Medium-chain Acid 2083
USP 36: (Niacinamide). A white crystalline powder, 4. Elam ME, et al. Effect of niacin on lipid and lipoprotein levels and P.r�P.?.r?ti?�� ·· ...... glycemic control inpatients with diabetes and peripheral arterial disease: odourless or practically so. Soluble I in 1.5 of water, I in 284: ProprietaryPreparations · · (details are given in Volume B) lO the ADMIT study: a randomized trial. lAMA 2000; 1263-70. of boiling water, and I in 5.5 of alcohol; soluble in 5. Grundy SM, et a!. Efficacy, safety, and tolerability of once-daily niacin Single-ingredient Preparations. Fr.: Molybdene Injectablet: glycerol. Its solutions are neutral to litmus. Store in airtight for the treatment of dyslipidemia associated with type 2 diabetes: results USA: Molypent. containers. of the assessment of diabetes control and evaluation of the efficacy of Niaspan trial. Arch InternMed 2002; 162: 1568-76. Multi-ingredient Preparations. Canad. : T-OS; Hung.: Humet-R; Thai.: Ferrovit; Ukr.: Vimifor Multivitamin with Beta-Carotene Uses and Administration Hyperlipidaemias. The first-line treatment for hyperlipi (BiMi¢op MynhTHBiTaMiH 3 Eera-KapoTHHOM)t. Nicotinic acid and nicotinamide, the form that occurs daemias remains dietary and lifestyle modification; where naturally in the body, are water-soluble vitamin B this fails, drug therapy may be considered (p. 1248.1 ). PharmacopoeialPreparations Nicotinic acid is reported to have a favourable effect on USP 36: Ammonium Molybdate Injection; Minerals Capsules; substances that are converted to nicotinamide adenine blood-lipid profiles, raising high-density lipoprotein Minerals Tablets; Oil- and Water-soluble Vitamins with Minerals dinucleotide (nadide, p. 2567.1) and nicotinamide adenine (HDL)-cholesterol and lowering low-density lipoprotein Capsules; Oil- and Water-soluble Vitamins with Minerals Oral dinucleotide phosphate (NADP). These coenzymes are Solution; Oil- and Water-soluble Vitamins with Minerals Tablets; involved in electron transfer reactions in the respiratory (LDL)·cholesterol.1·3 Nicotinic acid is used particularly in Oil-Soluble Vitamins with Minerals Capsules; Oil-Soluble chain. familial hypertriglyceridaemia, or in familial combined Vitamins with Minerals Oral Solution; Oil-Soluble Vitamins Nicotinic acid deficiency develops when the dietary hyperlipidaemia when both triglyceride and cholesterol with .Minerals Tablets; Trace Elements Injection; Water-soluble intake is inadequate. Deficiency leads to the development of concentrations are similarly elevated. Nicotinic acid was Vitamins with Minerals Capsules; Water-soluble Vitamins with a syndrome known as pellagra, characterised by skin less effective than lovastatin at reducing LDL-cholesterol Minerals Tablets. lesions, especially on areas exposed to sunlight. with in patients with primary hypercholesterolaemia, but more hyperpigmentation and hyperkeratinisation. Other symp effective at increasing HDL-cholesterol; lovastatin was bet toms include diarrhoea, abdominal pain, glossitis, stomat ter tolerated.4 A combination of nicotinic acid with lovas Nicotinamide Ascorbate IBANM r!NNM) itis, loss of appetite, headache, lethargy, and mental and tatin was found to be comparable to atorvastatin and neurological disturbances. Nicotinic acid deficiency may more effective than simvastatin in reducing LDL-cholester ��otlnarrtlda; Niacinamide Ascorbate de � Astorbat�; occur with other vitamin B -complex deficiency states, for ol, and more effective than either atorvastatin or simva Nicptinamlde; Nkos�ort.Jioe; •. Ascorbate de; Nicqtinamfdi example in alcoholism. statin in increasing HDL-cholesterol, in a study of patients H�
The symbol t denotes a preparation no longer actively marketed 2084 Nutritional and Vitamins
sweciting, chills, or oedema. These symptoms are transient release dosage forms the use of crystalline immediate under Interactions of Simvastatin, p. 1495.3). Nicotinic acid and various strategies have been proposed to reduce them release preparations should be preferred, a view shared by may increase the -requirements for insulin or oral (see Incidence of Adverse Effects, below). Nicotinamide other commentators.8 However, although studies appear hypoglycaemics. Aspirin may reduce the clearance of does not have a vasodilator action. to confirm a more frequent association of hepatotoxicity nicotinic acid. In vitro studies suggest that colestipol and Other adverse effects that have been reported, especially with modified-release dosage forms4•9•10 it should be borne colestyramine may reduce the availability of nicotinic acid, after high doses of nicotinic acid, include dryness of the skin, in mind that these effects can also occur with the immedi and some licensed product information recommends an pruritus, hyperpigmentation, rash, cramps, cough, diarr· ate-release preparations, especially at high doses. Some interval of at least 4 to 6 hours between giving nicotinic acid hoea, nausea and vomiting, anorexia, activation of peptic manufacturers of modified-release preparations have sta and bile-acid binding resins. ulcer, eye disorders including cystoid macular oedema and ted that cases of severe hepatotoxicity, including fulmi toxic amblyopia, decrease in glucose tolerance, hyperglyc nant hepatic necrosis, have occurred when patients have Antiepileptics. For the effect of nicotinamide on carbamaze aemia, and hyperuricaemia. Most of these effects subside on substituted modified-release dosage forms for immediate pine, see Vitamins, p. 517.3. withdrawal of the drug. Nicotinic acid has been associated release crystalline preparations at equivalent doses. There with abnormal liver function tests and jaundice. Increases in is also a suggestion that not all modified-release prepara Nicotine. A patient started to have flushing and dizziness liver transaminases are generally reversible on stopping tions are alike in their effects.11 For a study indicating a after her usual doses of nicotinic add when transdermal treatment. Hypophosphataemia, a reduction in platelet lower incidence of reported serious adverse effects in nicotine patches were added to her therapy. 1 She had counts, prolongation of prothrombin time, arrhythmias, patients given modified-release rather than conventional experienced such reactions 3 years previously on starting and hypersensitivity reactions including angioedema have formulations, see Incidence of Adverse Effects, above. nicotinic acid therapy, but not since, and it was suggested also been reported. Insomnia, myalgia, and hypotension l. Henkin Y, et al. Rechallenge with crystalline niacin after drug-induced that on this occasion an interaction might have been may occur. hepatitis from sustained-release niacin. lAMA 1990; 264: 241-3: responsible. 2. Hodis HN. Acute hepatic failure associated with the use of low-dose Topical nicotinamide may cause dryness of the skin and, l. Rockwell KA Potential interaction between niacin and transdermal sustained-release niacin. lAMA 1990; 264: 181. . nicotine. Ann Phannacother 1993; 27: 1283-4. less frequently, pruritus, erythema, burning sensation, and 3. Etchason JA, et al. Niacin-induced hepatitis: a potential side effect with irritation. Frequency of application should be reduced if low-dose time-release niacin. Mayo Clin Proc 1991; 66: 23-8. these effects occur. 4. Rader JI, et al. Hepatic toxicity of unmodified and time-release Pharmacokinetics preparations of niacin. Am J Med 1992; 92: 77-8 1. References. 5. Coppola A, et al. Niacin-induced hepatotoxicity: unusual presentations. Nicotinic acid and nicotinamide are readily absorbed from 1. Guyton JR, Bays HE. Safety considerations with niacin therapy. Am 1 South Med 1994; 87: 30-2. 99 1 the gastrointestinal tract after oral doses and widely Cardiol 2007; (suppl 1): S22-S3l. 6. Gavihin JC, et al. Hepatitis inducida por niacina. Med Clin (Bare) 2002; distributed in the body tissues. Nicotinic acid appears in liS: 558. Incidence of adverse effects. Nicotinic acid produces fre 7. Palumbo PJ. Rediscovery of crystalline niacin. MayoClin Proc 1991; 66: breast milk. The main route of metabolism is their quent adverse effects, but they are not usually serious, ll2-l 3. conversion to N-methylnicotinamide and the 2-pyridone tend to decrease with time, and some can be minimised 8. Kreisberg RA. Niacin: a therapeutic dilemma-"one man's drink is and 4-pyridone derivatives; nicotinuric acid is also formed. another's poison". Am 1 Med 1994; 97: 313-16. Small amounts of nicotinic acid and nicotinamide are by following appropriate instructions for use. L2 Dermal 9. McKenney JM, et al. A comparison of the efficacy and toxic effects of and gastrointestinal reactions are most common. Truncal sustained- vs immediate-release niacin in hypercholesterolemic excreted unchanged in urine after therapeutic doses; and facial flushing are reported in 90 to 100% of treated patients. lAMA 1994; 271: 672-7. however the amount excreted unchanged is increased with 10. Gray DR, et a!. Efficacy and safety of controlled-release niacin in patients in large clinical studies; they appear to be prosta larger doses. dyslipoprmeinemic veterans. Ann Intern Med 1994; 121: 252-8. glandin-mediated and can be reduced with aspirin 75 mg ll. Lavie CJ, Milani RV. Safety and side-effects of sustained-release niacin. References. or 325 mg given shortly before the nicotinic acid, or simply lAMA 1994; 272: 513-14. l. Pieper JA. Overview of niacin formulations: differences in pharmaco by giving nicotinic acid with food, and by starting therapy kinetics, efficacy, and safety. Am 1 Health-Syst Phann 2003; 60 (Suppl 2): S9-14. with a low dose and gradually increasing this. It may also Effects on the muscles. Myopathy has been noted with help to avoid eating spicy foods or drinking hot drinks or nicotinic acid. u Rhabdomyolysis has occurred when nico alcohol at the same time as taking nicotinic acid. Flushing tinic acid was given with lovastatin (see Lipid Regulating Human RequirefTients may be less common with modified-release formulations;2 Drugs, under Interactions of Simvastatin, p. 1495.3). How The daily human requirement of nicotinic acid, though not furthermore, an analysis of serious adverse events ever, an analysis of adverse events reported to the FDA definitely known, is probably about 15 to 20 mg. Yeast, reported to the FDA suggested that the incidence of such with a combination of modified-release nicotinic add and meat, fish, potatoes, legumes, and wholemeal cereals are effects (including effects on the liver) with modified lovastatin suggested the incidence was no higher than good sources of nicotinic acid and nicotinamide. However release preparations of nicotinic acid was about one-sixth with either drug alone, see Incidence of Adverse Effects, they may be present in a bound, unabsorbable form in of that with conventional formulations. 3 above. cereals, especially maize. Nicotinic acid can also be obtained 1. Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med l. Litin SC, Anderson CF. Nicotinic-add associated myopathy: a report of from the conversion of tryptophan in the body, 60 mg of 2: three cases. Am J Med 1989; 86: 481-3. Toxicol i987; 10-32. dietary tryptophan being considered equivalent to I mg of 2. American Society of Health-System Pharmacists. ASHP theraPeutic 2. Gharavi AG, etal. Niacin-induced myopathy. Am 1 Cardiol 1994; 74: 841- position statement on the safe use of niacin in the management of 2. dietary nicotinic acid, so requirements are influenced by dyslipidemias. Am 1 Health-Syst Phann 1997; 54: 2815-19. dietary protein intake and if protein intake is adequate there 3. Alsheikh -Ali AA, Karas RH. The safety of niacin in the US Food and Drug Hyperuricaemio. Nicotinic acid decreases urinary excre is little need for any preformed vitamin in the diet. There is Administration adverse event reporting database. Am 1 Cardio/2008; 101 tion of uric acid, which may result in elevation of serum generally little loss of nicotinic acid from foods during (suppl): 9B-13B. uric acid and exacerbation of pre-existing gout. 1 cooking. Effects on theeyes. Retrospective survey of hyperlipidae L American Society of Health-System Pharmacists. ASHP therapeutic position statement on the safe use of niacin in the management of UK and US recommended dietaryintake. In the UK diet mic patients suggested that dry eyes (sicca syndromes), dyslipidemias. Am J Health-Syst Phann 1997; 54: 2815-19. ary reference values (see p. 2046.1) have been published blurred vision, and swollen eyelids might be associated for nicotinic acid1 and in the USA recommended dietary with nicotinic acid therapy in some patients. 1 The effects allowances (RDAs) have been set.2 In the UK the refer appeared to be dose-related and reversible. In 2 patients Precautions ence nutrient intake (RNI) is 6.6 mg niacin equivalent per treatment was stopped because of symptoms suggestive of Liver function should be tested before starting treatment I 000 kcal daily and the estimated average requirement cystoid macular oedema. Other cases of nicotinic acid with nicotinic acid, every 6 to 12 weeks for the first year, (EAR) is 5.5mg niacin equivalent per lOOOkcal daily for maculopathy have been reported. 2•3 and periodically thereafter. A persistent increase in adult males and females. One niacin equivalent is equal to 1. Fraunfelder FW, et a!. Adverse ocular effects associated with niacin transaminases of 3 or more times the upper limit of normal I mg of dietary nicotinic acid or 60 mg of dietary trypto therapy. Br 1 Ophthalmol 1995; 79: 54-6. requires treatment to be stopped. Nicotinic add should not 2. Callanan D, et al. Macular edema associated with nicotinic acid {niacin). phan. In the US the RDAs are also expressed in niacin be used in patients with significant hepatic impairment, and lAMA 1998; 279: 1702. equivalents and are 16 mg daily for adult males and 14 mg 3. Spirn MJ, et a!. Optical coherence tomography findings in nicotinic acid treatment should be closely monitored in those with daily for adult females; the EAR is 12 mg daily in males maculopathy. Am 1 Ophthalmol 2003; 135: 913-14. jaundice or other hepato-biliary disorders. Modified-release and II mg daily in females. The tolerable upper intake preparations should not be substituted for equivalent doses level for adults is 35 mg daily 2 Effects on glucose tolerance. Nicotinic acid can reduce of immediate-release crystalline nicotinic acid preparations, glucose tolerance, and this may be problematic in patients I. DoH. Dietary reference values for food energy and nutrients for the as cases of severe hepatotoxicity, including fulminant United Kingdom: report of the panel on dietary reference values of the 2 with diabetes mellitus, 1• although it has been investigated hepatic necrosis, have occurred. committee on medical aspects of food policy. Report on health and soda/ in the prevention of diabetes mellitus (see p. 2083.2). A Caution is required when using nicotinic acid in patients subjects 41. London: HMSO, 1991. review3 of the effects of nicotinic add on glucose control with active peptic ulcer disease or acute coronary syndrome, 2. Standing Committee on the Scientific Evaluation of Dietary Reference in patients with dyslipidaemia found tbat, although it is Intakes of the Food and Nutrition Board. Dietary Reference Intakes for patients with or predisposed to gout, or in those who thiamin, riboflavin, niadn, vitamin B6t fo late, vitamin B pantothenic acid, 12, recognised that it can increase blood glucose concentra consume large amounts of alcohol. Nicotinic acid and its biotin, and choline. Washington, DC: National Academy Press, 2000. Also tions, the effects were typically minor (about 4 to 5%) metabolites are excreted via the kidneys and caution is available at: http://www .nap.edu/openbook.php?isbn=0309065 542 when given at dally doses of 2.5 g or less. In most patients required in patients with renal impairment. Patients with {accessed 21/07/08) with type 2 diabetes mellitus changes in blood glucose diabetes mellitus should be monitored closely when taking concentrations could be managed by adjusting antidiabetic nicotinic acid as increases in fasting blood glucose have therapy, and the cardiovascular benefits of nicotinic acid occurred. ProprietaryPreparations (details are given in Volume B) treatment might outweigh the risks. Arg.: NB-3; Niaspan; Austral.: I. American Society of Health-System Pharmacists. ASHP therapeutic Porphyria. The Drug Database for Acute Porphyria, com Single-ingredient Preparations. Papulex; Austria: Direktan; Niaspan; Belg.: Ucemine PP; Braz.: position statement on the safe use of niacin in the management of piled by the Norwegian Porphyria Centre (NAPOS) and dyslipidemias. Am 1 Health-Syst Pharm 1997; 54: 2815-19. Acinic; Metri; Papuless; Canad.: Ni-Odan; Niaspan; Chile: Coti the Porphyria Centre Sweden, classifies nicotinic acid as 2. Kreisberg RA. Niacin: a therapeutic dilemma-'one man's drink is na; Niacext; Niaspan; China: Ben Yue pjs:J\i); Gao Zi Ke (/11itt 97: not porphyrinogenic; it may be used as a drug of first another's poison". Am 1 Med 1994; 313-16. 51:);Niaspan Pu Fu Lin Rui Zhi (*�.�); Shu 3. Goldberg RB, Jacobson TA. Effects of niacin on glucose control in (t!l'Z-'1"); (ill'tl;;fi;); choice and no precautions are needed. Nicotinamide is not Cheng (llfPli:); Tian Xin Shuang Fin.: Niaspant; Fr.: patients with dyslipidemia. Mayo Clin Proc 2008; 83: 470-8. (l':®i'!l!:); classified. 1 Niaspant; Nicobion; Papulex; Ger. : Niaspant; Nicobiont; Gr.: The Drug Database for Acute Porphyria. Available at: http://www. Nicotivit; Hong Kong: Niaspan; Nicodnt; India: Neasyn; Nialip; Effects on the liver. Hepatotoxicity may occur with nico l. drugs-porphyria.org (accessed 07/ IO/ll) Nicocin; Indon.: Niacef; Niaspan; Irl. : Niaspan; Nicam; Pel tinic add.1-6 Significant elevations of liver enzymes are zontt; Israel: Niaspan; Ital. : Niaspanor; Mex.: Hipocol; Nacre; occasionally seen with nicotinic add therapy. They are Interactions Niaspan; Pepevitt; Neth.: Niaspant; Norw.: Niaspant; Philipp.: more common in patients given large dosage increases Niaspan; Port.: Niaspan; Rus.: Enduracin (3Hcypau;nn); Vita over short periods of time, and in patients treated with Although some evidence suggests that combinations of Iodurol (BIITa-IIo.rzypoJI); Singapore: Niaspan; Swed. : Niaspant; modified-release formulations. It has been suggested' that nicotinic acid and statins can be given safely (see Incidence Switz.: Niaspant; Thai.: Niaspan; Nicotabs; Turk.: Niascor; Nia since effects on liver function may in some instances lead of Adverse Effects, above), there may be an increased risk of span; UK: Freederm; Niaspant; Nicam; USA: Endur-acin; Niaw to hepatic failure and are more common with modified- myopathy or rhabdomyolysis (see Lipid Regulating Drugs, span; Slo-Niacin; Venez. : Niaspan.
All cross-references refer to entries in Volume A Nicotinic Acid 2085
Multi-ingredient Preparations. Arg.: Anemidox; Atomo Ordena r dor; Centella Asiatica Compuesta; Cordaptive; IP6; Proavenal P.r.�P.�. ?.li().n.�...... Omegatopic; Austral.: Dynamot; Papulex; Sunsense Anti Age ProprietaryPreparations (details are given in Volume B) Austria: Belg.: ing Face; Pelzontt; Tredaptivet; Tredaptivet; Single-ingredient Preparations. Pol.: Fluormex; Port. : Elmex; Trihistalex; Braz.: Cordaptive; Fortevit; Frutoplex; Frutovena; Elm ex. Sadolt; Canad. : Advicort; Formula 7441 t; Formula 7442t; Pharmacopoeias. In Chin., Eur. (see p. vii), Jp n, US, and Viet. Inner Shadet; Lipofactors & Niadnt; Nia-Plex; TBV; Chile: Multi-ingredient Preparations. Austria: Elmex; Elmex; Belg. : Cz.: Fin.: Ger.: US also has a monograph for Racemic Calcium Becomplina Fuertet; Benutrex lOOOt; Cicapost; Effaclar AI; Elmex; Elmex; Elmex; Elmex; Elmex; Elmex; Exomega; Kerium Anticaspa Intensive; Perfungolt; Proaven; Elmex; Ledermix Fluorid; Multifluoridt; Hung.: Elmex; Elmex; Pantothenate. Rodepan; Ureadin Forte; Ureadin Rx PS; Ureadin Rx RD; Israel: Elmex; Elmex; Meridol; Ital. : Elmex; Neth.: Elmex; Ger. also includes Sodium Pantothenate. Elmex; Pol.: Elmex; Fluormex; Switz.: Elmex; Elmex; Para aux China: Kai Yu (l'>\/tu); Cz.: Pelzontt; Tredaptivet; Trevaclynt; Ph. Em. 8: (Calcium Pantothenate). A white or almost fluorures d'amines Gelee. Denm.: Tredaptivet; Fin.: Neurovitant; Vertipamt; Fr.: Actipur white, slightly hygroscopic powder. Freely soluble in water; 3 en l; Actipur Anti-imperfections; Actipur Stop; Dicta; Papu slightly soluble in alcohol. A 5% solution has a of 6.8 to lex; Surelent; Tone; Tredaptivet; Vita-Dermacide; Ger.: Eukali pH 8.0. Store in airtight containers. san Nt; Floradix Eisen-Folsaure; Floradix Krauterblutt; Tredap Ornithine (r!NNI tivet; Gr.: Collyre Vitaphakol; Suprin; Tredaptivet; Vertigo USP 36: (Calcium Pantothenate). The calcium salt of the Vomex; Hong Kong: Tredaptivet; Hung.: Dietet-In; Klimin; dextrorotatory isomer of pantothenic acid. A white, Obesmin; Paniverint; India: Aclin; Acmic; Adifer-Z; Aglozyme; odourless, slightly hygroscopic powder. Soluble I in 3 of Alfariz; Aloederm; Altrazyme; Alvit; Aneudox-12; Aneudox-12; water; practically insoluble in alcohol, in chloroform, and in Atpro; Avas Plus; Avpro; B-12; CB-12; Clin-3; Clinicare; Clin ether; soluble in glycerol. Store in airtight containers. mide; Clinsoft; Diligan; Ecobal; Efcoba Plus; Exomega; Faceclin; USP 36: (Racemic Calcium Pantothenate). A mixture of the Feast; Femcinol-A; Folcin-12 Combi; Folium; Folnet; Folvina; calcium salts of the dextrorotatory and laevorotatory Fortox; Genprot; Globiron-Z; Hepa-Merzt; Hepasure; Hepawin; isomers of pantothenic acid. The physiological activity of Kalzana; L-Bex; Lesstrol-N; Livogen; Livosil-B; Lornit; Mecona Racemic Calcium Pantothenate is about one-half that of Plus; Mego-XL; Mericobal; Methoneuron-C; Methovit; N-Mee dia; Neogadine SG; Neurophosphatest; Neurotrat; Neurotrat; Calcium Pantothenate. A white, slightly hygroscopic Nicinal; Nicolin; Nisacne; Niyat; Nurokind Plus; Nurokind powder, having a faint characteristic odour. Freely soluble More; Nutra; Nutrared; Nutrozyme; Oraflora; Ornipan; Paba in water; practically insoluble in alcohol, in chloroform, and tab-BZ; Sioneuron; Indon.: Baliin Q10; Biocholest; Carni Plus; Ornithine is an aliphatic non -essential amino acid. It is used in ether; soluble in glycerol. Its solutions are neutral or Cereton; Combiplex; Dansera; Dialac; Hemaviton Jreng; as a dietary supplement. alkaline to litmus. Store in airtight containers. Kitolest; Sangobion ActiFe; Sotenst; Tonikum Bayer; Vionin; The aspartate, hydrochloride, and oxoglurate (ornithine Yeastafort; Irl. : Crampex; Effaclar AI; Effico; Quiet Life; Tredap ketoglutarate, see also Parenteral and Enteral Nutrition Uses and Administration tivet; Trevaclynt; Israel: Babyzim; Tredaptivet; Ital. : AMD; under Glutamic Add, p. 2070.3) and phenylacetate have Pantothenic acid is traditionally considered to be a vitamin Disepavit; Emopon; Epargriseovit; Epaviten; Folepar Bl2; Fos been used in various indications including the treatment of B substance. It is a component of coenzyme A which is forilasi; Konorderm; Novostatin; Pineal; PML Crono; Solvobilt; hyperantmonaemia (p. 2049.3) and hepatic encephalo essential in the metabolism of carbohydrate, fat, and Virman Plus; Malaysia: Dermaheal DeAkni; P-Trovite; Mex. : pathy (p. 1808.2). Cordaptive; Mon.: Monasens; Vitarutine; Neth.: Pelzontt; Tre protein. daptivet; Trevaclynt; Norw. : Tredaptivet; NZ: Tredaptivet; References. Deficiency of pantothenic acid is unlikely in man because 1. Rapport L, Lockwood B. Ornithine ketoglutarate. Phann 1 2001; 266: Philipp.: Hiruscar; Jetepar; Tredaptivet; Pol.: Dernilan; Pel of its widespread distribution in food. 688-90. zontt; Tredaptivet; Trevaclynt; Port.: Cicapost; Pelzontt; Tre 2. Coudray-Lucas C, et a!. Ornithine alpha-ketoglutarate improves wound Pantothenic acid has no accepted therapeutic uses in daptivet; Trevaclynt; Ureadin Forte; Rus.: Cytoflavin healing in severe burn patients: a prospective randomized double-blind human medicine, though it has been given orally as a (I{HTo£PnaBHH); Doppelherz Ginseng Aktiv (,[{orrrrenbrepi.t trial versus isonitrogenous controls. Crif Care Med 2000; 28: 1772-6. nutritional supplement, often as the calcium salt and 3. Kircheis G, et al. Clinical efficacy of L-ornithine-L-aspartate in the )J{eHbmeHb AKnm); Essliver Forte (3ccmmep tl>opTe); Lidevine usually with other vitamins of the B group. (JIHAeBHH); Multi-Tabs B-Complex (Mynhru-Ta6c B-KoMruiexc); management of hepatic encephalopathy. Metab Brain Dis 2002; 17: 453- 62. (O l. DoH. Dietary reference values for food energy and nutrients for the United Kingdom: report of the panel on dietary reference values of the committee on medical aspects of food policy. Report on health and social subjects 41. London: HMSO, 1991. 2. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes of the Food and Nutrition Board. Dietary Reference Intakes for thiamin, riboflavin, niacin, vitamin B6, fo late, vitamin B12, pantothenic acid, biotin, and choline. Washington, DC: National Academy Press, 2000. Also available at: http: //www.nap.edu/openbook.php?isbn=030906 5 542 (accessed 21/07/08) P.r.�P.�.r?.li().n.�...... ProprietaryPreparations (details are given in Volume B) Single-ingredient Preparations. Austral.: Pantonatet; Denm.: BiOrto Pantothensyre; Ger. : Kerato Biciron; Mex. : Span Plext; Profile Rus.: Zorex (3opeKc); Switz.: Pantothen. Olaflur is used as a source of fluoride (see Sodium Fluoride, Multi-ingredient Preparations.Arg.: Bifena; Cellskinlab Hydragel p. 2089.2) in the prevention of dental caries. For a report of B5; Cidermex; Culuflex Ht; Garcinia + Fucus; Guarana Diatest; stomatitis considered to be due to olaflur, see Hypersensi Hairplus; Megaplus; Triconal; Valcatil Max; Valcatil Plus; Valeri tivity, under Sodium Fluoride, p. 2091.1. ana Relax Diatest; Austral.: Bio ACE Excell; Bio ACE; Otrivin The symbol t denotes a preparation no longer actively marketed