Are there liquid formulations of multivitamins available?

Liquid Multivitamin Formulations

Yes, liquid multivitamin formulations are available, particularly for parenteral (intravenous) administration in clinical settings, and oral nutritional supplements (ONS) are also available in liquid form for enteral use. 1

Parenteral (Intravenous) Liquid Multivitamin Formulations

Pediatric parenteral multivitamin preparations exist specifically for neonates and infants requiring intravenous nutrition. 1, 2 These formulations are designed for:

• Preterm and term infants on parenteral nutrition who cannot receive adequate nutrition enterally 1
• Administration with lipid emulsions to maximize vitamin stability and minimize degradation, particularly for fat-soluble vitamins like vitamin A 1, 3
• Weight-based dosing with specific concentrations of both fat-soluble (A, D, E, K) and water-soluble vitamins (B-complex, C) 1, 2

Key Formulation Examples

• Pediatric-specific multivitamin preparations are available that can be used in reduced doses for infants below 3 kg or 1 kg body weight 1
• Cernevit™ is mentioned as one multivitamin preparation, though it notably does not contain vitamin K 1
• Single-vitamin parenteral products are also available for water-soluble vitamins like B1, B6, B12, and C 1

Critical Safety Warning for Parenteral Formulations

Adult multivitamin formulations containing propylene glycol and polysorbate additives must never be used in infants due to potential toxicity. 2, 3 Only neonatal-specific parenteral multivitamin preparations should be used for this population. 2

Oral Liquid Multivitamin Formulations

Oral nutritional supplements (ONS) are available in liquid form and contain balanced compositions of macronutrients and micronutrients (vitamins and minerals). 1 These products:

• Are available in a wide range of flavors and are the most common formulation for ONS, though powder, dessert-style, and bar forms also exist 1
• Are classified as "food for special medical purposes" (FSMP) and should be used under medical supervision 1
• Can be nutritionally complete and used as a sole source of nutrition, though most commonly used as dietary supplements 1

Pediatric Oral Liquid Formulations

Standard pediatric multivitamin liquid formulations (0.5-1.0 mL doses) are adequate for children requiring supplementation when oral intake is less than 100% of the Recommended Dietary Allowance. 4

Stability and Administration Considerations

Liquid multivitamin formulations for parenteral use have specific stability requirements: 1

• Vitamins B1, B2, B6, and C in pediatric parenteral formulations are stable for 72 hours when stored between 2-8°C 1
• At 25°C storage, vitamin C presents instability after 48 hours 1
• Light protection is essential as vitamins A and E are vulnerable to degradation by specific wavelengths of light 1, 3

Common Pitfalls to Avoid

• Do not assume all "multivitamin" products contain all 13 established vitamins - the term has no standard regulatory definition and most preparations do not contain the complete spectrum 5, 6
• Avoid using adult formulations for pediatric patients due to inappropriate additives and dosing 2, 4
• When mixing with crystalloid solutions alone (without lipid emulsions), actual delivered vitamin doses may be significantly lower than intended due to degradation and adherence losses to tubing 3