High doses of individual components of this product have been associated with eczematous and exanthematous skin lesions, fatigue and insomnia. In high doses of pyridoxine, sensory neuropathy and vesicular skin lesions have been reported. In higher doses of niacinamide, liver damage, gout and ulcer formation have been noted. Vasodilatory effects such as giddiness, faintness, vasovagal attacks and anaphylactic shock have also been reported. Hemolysis has been reported at high ascorbic acid doses, especially in patients with glucose-6-phosphate dehydrogenase deficiency.