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Medically reviewed by Oliinyk Elizabeth Ivanovna, PharmD. Last updated on 13.05.2022
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is used for its antoxidant effects in the treatment of diabetic neuropathy. It has been tried in the treatment of liver dysfunction and in subacute necrotising encephalopathy. Beneficial results have been claimed in amanitin poisoning after ingestion of the mushroom Amanita phalloides, but such use is controversial
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.Pernicious anaemia, peripheral neuritis especially diabetic and alcoholic polyneuritis, trigeminal neuritis, vomiting of pregnancy, vitamin B complex deficiency, anorexia, agranulocytosis, radiation sickness, coeliac and idiopathic, steatorrhoea which are usually accompanied by malabsorption of vitamin B 12 and during administration of broad-spectrum antibiotics.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.Mecobalamin (Benfomet PLUS) (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.
Alpha-lipoic acid is a naturally occurring fatty acid that can be found in many foods such as yeast, spinach, broccoli, potatoes, and organ meats such as liver or kidney.
Alpha-lipoic acid has been used as a nutritional supplement and antioxidant.
Not all uses for alpha-lipoic acid have been approved by the FDA. Alpha-lipoic acid should not be substituted for medications prescribed for you by your doctor.
Alpha-lipoic acid 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.
Alpha-lipoic acid may also be used for purposes not listed in this product guide.
Not all uses for alpha-lipoic acid have been approved by the FDA. Alpha-lipoic acid should not be substituted for medications prescribed for you by your doctor.
Alpha-lipoic acid 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.
Talk with a doctor, pharmacist, herbalist, or other healthcare provider before using alpha-lipoic acid if you have kidney or liver disease, diabetes, low blood sugar (hypoglycemia), or a thyroid disorder.
Use alpha-lipoic acid as directed on the label, or as your healthcare provider has prescribed. Do not use this product in larger amounts or for longer than recommended.
Taking alpha-lipoic acid may lower your blood sugar. Tell your doctor, pharmacist, herbalist, or other healthcare provider if you have symptoms such as hunger, weakness, nausea, irritability, dizziness, headache, blurred vision, confusion, sweating, fast heart rate, or fainting.
Less serious side effects are more likely to occur, and you may have none at all.
Usual Adult Dose for Dietary Supplement
Alpha-lipoic acid 300 mg oral capsule:
1 capsule once or twice daily.
Alpha-lipoic acid 50 mg oral tablet:
1 tablet orally per day with a meal.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Dialysis
Data not available
Oral
Alcoholic neuropathy; Diabetic neuropathy
Adult: 100 mg 4 times daily.
Mecobalamin (Benfomet PLUS) SHOULD ONLY BE ADMINISTERED INTRAVENOUSLY.
Mecobalamin (Benfomet PLUS), 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 (Benfomet PLUS) 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 (Benfomet PLUS), 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 (Benfomet PLUS) produces good-to-excellent conditions for tracheal intubation in 5 minutes in approximately 90% of patients. Lower doses of Mecobalamin (Benfomet PLUS) 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 (Benfomet PLUS) administered to patients receiving balanced anesthesia.
An initial Mecobalamin (Benfomet PLUS) 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 (Benfomet PLUS) is administered during steady-state isoflurane, enflurane, or halothane anesthesia, reduction of the dose of Mecobalamin (Benfomet PLUS) 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 (Benfomet PLUS) 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 (Benfomet PLUS) or 100 minutes after an initial dose of 0.05 mg/kg Mecobalamin (Benfomet PLUS) 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 (Benfomet PLUS) 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 (Benfomet PLUS) 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 (Benfomet PLUS) has not been studied in pediatric patients below the age of 2 years.
Compatibility
Y-site Administration
Mecobalamin (Benfomet PLUS) Injection may not be compatible with alkaline solutions with a pH greater than 8.5 (e.g., barbiturate solutions).
Mecobalamin (Benfomet PLUS) 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 (Benfomet PLUS) 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 (Benfomet PLUS) should be discarded after 8 hours.
do not use in the treatment of leber disease or tobaco intoxication.
Mecobalamin (Benfomet PLUS) (doxacurium chloride) is contraindicated in patients with known hypersensitivity to the product and its components. Mecobalamin (Benfomet PLUS) (doxacurium chloride) is contraindicated for use in premature infants because the formulation contains benzyl alcohol.
Alpha lipoic acid (Benfomet PLUS) (ALA) is used to enhance effects of primary antidiabetic therapy (adjuvant therapy) in patients with diabetes as it lowers blood glucose by binding to insulin (a hormone that controls blood sugar level in the body) receptor in the body which leads to increase glucose utilization. Also, due to its antioxidant activity, ALA is used to treat nerve damage due to uncontrolled blood sugar level that causes pain, tingling, or numbness over hands and feet (diabetic neuropathy). ALA is used as an antioxidant as an adjuvant treatment of HIV, cancer, liver ailments, and various other conditions.
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.Beri Beri, Wenicke-korsakoff syndrome. diabetic neuropathy.
none known
Antibiotics: The use of antibiotics may alter the intestinal microflora and may decrease the possible contribution of Mecobalamin (Benfomet PLUS) 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 (Benfomet PLUS). Colestipol:
H2-Blockers (Cimetidine, Famotidine, Nizatidine, Ranitidine): Chronic use of H2-blockers may result to decreased absorption of Mecobalamin (Benfomet PLUS). They are unlikely to affect the absorption of supplemental B12.
Metformin: Metformin may decrease the absorption of Mecobalamin (Benfomet PLUS). 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 (Benfomet PLUS), 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 (Benfomet PLUS).
Potassium Chloride: It has been reported that potassium chloride may decrease the absorption of Mecobalamin (Benfomet PLUS).
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 Alpha lipoic acid (Benfomet PLUS)?
Nausea, Abdominal pain, Allergic reaction, Diarrhoea, Vertigo, Vomiting
anaphylactic reactions rarely, severe cases can cause death, urine yellow colouration,peripheral neuropathy in case of prolonged useage, arrythmias,
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 (Benfomet PLUS) (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 (Benfomet PLUS) (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 (Benfomet PLUS) (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%
| Cardiovascular:* | Hypotension,† flushing,† ventricular fibrillation, myocardial infarction |
| Respiratory: | Bronchospasm, wheezing |
| Dermatological: | Urticaria, injection site reaction |
| Special Senses: | Diplopia |
| Nonspecific: | Difficult neuromuscular block reversal, prolonged drug effect, fever |
| * Reports of ventricular fibrillation (n = 1) and myocardial infarction (n = 1) were limited to ASA Class 3-4 patients undergoing cardiac surgery (n = 142). † 0.3% incidence. All other reactions unmarked were ≤ 0.1%. |
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 (Benfomet PLUS) (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.
Benfotiamine (Benfomet PLUS) (rINN, or S-benzoylthiamine O-monophoshate) is a synthetic S-acyl derivative of thiamine (vitamine B1). After absorption, Benfotiamine (Benfomet PLUS) can be dephosphorylated by cells bearing an ecto-alkaline phosphatase to the lipid-soluble S-benzoylthiamine. Benfotiamine (Benfomet PLUS) should not be confused with allithiamine, a naturally occurring thiamine disulfide derivative with a distinct pharmacological profile.
Mecobalamin (Benfomet PLUS)/Mecobalamin (Benfomet PLUS)-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.