Myers Cocktail Injection

Myers Cocktail Injection

Available presentation(s): 50, 100 mL. Verify the exact concentration and total active quantity on the prescription and dispensing label.

Introduction: A compounded multi-nutrient intravenous mixture commonly called a Myers Cocktail. Published evidence is limited, formulations vary, and there is no universally accepted indication, composition or dosing regimen. The source list appears to repeat ‘vitamin B3’; the intended identity of every component must be confirmed before compounding or prescribing.

Dosage: No standard regimen can be recommended. The prescription must identify every active and dose, total volume, diluent, infusion rate, frequency, duration and monitoring. Calculate magnesium, calcium, zinc, vitamin C and B-vitamin exposure from all sources. Do not administer until the duplicated B3 entry is clarified.

Mechanisms of Action: Provides vitamin and mineral cofactors involved in energy metabolism, antioxidant defence, collagen synthesis, neuromuscular function and electrolyte homeostasis. A plausible biochemical role does not establish clinical efficacy of the combined infusion.

Contraindications & Precautions: Assess renal function, G6PD status and oxalate/stone risk for high-dose vitamin C; magnesium-related heart block/renal risk; calcium and zinc exposure; thiamine hypersensitivity; B6 cumulative neurotoxicity; and fluid/osmolar load. Confirm admixture compatibility and stability.

Interactions: Magnesium can potentiate neuromuscular blockers and hypotensive medicines; calcium interacts with several IV drugs; ascorbate interferes with some glucose/lab tests; B6 can reduce levodopa effect without carbidopa; zinc and antioxidants may be relevant to oncology care.

Adverse Reactions / Side Effects: Infusion-site pain, flushing, warmth, nausea, headache, dizziness and metallic taste may occur. Serious risks include hypersensitivity, hypotension, electrolyte disturbance, arrhythmia, renal injury/oxalate nephropathy, haemolysis in G6PD deficiency and dosing/compatibility errors.

Pregnancy & Breastfeeding: Routine wellness infusion is not recommended during pregnancy or breastfeeding. Treat identified deficiencies individually using pregnancy-specific guidance.

Storage: Store under the conditions stated on the Optimus dispensing label and product-specific worksheet. Protect from light where labelled. Do not freeze unless explicitly validated. Maintain cold chain if the label requires refrigeration. Do not use after the assigned beyond-use date or if there is visible particulate matter, precipitation, colour change, loss of container integrity or evidence of improper storage. Once entered, follow the validated in-use time; do not assume a compounded vial is multi-dose.

References

• New Zealand Formulary (NZF), current online edition; product-specific approved data sheets where available; USP Pharmaceutical Compounding—Sterile Preparations; and Optimus Healthcare validated formulation, sterility/endotoxin controls and assigned beyond-use date.
• Gaby AR. Intravenous nutrient therapy: the ‘Myers’ cocktail’. Alternative Medicine Review. 2002;7(5):389–403. Evidence is limited and does not establish a universal regimen.
• NIH Office of Dietary Supplements. Health Professional Fact Sheets (vitamins and minerals), current online editions. https://ods.od.nih.gov/factsheets/list-VitaminsMinerals/
• DailyMed. ASCOR (ascorbic acid injection)—prescribing information, current edition. https://dailymed.nlm.nih.gov/
• DailyMed. Magnesium Sulfate Injection—prescribing information, current edition. https://dailymed.nlm.nih.gov/
• US FDA. Compounding and the FDA: Questions and Answers. Updated 16 September 2025. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers