Vit B1 + Vit B2 (Riboflavin 5 Phosphate) + Vit B3 + Vit B5 + Vit B6 25 + Methylcobalamin (B Complex Plus)

Vit B1 + Vit B2 (Riboflavin 5 Phosphate) + Vit B3 + Vit B5 + Vit B6 25 + Methylcobalamin (B Complex Plus)

Available presentation(s): 10, 50 mL. Verify the exact concentration and total active quantity on the prescription and dispensing label.

Introduction: A compounded B-complex combination containing thiamine, riboflavin-5-phosphate, niacin, pantothenic acid, pyridoxine and methylcobalamin. It is intended only for an individual patient with a documented clinical rationale when a suitable approved product is unavailable.

Dosage: No universal regimen exists. Prescribe exact volume and component doses, route, frequency and duration. Review cumulative pyridoxine and niacin exposure and confirm whether ‘niacin’ denotes nicotinamide or nicotinic acid because tolerability differs.

Mechanisms of Action: Provides coenzymes for carbohydrate, amino-acid and lipid metabolism, redox reactions, methylation and haematopoiesis. Benefit is most plausible when deficiency or increased requirement is present.

Contraindications & Precautions: Avoid in hypersensitivity. Parenteral thiamine can cause anaphylaxis; high cumulative B6 causes neuropathy; niacin forms can cause flushing, hypotension, hyperglycaemia, hyperuricaemia or hepatic injury. Methylcobalamin can rarely cause hypersensitivity.

Interactions: Pyridoxine reduces levodopa effect without carbidopa; chloramphenicol can blunt B12 response; fluorouracil affects thiamine; glucose-lowering and antihypertensive medicines may require review if niacin exposure is material.

Adverse Reactions / Side Effects: Injection-site pain, flushing, nausea, headache, dizziness, rash and hypersensitivity may occur. Serious but uncommon risks include anaphylaxis, hepatotoxicity (niacin), neuropathy (excess B6) and dosing errors.

Pregnancy & Breastfeeding: Correct documented deficiencies in pregnancy and breastfeeding, but avoid supraphysiologic combination dosing unless a specialist determines it is necessary.

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.
• NIH Office of Dietary Supplements. Health Professional Fact Sheets (vitamins and minerals), current online editions. https://ods.od.nih.gov/factsheets/list-VitaminsMinerals/
• DailyMed. Thiamine Hydrochloride, Pyridoxine Hydrochloride, Hydroxocobalamin and Levocarnitine injection labels, current editions. 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