MVI (multivitamin)
Formal Definition
MVI — a standard medical abbreviation for "multivitamin" (or "multiple vitamin infusion" when referring to IV formulations added to TPN), commonly used in inpatient medication orders as a standing daily oral vitamin supplement or as part of total parenteral nutrition (TPN) admixtures; oral MVIs typically include essential vitamins A, B-complex (thiamine, riboflavin, niacin, B6, B12, folate), C, D, E, K, with iron often separate; IV multivitamin formulations standardized for TPN add specific doses per liter of solution.
How It's Used on the Ward
"MVI" — what gets ordered daily for inpatients on PO diets as a routine vitamin supplement, often reflexively with the admission orders; "MVI with iron" — combined formulation; the TPN pharmacy often adds IV multivitamin solution (MVI-12 or MVI-13) to parenteral nutrition admixtures per protocol.
Example
""Routine admission orders for a 58-year-old with pneumonia and poor PO intake awaiting dietary consult: 'MVI PO daily, folic acid 1 mg PO daily, thiamine 100 mg PO daily (given with MVI to avoid Wernicke's encephalopathy in malnourished patient given glucose).' Pharmacy: standard MVI 1 tab PO QAM; thiamine available as separate tablet to dose more aggressively. Dietitian supplemented with protein-calorie recommendations; PO advanced and MVI continued at home post-discharge.""
Clinical Context
Common scenarios for MVI: (1) Chronic alcohol use disorder — thiamine, folate, B12 deficiency common; MVI given prophylactically with thiamine (especially before any glucose-containing fluids to prevent precipitating Wernicke's). (2) Poor nutritional intake, malnutrition. (3) Eating disorders. (4) Pregnancy (with iron; specifically formulated prenatal MVI with folate). (5) Post-bariatric surgery (lifelong specialized formulations). (6) Cystic fibrosis with pancreatic insufficiency (fat-soluble vitamin replacement). (7) Long-term TPN (IV multivitamin in admixture). Caution with vitamin K and anticoagulation: high-dose vitamin K in MVI can affect warfarin dosing; some formulations are MVI without vitamin K for patients on warfarin. Thiamine should be given before glucose in at-risk patients (alcoholics, malnutrition) to avoid precipitating Wernicke's encephalopathy; thiamine is not stored in the body and is depleted quickly. "Standing MVI" orders are common but not always evidence-based in well-nourished patients with normal PO intake.