Polybion Ampoule

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What is Polybion Ampoule?

Polybion is a multi-B-complex injection combining the major water-soluble B vitamins in a single ampoule for IM (or slow IV) administration. The combination addresses the typical pattern of multi-B deficiency seen in alcohol use disorder, severe malnutrition, post-bariatric malabsorption, and prolonged TPN without adequate B-vitamin coverage.

Indikationer

• Severe nutritional deficiency in malnutrition or eating disorders
• Alcohol use disorder — multi-B deficiency (especially thiamine, B12, folate) is the rule rather than exception
• Post-bariatric malabsorption — particularly after Roux-en-Y or BPD-DS
• Prolonged severe diarrhoea, fistula losses
• Hyperemesis gravidarum — thiamine + B-complex parenteral cover
• Refeeding syndrome prophylaxis — thiamine load before refeeding (specialist)
• Adjunct in peripheral neuropathy of mixed nutritional aetiology

Dosis

Typical use: one ampoule IM or slow IV daily for 5–7 days, then once weekly until oral intake is restored, then transition to oral B-complex (Beplex Forte, Becozinc) for maintenance. In hospital settings the dose and route are individualised to the indication.

Bivirkninger

• Injection site reaction — common, usually mild
• Anaphylaxis — rare but reported with parenteral thiamine; resuscitation should be available for first IV doses in high-risk patients
• Pyridoxine neuropathy — only at sustained extreme doses (B6 >500 mg/day for weeks)
• Niacin flushing — transient
• Yellow discoloration of urine from riboflavin — harmless

Lægemiddelinteraktioner

• Levodopa — B6 (pyridoxine) reduces effect of unprotected levodopa (relevant if levodopa is given without a peripheral decarboxylase inhibitor, which is rare in modern formulations)
• Phenytoin — pyridoxine may slightly reduce phenytoin levels
• Loop diuretics — can deplete thiamine; high-dose loop users (heart failure) may benefit from B-complex supplementation

Kontraindikationer

• Hypersensitivity to any component
• Active peptic ulcer (relative; high-dose niacinamide can aggravate)

Opbevaring

Store below 25°C, protect from light. Use ampoule once opened.

Ofte stillede spørgsmål

When is parenteral B-complex needed instead of oral?

When absorption is impaired (malabsorption, post-bariatric, severe diarrhoea), when adherence is unreliable, when rapid replacement is needed, or when the patient cannot tolerate oral intake (severe vomiting, post-op fasting). Otherwise oral B-complex (Beplex Forte, Becozinc) is preferred — cheaper and effective.

Will it help with fatigue?

Only if fatigue is due to documented B-vitamin deficiency. Most fatigue in well-fed adults is not B-vitamin deficiency; check thyroid, ferritin, vitamin D, B12, folate, glucose, and depression first. Megadose B-complex without deficiency does not increase energy.

Is the injection painful?

Some discomfort at the site is common. Slow IV injection (where label permits) reduces stinging.

Can I take it long-term?

Long-term parenteral B-complex is unusual. If maintenance is needed, transition to oral (Beplex Forte, Becozinc) or specific replacement (B12 IM monthly for pernicious anaemia, oral folate, oral thiamine). Re-injecting B-complex monthly without indication is not evidence-based.

Does it help peripheral neuropathy?

In neuropathy with documented B-vitamin deficiency (alcoholic, diabetic with B12 deficiency, post-bariatric, malabsorption), replacement helps. In neuropathy without deficiency the benefit is small to none.

Is it safe in pregnancy?

Used in hyperemesis gravidarum with thiamine cover for Wernicke prophylaxis. Megadose B6 (pyridoxine) above 500 mg/day for weeks risks fetal sensory neuropathy; standard parenteral B-complex doses are well below this.

What about thiamine alone in alcohol use disorder?

High-risk alcohol-use-disorder patients (especially those representing for detox or with refeeding risk) should receive parenteral thiamine 100–300 mg before any glucose-containing fluids — glucose without thiamine can precipitate Wernicke’s in deficient patients. Polybion contains thiamine but the concentration may be insufficient for high-risk treatment doses.

Hvor hurtigt virker det?

Onset depends on indication. For nutritional deficiency, biochemistry begins improving within days, clinical symptoms over weeks. For acute Wernicke’s, dedicated high-dose thiamine is needed (not standard B-complex).

Polybion vs Walcobal?

Polybion is multi-B (1, 2, 3, 5, 6, 12). Walcobal is methylcobalamin only at higher dose (2500 mcg vs the smaller B12 amount in Polybion). Use Polybion for multi-B deficiency, Walcobal for isolated B12 deficiency or B12-specific neuropathy.

Can my GP give me Polybion?

Yes — IM injection is within standard primary care scope. Always confirm the indication and ensure resuscitation is available for first parenteral B-complex dose in patients with allergy history.

Andre vitaminer og mineraler

• Vitamin B12 1500 mcg — high-dose oral cyanocobalamin
• Walcobal Injektion — methylcobalamin IM
• Polybion Ampoule — B-complex parenteral
• Beplex Forte — B-complex oral
• Becozinc — B-complex with zinc
• Thiamine HCL 100 — thiamine 100 mg for alcohol-related neuropathy

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