Vidalin D

Vidalin D is a parenteral (intravenous) nutritional supplement used when a patient cannot meet fluid, caloric, or vitamin requirements through oral or enteral intake. It combines a source of carbohydrate calories and free water (5% dextrose) with a multivitamin preparation.

Established/guideline-supported uses

• Supplemental source of calories, fluid, and water-soluble vitamins in postoperative patients or those temporarily unable to take food or fluids by mouth (nil-per-os/NPO status).
• Adjunct to total or partial parenteral nutrition (TPN/PPN) regimens to help meet daily vitamin requirements in patients who are unable to tolerate oral vitamin supplementation.
• Short-term maintenance fluid, calorie, and vitamin support in dehydrated or debilitated patients under close medical supervision.

Adjunct/off-label use

• Occasionally used as an adjunct in patients with mild vitamin depletion (e.g., prolonged illness, poor intake) where oral vitamin therapy is not feasible; this use should be individualized by the treating physician.

Vidalin D is not a substitute for a complete parenteral or enteral nutrition regimen and does not replace protein, lipid, electrolyte, or trace-element supplementation when those are clinically required.

Multivitamin and 5% Dextrose is a sterile intravenous infusion consisting of Dextrose (as dextrose monohydrate) 5% w/v in water for injection, fortified with a multivitamin preparation typically containing water-soluble vitamins such as Thiamine (Vitamin B1), Riboflavin (Vitamin B2), Pyridoxine (Vitamin B6), Cyanocobalamin (Vitamin B12), Nicotinamide, Panthenol/Dexpanthenol, Ascorbic acid (Vitamin C), Biotin, and Folic acid, with or without fat-soluble vitamins depending on the specific brand/formulation available.

Exact vitamin content, strength, and pack size (e.g., 500 mL or 1000 mL infusion bottles/bags, or a vitamin ampoule/vial to be added to a dextrose infusion) vary by manufacturer; the product label and package insert of the specific brand should always be checked.

Vidalin D is a ready-to-infuse or vial-plus-diluent combination product used in hospital and clinical settings for intravenous nutritional support. The dextrose component supplies calories (approximately 3.4 kcal/g of dextrose) and free water, while the multivitamin component supplies water-soluble (and in some formulations fat-soluble) vitamins that act as essential coenzymes in carbohydrate, protein, and fat metabolism.

It is administered only by, or under the direct supervision of, a qualified healthcare professional via a suitable intravenous access, typically as part of a patient's overall fluid and nutrition management plan.

Vidalin D belongs to the therapeutic class of intravenous fluid and electrolyte/carbohydrate replenishers combined with vitamin supplements — specifically, a parenteral nutritional support and vitamin-replacement preparation.

Multivitamin and 5% Dextrose provides two pharmacologically distinct but complementary actions:

• Dextrose component: Dextrose (glucose) is metabolized to provide readily available calories and osmotically active free water, helping maintain fluid balance and reduce protein catabolism during periods of inadequate oral intake.
• Multivitamin component: The water-soluble B-complex vitamins (B1, B2, B6, B12, niacinamide, pantothenic acid) and vitamin C function as essential coenzymes and cofactors in carbohydrate, amino acid, and lipid metabolism, as well as in antioxidant defense and connective tissue synthesis. Folic acid supports nucleic acid synthesis and hematopoiesis.

Together, Multivitamin and 5% Dextrose helps prevent or correct vitamin deficiency and caloric/fluid deficits that can otherwise develop during prolonged parenteral therapy or inadequate oral intake.

Vidalin D is for intravenous infusion only and must never be given by intramuscular, subcutaneous, or intra-arterial injection. It should be administered through a patent peripheral or central venous line using a controlled infusion device where available. Do not mix with other medications in the same infusion bag/line unless compatibility has been confirmed, and inspect the solution visually for particulate matter or discoloration before use. Discard any unused portion; do not use partially used containers for a subsequent patient.

Clinically significant interactions with Vidalin D are related mainly to its vitamin and dextrose components:

• Levodopa: Pyridoxine (vitamin B6) in the multivitamin component can reduce the therapeutic effect of levodopa (when levodopa is used without a decarboxylase inhibitor) by enhancing its peripheral breakdown.
• Warfarin and other oral anticoagulants: High-dose vitamin C or any fat-soluble vitamin K present in some multivitamin formulations may reduce anticoagulant efficacy; monitor INR if used concurrently.
• Insulin and other glucose-lowering agents: The dextrose load can affect blood glucose control, requiring dose adjustment of insulin or oral hypoglycemic agents.
• Other intravenous additives: Physical/chemical incompatibility may occur if other drugs are co-administered in the same line without confirmed compatibility; administer separately when in doubt.

Most adverse effects associated with Vidalin D are related to the infusion itself or to excessive/rapid administration:

• Common: Infusion-site pain, redness, or phlebitis; mild transient hyperglycemia; flushing (sometimes associated with rapid B-vitamin or niacinamide administration).
• Less common: Allergic/hypersensitivity reactions (rash, pruritus, urticaria); local irritation or thrombophlebitis at the injection site.
• Rare but serious: Anaphylactoid reactions (more often reported with thiamine given rapidly by injection); fluid overload or electrolyte disturbance with excessive or rapid infusion, particularly in patients with cardiac or renal impairment.

Report any signs of an allergic reaction (breathing difficulty, facial swelling, severe rash) or infusion-site problems to the healthcare provider immediately.

Vidalin D should be used in pregnancy and lactation only if clearly needed, when parenteral nutritional or vitamin support is medically indicated and the potential benefit to the mother justifies any potential risk. Physiological vitamin and fluid requirements increase during pregnancy and lactation, and short-term parenteral vitamin supplementation is generally considered acceptable when properly indicated and monitored by a physician; however, high doses of certain vitamins (e.g., vitamin A analogues, if present in a specific formulation) should be avoided. Use in pregnant or breastfeeding women should always be under direct medical supervision, with attention to appropriate dose and infusion rate. Consult a physician before use in pregnancy or while breastfeeding.

Vidalin D must be used with caution and close monitoring in the following situations:

• Diabetes mellitus/glucose intolerance: The dextrose load can raise blood glucose; monitor blood glucose regularly and adjust glucose-lowering therapy as needed.
• Fluid and electrolyte balance: Use cautiously in patients with cardiac, renal, or hepatic impairment, or conditions predisposing to fluid or sodium/potassium overload; monitor fluid balance, serum electrolytes, and signs of fluid overload (edema, dyspnea).
• Infusion-site monitoring: Inspect the infusion site regularly for signs of extravasation, phlebitis, or infection.
• Rate of administration: Infuse slowly; rapid administration increases the risk of hyperglycemia, osmotic effects, and vitamin-related infusion reactions.
• Aseptic technique: Strict aseptic technique is required during preparation and administration to prevent catheter-related bloodstream infection.

Vidalin D should only be administered by trained healthcare personnel with the facilities to monitor and manage infusion-related complications.

Overdose or excessively rapid administration of Vidalin D may lead to hyperglycemia, osmotic diuresis, dehydration, electrolyte disturbances (e.g., hypokalemia), and fluid overload, which can be particularly dangerous in patients with cardiac or renal impairment. Excess water-soluble vitamin intake is generally excreted renally, but rapid infusion of certain B-vitamins can provoke flushing or hypersensitivity-type reactions.

If an overdose or infusion reaction is suspected, stop the infusion immediately and seek immediate medical attention; supportive treatment (fluid/electrolyte correction, glucose control, and management of any hypersensitivity reaction) should be provided in a monitored clinical setting. Do not attempt to manage a suspected overdose at home.

Store at room temperature (below 30°C), protected from light and moisture. Do not freeze. Use immediately after opening/reconstitution and discard any unused portion. Keep out of reach of children.

Pediatric patients

Use of Vidalin D in infants and children requires individualized, weight-based dosing under the supervision of a pediatrician or neonatologist; safety and efficacy of adult-strength formulations have not been established in neonates, and pediatric-specific parenteral vitamin preparations are generally preferred where available.

Elderly patients

Elderly patients, who more often have reduced renal or cardiac reserve, should receive Vidalin D with careful attention to infusion rate and volume to avoid fluid overload and hyperglycemia; dose adjustment and closer monitoring are advised.

Renal/hepatic impairment

Use with caution and reduced infusion volume/rate in patients with significant renal or hepatic impairment, with close monitoring of fluid balance, electrolytes, and blood glucose.

The duration of Vidalin D therapy is determined by the treating physician based on the patient's clinical status and nutritional needs, and is typically continued only for as long as oral or enteral intake remains inadequate; it is generally intended for short-term supplemental use rather than prolonged, unsupervised therapy.

Where Vidalin D is supplied as a multivitamin concentrate/ampoule intended for addition to a diluent, it should be reconstituted or added using strict aseptic technique: withdraw the contents of the vitamin ampoule/vial and add to the specified volume (e.g., 500 mL or 1000 mL) of 5% Dextrose infusion, mixing gently to ensure uniform distribution before infusion. Use the admixture promptly after preparation and discard any unused portion; do not store prepared admixtures for later use unless the product labeling specifically supports it.

Intravenous carbohydrate/fluid replenisher (5% dextrose) combined with a water-soluble multivitamin supplement; parenteral nutritional support preparation.

Multivitamin and 5% Dextrose acts through two complementary mechanisms: dextrose is taken up by cells and metabolized via glycolysis to yield ATP, sparing endogenous protein and providing free water and calories; the accompanying B-complex and other vitamins serve as essential coenzymes and cofactors in carbohydrate, fat, and amino acid metabolism, DNA synthesis (folic acid), and antioxidant defense (vitamin C), thereby supporting normal cellular metabolic function during periods of inadequate nutritional intake.

Vidalin D may be used in pediatric patients as a source of supplemental calories, fluid, and vitamins when oral or enteral intake is inadequate, but only under the direct supervision of a pediatrician/neonatologist, with dosing individualized by body weight and clinical status. Safety and efficacy of standard adult-strength multivitamin-dextrose formulations have not been formally established in neonates and young infants; pediatric-specific parenteral vitamin products are generally preferred for this age group where available. Blood glucose and fluid balance should be monitored closely in children receiving this infusion.