthesia. This effect may vary from skeletal muscle weakness to profound and prolonged skeletal muscle paralysis resulting in respiratory insufficiency and apnea which require manual or mechanical ventilation until recovery is judged to be clinically adequate. Inadequate reversal of neuromuscular block from Mecobalamin (Avina) (doxacurium chloride) is possible, as with all nondepolarizing agents. Prolonged neuromuscular block and inadequate reversal may lead to postoperative complications.

Observed in Clinical Trials

Adverse experiences were uncommon among the 1034 surgical patients and volunteers who received Mecobalamin (Avina) (doxacurium chloride) and other drugs in US clinical studies in the course of a wide variety of procedures conducted during balanced or inhalational anesthesia. The following adverse experiences were reported in patients administered Mecobalamin (Avina) (doxacurium chloride) (all events judged by investigators during the clinical trials to have a possible causal relationship):

Incidence Greater than 1%

None

Incidence Less than 1%

Observed During Clinical Practice

There have been post-marketing reports of severe allergic reactions (anaphylactic and anaphylactoid reactions) with the use of neuromuscular blocking agents of which Mecobalamin (Avina) (doxacurium chloride) is a member. These reactions, in some cases, have been life threatening and fatal. Because these reactions were reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency.

See also:
What are the possible side effects of Niacinamide (Avina)?

Applies to Niacinamide (Avina): tablets

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; itching; nausea; stomach upset; temporary feeling of warmth or flushing of the skin.

Seek medical attention right away if any of these SEVERE side effects occur while taking Niacinamide (Avina):

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry, or bloody stools; changes in vision; dark urine; decreased urination; fast or irregular heartbeat; loss of appetite; muscle pain or weakness; numbness or persistent tingling of the skin; persistent nausea, vomiting, or general "unwell" feeling; severe or prolonged flushing of the skin; stomach pain; swelling of the hands, legs, or feet; vomit that looks like coffee grounds; yellowing of the skin or eyes.