Recommended Usage and Dosage of Neurobion Forte for Vitamin B Deficiencies
For treating vitamin B deficiencies, Neurobion Forte (containing Cyanocobalamin, Pyridoxine, and Thiamine) should be administered according to the specific deficiency type, with dosages typically ranging from 200-300 mg thiamine, 100-400 mg pyridoxine, and 1000 μg cyanocobalamin daily for therapeutic purposes. 1
Dosage Recommendations by Vitamin Component
Thiamine (Vitamin B1)
- For prevention of deficiency: Complete multivitamin and mineral supplement containing at least government dietary recommendations for thiamine 1
- For treatment of deficiency: 200-300 mg oral thiamine daily 1
- For patients with symptoms such as dysphagia, vomiting, poor dietary intake or rapid weight loss: 200-300 mg oral thiamine daily plus vitamin B co strong 1-2 tablets three times daily 1
- For severe deficiency with neurological symptoms: Intravenous thiamine may be required 1
Pyridoxine (Vitamin B6)
- For prevention of deficiency: 15-30 mg daily as part of multivitamin supplement 1, 2
- For treatment of mild to moderate deficiency: 100 mg daily 3, 2
- For treatment of severe deficiency or neuropathy: 100-400 mg daily, with monitoring for toxicity 3, 4
- Caution: High doses (>100 mg daily) for extended periods may cause sensory neuropathy 3, 4
Cyanocobalamin (Vitamin B12)
- For prevention of deficiency: 250-350 μg daily or 1000 μg weekly sublingual 1
- For treatment of deficiency without neurological involvement: 1000 μg intramuscularly three times weekly for 2 weeks 1
- For treatment of deficiency with neurological involvement: 1000 μg intramuscularly on alternate days until no further improvement 1
- Maintenance therapy: 1000 μg intramuscularly every 2-3 months 1, 5
Clinical Applications
For Peripheral Neuropathy
- Combination therapy with all three vitamins shows better outcomes than monotherapy 6, 2
- Initial loading dose followed by maintenance dose is recommended for peripheral neuropathy 2
- Particularly effective for diabetic neuropathy, alcoholic neuropathy, and drug-induced neuropathy 6, 2
For Post-Bariatric Surgery Patients
- Higher doses may be required due to malabsorption 1
- Regular monitoring of vitamin levels is essential 1
- For those with prolonged vomiting: Thiamine 200-300 mg daily plus vitamin B co strong 1-2 tablets three times daily 1
For Pregnancy-Related Deficiencies
- Supplementation with vitamin B6 (pyridoxine) is recommended as first-line treatment for mild nausea and vomiting in pregnancy 1
- Thiamine therapy should start at 100 mg daily for minimum 7 days, followed by maintenance dose of 50 mg daily until adequate oral intake is established 1
Important Considerations and Precautions
- Vitamin B12 deficiency left untreated for longer than 3 months may produce permanent degenerative lesions of the spinal cord 5
- High doses of folic acid may mask B12 deficiency while allowing neurological damage to progress 1, 5
- When treating B12 deficiency, always check for and treat B12 deficiency before initiating folic acid treatment 1
- Monitor for signs of vitamin B6 toxicity with long-term high-dose therapy (>100 mg daily) 3, 4
- For patients with malabsorption disorders, higher doses or parenteral administration may be necessary 5
Monitoring Recommendations
- For B12 deficiency: Check hematocrit and reticulocyte counts frequently until hematocrit normalizes 5
- For B6 supplementation: Monitor for symptoms of sensory neuropathy with high-dose therapy 3, 4
- For thiamine supplementation: Monitor for clinical improvement in neurological symptoms 1, 7
- Regular follow-up every 3 months initially to adjust dosing as needed 1
Neurobion Forte provides an effective combination therapy for various vitamin B deficiencies, but dosage should be adjusted based on the severity of deficiency, presence of neurological symptoms, and underlying conditions affecting absorption 6, 2, 4.