In clinical practice, "250mL of 5% glucose injection+1g of vitamin C injection+0.1g of vitamin B6 injection+0
In clinical practice, "250mL of 5% glucose injection+1g of vitamin C injection+0.1g of vitamin B6 injection+0.75g of 15% potassium chloride injection" can be seen everywhere, collectively referred to as the energy group. This group of liquids is often used as an "energy formula" for patients in clinical practice, but is this use really safe?
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Conclusion:
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The combination of vitamin C injection and vitamin B6 injection can increase the risk of adverse reactions.
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There is research[1]410 cases of ADR/ADE related to vitamin B6 injection were reported in the Yunnan Province Adverse Drug Reaction Monitoring System from January 1, 2016 to December 31, 2019. Among them, 47 cases were treated separately (accounting for 11.46%), and 363 cases were treated in combination (accounting for 8854%). Among the 363 cases of combined medication, a total of 785 cases were involved. Common combined medications include vitamin C injection, potassium chloride injection, omeprazole sodium for injection, etc. Combined medication ranks among the top 10 drugs, accounting for 59.88% of all combined medication. Among them,There are 282 reports of the combination of vitamin C injection and vitamin B6 injection, accounting for the highest proportion at 35.92%.
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Combined medication situation
Source: Reference [1]
There were 530 cases of ADR involving organs/systems and clinical manifestations in the combination of vitamin C and vitamin B6 injection. The top three organs/systems involved are skin and its accessories damage, systemic damage, and gastrointestinal system damage, with clinical manifestations including itching, rash, chills, nausea, and vomiting.
ADR involving organs/systems and clinical manifestations in combination with vitamin C and B6 injection
Source: Reference [1]
Medication recommendations
The combination of vitamin C injection and vitamin B6 injection is the most common in clinical practice, and both vitamins are water-soluble vitamins. The drug manual does not mention the precautions or compatibility contraindications for the combination of vitamin B6 injection and vitamin C injection. A search table for the clinical compatibility application of 400 Chinese and Western medicine injections showed compatibility.
However, the combination of vitamin B6 injection and vitamin C injection results in a high proportion of ADR/ADE, with clinical manifestations such as chills, high fever, and rash. There are also reports[2]It is shown that the clinical manifestations of ADR/ADE caused by the combination of the two drugs include pale complexion, purple lips, general convulsions, itching, etc. Therefore, for safety reasons, vitamin B6 injection and vitamin C injection should be avoided as much as possible.
What are the incompatibilities between vitamin C injection and vitamin B6 injection with other drugs?[3-9]
Vitamin C instruction manual prompts:Vitamin C is an enol structure with strong reducibility. The injection is acidic and should not be compatible with alkaline drugs (such as aminophylline, sodium bicarbonate, sodium glutamate, etc.), riboflavin, trichlorobutanol, copper, and iron ions (in trace amounts) to avoid affecting the therapeutic effect.
The pH of vitamin B6 injection is 2.5-4, which is incompatible with many drugs:
Transfer from Dingxiangyuan Medication Guidelines
References(Swipe up and down to see everything)
[1], , .410 B_6 [J]. ,2021,43(03)
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[2] Zhang Lei. Three cases of adverse reactions in children caused by intravenous infusion of vitamin C and vitamin B6 injection [J]. Chinese Journal of Drug Abuse Prevention and Control, 2018, 24 (4): 234-235
[3] Qiu Xiaomei. Incompatibility Contraindications between Vitamin C Injection and Polyene Phosphatidylcholine Injection [J]. Chinese Journal of Practical Nursing, 2013 (08): 78
[4] Xu Juan, Chen Min. Contraindications in compatibility between vitamin C injection and omeprazole [J]. Chinese Journal of Misdiagnosis, 2009,9 (32): 7823
[5] Wang Sujuan. Contraindications to compatibility between pantoprazole sodium and vitamin C injection [J]. General Nursing, 2011.9 (22): 1980
[6] Yan Wenna, Wang Lili. Contraindications for the compatibility of vitamin C injection [J]. Dietary Health, 2017,4 (021): 113-114. [7] Liang Linli. Changes in the compatibility of Yanhu Ning injection and vitamin B6 injection in infusion [J]. Journal of Youjiang Ethnic Medicine College, 2008,30 (2): 2
[8] Luo Lixiong, Zeng Xiangping, Xia Huirong. Contraindications in compatibility between lansoprazole and vitamin B6 injection [J]. Southwest National Defense Medicine, 2014,24 (4): 1
[9] Wang Xuqin, Pan Jingjing, Zhang Qiaoping. 15 Drugs and Vitamin B_ 6 Injections have compatibility contraindications [J]. China Rural Medicine, 2015,22 (17)
: 83-84. DOI: 10.19542/j.cnki.1006-5180.2015.17.051
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