Description
NEFITA injection is a multi-vitamins formulation specifically designed to suit the nutritional needs of patients of kidney disease and/or on dialysis treatment. The need of the injection arises just after a dialysis procedure is done to a patient. The need of medication is so as to correct or fulfill the immediate requirement of vitamins in the body that will lose during a dialysis.
NEFITA injection has developed considering a very special need and to avoid deficiency of vital nutrients.
Nefita Injection has the following composition:
| Methylcobalamin | 1500 mcg |
| Folic Acid | 1.5 mg |
| Niacinamide | 100 mg |
| Pyridoxine Hcl | 100 mg |
Nefita Injection is a well thought and researched composition that has a high scope and extent considering the use after each dialysis session. Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.
In patients with kidney failure, heart attacks occur 5–10 times more than in the general population. More than 90% of dialysis patients have high homocysteine levels. By taking adequate amounts of folic acid and vitamins B12 and B6, the risk for heart disease may decrease by 20%–55%.
Pharmacology
Nefita Injection is a combination of Vitamins endowed with a particular hepato-protective activity in an optimal ratio so as to attain maximum therapeutic synergy. It also acts at a level of bone marrow to stimulate erythropoiesis. Methylcobalamin has a complex biological activity and takes part in protein synthesis particularly in neuronal and hepatic tissues. Depending on the level and type of Anemia, Nefita injection is indicated for the following conditions:
– Mild Anaemia
– Moderate Anaemia
– Post blood profusion maintenance of haemoglobin
– Chronic or Severe anaemia
Role of Nefita Injection in Dialysis Patients
Methylcobalamin in Dialysis
- Methylcobalamin helps make new cells, maintains nerve cells, works with folic acid to make red blood cells
- Neuropathy is found in 65% of patients on or nearing dialysis when GFR falls below 10%. Uremic neuropathy is an important cause of morbidity among patients undergoing chronic haemodialysis. Methylcobalamin is a safe and potentially beneficial therapy for neuropathy in Chronic HD patients
Nicotinamide in Dialysis
- Niacinamide helps the body use sugars and fatty acids, helps cells produce energy and helps enzymes function in the body
- It provides an interesting therapeutic approach to both Hyperphosphatemia and low HDL levels in dialysis patients. Low HDL, type 2 diabetes, and progressive atherosclerosis are important issues contributing to morbidity and mortality of dialysis patients . Findings indicate that Niacinamide significantly increased the HDL values in dialysis patients
Pyridoxine in Dialysis
- Pyridoxine helps the body make protein, which is then use to make cells
- Helps make Red Blood Cells
Folic Acid in Dialysis
- Folic Acid helps make DNA for new cells, works with Methylcobalamin to make red blood cells
- Hyperhomocysteinemia occurs in renal failure and may increase the risk for cardiovascular disease
- Peritoneal dialysis patients have Hyperhomocysteinemia, which can be normalized with folic acid alone in about 40% of patients
- A maintenance dose of 1 or 5 mg folic acid daily results in equivalent plasma homocysteine levels
Indications
- Vitamin B12 Deficiency
- Anemia
- Hyperhomocysteinemia
- Uremic Neuropathy
- Liver Disorders
- Megaloblastic Anemia
- Pre & Post Surgery
- In all ages – Infections, General Debility, Weakness
CKD Recommendation
| Methylcobalamin (Vit-B12) | 2-3 ug/day supplement for CKD patient, always include B12 with Folic acid |
| Folic Acid | 1 mg/day supplement for CKD patients |
| Niacinamide | 14-20 mg/day supplement for CKD patients (Dialysis and Non – dialysis) |
| Pyridoxine Hcl | 5/ 10 mg/day supplement for CKD patients (non-dialysis/ dialysis) —————————————————————————————————————————— 50 mg/day when prescribed with folic acid and vitamin B12 to reduce homocysteine levels. Large doses (200 mg/day) over long period can cause nerve damage. |
Dosage
IM (Intramuscular)
– Routine Antenatal Care: Once a week, Stop if Hb is > 13 g/dl and recommence if Hb < 11 g/dl
– Mild Anemia: Once/Twice a week
– Severe Anemia: Alternate days till the Hb improves
– Post-Dialysis: One ampoule after each dialysis followed by Nefita tabs once daily (except on the day of dialysis)
IV (Intravenous)
Dosage same as for intramuscular but should be mixed with 500 ml of infusion and given over 2 hours
Storage
Store NEFITA Injection in a cool and dry place. Protect from light and moisture.
Presentation
NEFITA injection pack contains 5 ampoule of 2 ml each in a pack and a sterile disposable syringe with needle.