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# MYERS COCKTAIL IV INFUSION

## Clinical Purpose

The Myer's Cocktail IV is a foundational micronutrient infusion designed to restore cellular energy, support immunity, reduce fatigue, and promote metabolic balance. It combines vitamins, minerals, and coenzymes delivered intravenously for optimal absorption and bioavailability.

## MYER'S MAKE UP (can vary from different pharmacies)

- VITAMIN C (ASCORBIC ACID) 500MG/ML
- MAGNESIUM SULPHATE 500MG/ML
- THIAMINE (B1) 100MG/ML
- RIBOFLAVIN-5-PHOSPHATE (B2) 2MG/ML
- NIACINAMIDE (B3) 100MG/ML
- DEXPANTHENOL (B5) 250MG/ML
- PYRIDOXINE (B6) 100MG/ML
- METHYLCOBALAMIN (B12) 1MG/ML
- CALCIUM GLUCONATE 100MG/ML

Please adhere to Standard Wellness Dose per your dose reference guide

💧 **Diluent:** 500ml Hartmann's Sodium Chloride

🕒 **Infusion Time:** 30–45 minutes (slow IV drip)

## Contraindications / Cautions

⚠

- Known hypersensitivity to any ingredient
- Severe renal impairment or acute dehydration
- Uncontrolled hypertension or arrhythmia
- Pregnancy or breastfeeding (safety data limited)
- G6PD deficiency (use caution with high-dose Vitamin C)

## Potential Side Effects

🩺

- Transient warmth or flushing (from Magnesium/Niacinamide)
- Metallic taste or mild nausea
- Localised vein irritation (rare)
- Dizziness or hypotension if infused too rapidly

**Management:** Slow or stop infusion immediately if symptomatic. Monitor BP and HR. Provide reassurance and maintain observation for 15 minutes post-infusion.

## Frequency

⏱

- **Initial Phase:** Weekly for 4–6 weeks
- **Maintenance:** Every 2–4 weeks depending on client needs

## Mechanism of Action

🧠

The Myer's Cocktail replenishes key cellular cofactors (B-vitamins and magnesium) required for the Krebs cycle, promoting ATP production, neurotransmitter balance, and immune system function. Vitamin C and Niacinamide enhance redox balance and NAD⁺ synthesis, improving fatigue and recovery.

## Compliance Statement

🧾

This protocol aligns with TGA & AHPRA professional communication guidelines and IV Therapy Academy Australia clinical governance standards. Use only under the direction of an authorised prescriber within scope of practice.

## Australian Injectable Drugs Handbook

**VITAMIN C (ASCORBIC ACID)** - See Vitamin C

**MAGNESIUM SULPHATE** - See Magnesium Sulphate

### THIAMINE (B1)

**STABILITY**

Store below 25 °C. Protect from light.1,2

Nil Incompatibility

**REFERENCES**

1. Product information. Available from www.tga.gov.au. Accessed 07/11/2024.
2. Thiamine Sterop. Product information. North Sydney: Boucher & Muir Pty Ltd. Approved 10/07/2024.
3. Water-soluble vitamin deficiencies [June 2023]. In: Therapeutic Guidelines [internet]. Melbourne: Therapeutic Guidelines Limited; June 2024.
4. Latt N, Dore G. Thiamine in the treatment of Wernicke encephalopathy in patients with alcohol use disorders. Intern Med J 2014; 44: 911-5.
5. ASHP Injectable drug information 2021. Bethesda, MD: American Society of Health-System Pharmacists; 2021.
6. Paediatric Formulary Committee. BNF for children. London: BMJ group and Pharmaceutical Press; 2024.
7. Thiamine hydrochloride. In: IV Index [internet]. Trissel's 2 clinical pharmaceutics database (parenteral compatibility) Greenwood Village, CO: IBM Watson Health. Accessed 08/08/2022.

### DEXPANTHENOL (B5)

No Data on Dexpanthenol in AIDH

### PYRIDOXINE (B6)

**STABILITY**

Store below 25 °C. Protect from light. Do not refrigerate or freeze.1

No Incompatibility

**REFERENCES**

1. Australian product information. Braeside, VIC: Biological Therapies. Updated 27/04/2020. Accessed 22/03/2023.
2. Kerr S. pH of injectable products [email]. Braeside, Vic: Biological Therapies; 18/01/2023.
3. Isoniazid poisoning [August 2020]. In: Therapeutic Guidelines [internet]. Melbourne: Therapeutic Guidelines Limited; August 2022.
4. Lexicomp pediatric and neonatal dosage handbook. 29th ed. Hudson, OH: UpToDate Inc; 2022-2023.
5. Pyridoxine hydrochloride. In: IV index [internet]. Trissel's 2 clinical pharmaceutics database (parenteral compatibility). Ann Arbour, MI: Merative. Accessed 11/02/2023

### METHYLCOBALAMIN (B12)

See Methylcobalamin B12

### CALCIUM GLUCONATE

**STABILITY**

Vial: store below 30 °C. Do not refrigerate.1

Infusion solution: complete the infusion within 24 hours.1

No Incompatibility with other compounds

**REFERENCES**

1. Product information. Available from www.tga.gov.au. Accessed 29/01/2024.
2. ASHP Injectable drug information 2021. Bethesda, MD: American Society of Health-System Pharmacists; 2021.
3. Electrolyte abnormalities [March 2021]. In Therapeutic Guidelines [internet]. Melbourne: Therapeutic Guidelines Limited; June 2023.
4. Hypocalcaemia [August 2022]. In: Therapeutic Guidelines [internet]. Melbourne: Therapeutic Guidelines Limited; June 2023.
5. Phelps SJ, Hagemann TM, Lee KR, Thompson AJ. Pediatric injectable drugs. The teddy bear book. 11th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2018.
6. Medical information. Plasma-Lyte 148 compatibility summary. Toongabbie, NSW: Baxter; March2022.
7. Trissel LA, Leissing NC. Trissel's Tables of physical compatibility. Lake Forest IL: Multimatrix; 1996.
8. Calcium gluconate. In: IV index [internet]. Trissel's 2 clinical pharmaceutics database (parenteral compatibility). Ann Arbour, MI: Merative. Accessed 09/05/2023.
9. Trissel LA. Handbook on injectable drugs. 16th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2011.

### RIBOFLAVIN-5-PHOSPHATE (B2)

No Data on Riboflavin-5-Phosphate in AIDH

### NIACINAMIDE (B3)

No Data on Niacinamide in AIDH

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