B-TOTAL, B-TOTAL FORTE
B-TOTAL EXTRA (Film Coated Tablets)

Composition:
B-TOTAL, Each tablet contains: Vitamin B1 (as Thiamine Hydrochloride) 100 mg, vitamin
B6 (as Pyridoxine Hydrochloride) 100 mg, vitamin B12 (Cyanocobalamin) 200 mcg.
B-TOTAL FORTE, Each tablet contains: Vitamin B1 (as Thiamine Hydrochloride)
100 mg, vitamin B6 (as Pyridoxine Hydrochloride) 100 mg, vitamin B12
(Cyanocobalamin) 1000 mcg.
B-TOTAL EXTRA, Each tablet contains: Vitamin B1 (as Thiamine Hydrochloride)
100 mg, vitamin B6 (as Pyridoxine Hydrochloride) 100 mg, vitamin B12
(Cyanocobalamin) 5000 mcg.
Excipients:
B-TOTAL : Calcium Carbonate, Dicalcium Phosphate, Microcrystalline Cellulose,
Hydroxypropyl Methylcellulose, Triacetin, Stearic Acid, Magnesium Stearate,
Croscarmellose Sodium, Silica, Maltodextrin, Propylene Glycol, Titanium Dioxide.
B-TOTAL FORTE/ B-TOTAL EXTRA: methylcellulose, magnesium stearate,
povidone, calcium carbonate, colloidal silicon dioxide, corn starch, kaolin, lactose
monohydrate, sucrose, Montan-glycol wax, gelatin, glycerol 85%, titanium dioxide,
talc, and acacia
Chemical and pharmacological Properties of the product:
A combination of the 3 essential neurotropic vitamins (B1, B6 and B12) in high
dosage. Vitamins B1, B6 and B12 are of special importance for the metabolism in the
peripheral and central nervous system. Their effect on the nerves has been shown in
various investigations using the vitamins individually and in combination.
Vitamin B1, B6, B12 combination greatly enhances their therapeutic efficacy as
compared to the effect of the respective vitamins given individually.
Vitamin B1 plays an important role in major metabolic processes.
Vitamin B6 has an analgesic effect.
Vitamin B12 ensures blood cell formation and prevents degenerative processes of
the nervous system.
Pharmacokinetics:
The bioavailability of single oral doses of vitamins B1 and B12 is dependent on the
amount presented.
Vitamins B1 and B12 are initially absorbed by active transport mechanisms. After the
relatively rapid saturation of the carrier, however, passive concentration-dependent
diffusion mechanisms set in. Thus, despite the relatively low rate of absorption with
this alternative route, higher individual doses eventually lead to the desired increase
in the serum level. Vitamin B6 is absorbed exclusively by passive diffusion.
Vitamin B1: After absorption, thiamine is distributed throughout almost all the tissues
of the body. If the metabolic requirement is saturated and once the very limited
storage capacity of the tissues is filled, this vitamin is immediately eliminated with the
urine in the unaltered or metabolized form.
Vitamin B6: Storage of vitamin B6 takes place mainly in the liver, the musculature
and the brain. Unutilized vitamin B6 is excreted with the urine within the first 24 hours
post administration almost entirely in the unaltered form (a small fraction is excreted
as 4-pyridoxic acid).
Vitamin B12: After absorption, vitamin B12 is very strongly bound to specific
transport proteins, with the aid of which it is distributed throughout the individual
tissues. In the liver, vitamin B12 is stored in the form of the active coenzyme up to
about 5-10 mg at a turnover rate of only 0.5-8 mcg/day. About 3-8 mcg vitamin B12 is
excreted with the bile per day, the greater part of which is reabsorbed in the ileum
(enter hepatic circulation). Small amounts are also excreted renally at the same time.
The great stock of vitamin B12 explains the time lag between the start of a supply
deficiency and the appearance of deficiency symptoms.
INDICATIONS:
Mono- and polyneuropathies e.g., diabetic, alcoholic or toxic neuropathies.
Neuritis and neuralgia, especially cervical syndrome, shoulder-arm syndrome,
lumbago, sciatica, root irritation due to degenerative changes of the vertebral
column, herpes zoster, for the follow-up treatment of trigeminal neuralgia and for
supportive treatment in facial paresis.
Deficiency or raised requirement of vitamins B1, B6 and B12.
Contraindications:
Hypersensitivity to any of the active ingredients or excipients.

SIDE EFFECTS
• Hypersensitivity reactions to vitamin B1 e.g., sweating, tachycardia (rapid
heartbeat), and skin reactions with itching and urticaria are very rare.
• Gastrointestinal complaints e.g., nausea, vomiting, diarrhea or abdominal pain may
occur.
PRECAUTIONS:
Neuropathies are described under long-term intake (6-12 months) of >50 mg mean
daily dose of vitamin B6. Therefore, under long-term treatment, regular monitoring is
recommended.
If symptoms of peripheral sensory neuropathy (paraesthesia) occur, the dosage should
be reviewed and treatment with the medicinal product discontinued, if necessary.
Pregnancy:
No risks have become known associated with the use of this drug during pregnancy
at the recommended dosage.
Nursing Mothers:
Vitamins B1, B6 and B12 are secreted into human breast milk, but risks of over
dosage for the infant are not known. In individual cases, high doses of vitamin B6 ie,
>600 mg daily, may inhibit the production of breast milk.
DRUG INTERACTIONS:
• The effect of levodopa may be reduced when vitamin B6 is administered concomitantly.
• Pyridoxine-Antagonists e.g. Isoniazid, Cycloserine, Penicillamine, Hydralazine: The
efficacy of vitamin B6 (pyridoxine) may be decreased.
• Loop Diuretics e.g. Furosemide: In long-term use, the blood level of thiamine may
be reduced.
DOSAGE AND ADMINISTRATION:
Tablets:
• 1 tab 3 times daily to treat moderate cases, or to provide interval and follow-up therapy
for a course of injections.
• The duration of the treatment is determined by the physician.
• The tablets are swallowed without chewing with a little liquid with or after meals.
OVERDOSE:
Prolonged overdosage of vitamin B6 , i.e., for longer than 2 months and >1g daily,
may lead to neurotoxic effects.
Storage: Store at temperature between (15-30 °C) Protected from moisture, light,
and out of the reach of children.
Packaging:
B-TOTAL, Carton box contains 50 film coated tablets.
B-TOTAL FORTE, Carton box contains 30 film coated tablets.
B-TOTAL EXTRA, Carton box contains 30 film coated tablets.
B-TOTAL, B-TOTAL FORTE
B-TOTAL EXTRA (Film Coated Tablets)
THIS IS A MEDICAMENT
A medicament is a product but unlike any other products.
A medicament is a product which affects your health, and its consumption contrary to
instructions is dangerous for you.
Follow strictly the doctor’s prescription, the method of use and the instructions of the
pharmacist who sold the medicament. The doctor and the pharmacist are experts in
medicine, its benefits and risks.
Do not by yourself interrupt the period of treatment prescribed for you.
Do not repeat the same prescription without consulting your doctor.

KEEP MEDICAMENTS OUT OF REACH OF CHILDREN
(Council of Arab Health Ministers) (Arab Pharmacists Association)
Biomedpharma