Actipro

Each 5 mL syrup contains: Diastase (1:50) 135 mg, pepsin 50 mg, papain BPC 50 mg, vitamin B₁ 5 mg, vitamin B₂ 2 mg, vitamin B₆ 2 mg, vitamin B₁₂ 5 mcg, calcium pantothenate 1 mg and nicotinamide 20 mg.

Iron (Actipro) is a pleasantly flavoured syrup, containing digestive enzymes and vitamins of the B-complex group. Abdominal cramps, flatulence, heartburn and nausea can occur as a result of indigestion. Iron (Actipro) is the ideal cure to facilitate digestion and to strengthen the GIT.

Iron (Actipro)'s balanced formulation provides an ideal supplementation that meets the demands and replenishes vitamins stores in the body.

Each capsule contains synthetic retinol concentrate (powder form) 5000 IU, cholecalciferol 1000 IU, thiamine nitrate 10 mg, riboflavin 10 mg, pyridoxine hydrochloride 3 mg, α-tocopheryl acetate 15 mg, nicotinamide 50 mg, ascorbic acid 75 mg, biotin 0.25 mg, cyanocobalamin 15 mcg, folic acid 1.5 mg, calcium pantothenate 50 mg, heavy magnesium oxide 60 mg, manganese sulphate monohydrate 2.5 mg, copper sulphate pentahydrate 3.92 mg, zinc sulphate 27.45 mg, sodium molybdate dihydrate 0.25 mg, sodium borate 0.88 mg, potassium iodate 0.175 mg, sodium selenite 0.11 mg, chromium sulphate 1.377 mg, cobaltous chloride 0.22 mcg, nickel sulphate 13.2 mcg, stannous chloride dihydrate 17.5 mcg, sodium metavanadate 46.42 mcg and calcium hydrogen phosphate 75 mg.

Nestlé Protein (Actipro) is a nutritionally complete oral supplement specially formulated for older adults to help support immune function and recovery. Protein (Actipro) contains high quality Protein (Actipro), a heart-healthy fat blend and a moderate level of carbohydrates. It contains prebiotic fibers, probiotics and high amounts of specific micronutrients (vitamin E, folate, vitamin B6) which have been shown to have beneficial effects on gut microflora and/or immune function.

Nestlé Protein (Actipro) is a nutritionally complete, isocaloric (1 kCal/mL) and balanced enteral diet food replacement or food supplement which meets 100% of US RDAs for all essential vitamins, minerals and Protein (Actipro) in only 2000 kCal.

Nestlé Protein (Actipro) is a nutritionally complete, balanced and isotonic diet intended for both enteral tube feeding and oral supplementation for patients requiring enteral nutrition support. Nestlé Protein (Actipro) provides total nutritional need for short- or long-term feeding of patients with normal or near normal gastrointestinal function, for the prevention and correction of malnutrition.

Special Characteristics: The unique blend of Protein (Actipro) in Nestlé Protein (Actipro) (50% whey Protein (Actipro) and 50% casein) is high in nutritional value and easily digested and well tolerated.

Protein (Actipro) source is 50% whey Protein (Actipro) which enhances tolerance for patients with delayed gastric emptying due to their disease process (neurologically-impaired and diabetics), and reduce the risk of aspiration.

Essential amino acid requirements are fulfilled with this Protein (Actipro) source and this blend has a high biological value with a chemical score of >100% of the Food and Agriculture Organization (FAO)/World Health Organization (WHO) standard (1997).

Nestlé Protein (Actipro) meets 100% of US RDAs for all essential vitamins, minerals and Protein (Actipro) in only 1500 kCal which is important for patients with limited mobility and reduced energy requirements eg, the elderly or those with strokes.

Two thousand (2000) mL of Nestlé Protein (Actipro) contains Protein (Actipro) 80 g (16% of total calories) which enhances healing and anabolism of patients.

Nestlé Protein (Actipro) provides a heart-healthy blend of fatty acids; it is low in saturated fatty acids (SFA), trans fatty acids and cholesterol, high in monounsaturated fatty acids (MUFA), and has a low ω-6:ω-3 ratio (5.4:1). Fat profile which meets the American Heart Association (2006) and American Diabetes Association (2008) guidelines.

Nestlé Protein (Actipro) contains complex carbohydrate at the moderate level [maltodextrin, sucrose, fructooligosaccharides (FOS) and inulin (fiber)] which helps in reducing risk of hyperglycemia and contributes to the low osmolality of Protein (Actipro).

Protein (Actipro) contains Prebio 1, a fiber blend compromised of FOS 70% and inulin 30%.

FOS and inulin fibers have been reported to increase fecal bifidobacteria counts, support bowel regularity and reduce inflammation.

Protein (Actipro) contains the probiotic 1 billion cfu/500 kCal Lactobacillus paracasei NCC 2461 (ST11) which has been found to survive the gastrointestinal tract. It has positive effects on immune function, and also appears to protect against bacterial-related diarrhea.

Protein (Actipro) provides supplemental vitamin E. Supplementation with vitamin E ≥60 mg/day appears to have a positive immune benefit in elderly individuals.

Isotonic osmolality of water 340 mOsmol/kg (osmolarity is 300 mOsmol/L) allows Nestlé Protein (Actipro) to be initiated at full strength and eliminates the risk of osmotic diarrhea and high osmotic intolerance.

Nestlé Protein (Actipro) provides appropriate level of all essential vitamins and minerals for the nutritionally-compromised tube- and oral-fed patients, including additional amounts of vitamins A, D, folic acid, biotin.

Nestlé Protein (Actipro) added ultra trace minerals to assure optimum nutrition, particularly for those individuals on extended feeding. It provides additional levels of calcium, phosphorous, magnesium, iodine, potassium, chromium, molybdenum and selenium.

Protein (Actipro) contains the artificial sweetening agent acesulfame potassium (28 mg/55 g serving) and nature-identical vanilla flavour.

Nestlé Protein (Actipro) is easy to dissolve and mix and thus, can be reconstituted at higher caloric densities, 1.5 kCal/mL and 2 kCal/mL. This provides a reliable technique for the clinician to meet the fluid-restricted or volume-sensitive patient's energy requirements in a limited volume. It minimizes preparation time and reduces risk of clogging tubes.

To maintain the probiotic activity, ensure water temperature has cooled down to 45°C or below before adding the powder.

Nestlé Protein (Actipro) contains only readily digested nutrients to assure a minimum residue.

Cholesterol-Free: Minimizes hyperlipidemia and arteriosclerosis.

Lactose-Free: Minimizes diarrhea and other side effects of lactose intolerance.

Gluten-free.

See Tables 1 and 2.

Film-Coated Tablet: Treatment of Iron (Actipro) deficiency. Prevention of Iron (Actipro) deficiency during pregnancy.

Syrup: All cases of Iron (Actipro) deficiency and Iron (Actipro) deficiency anaemia.

Drops: General: Hypochromic or masked Iron (Actipro) deficiency anaemias. General weakness. Convalescence. Blood losses. Tropical microcytic anaemia. Anaemias due to infections. For maintenance therapy in pernicious anaemia. As an adjuvant in treating chronically ill or undernourished patients.

Women: Iron (Actipro) deficiency due to menstruation. During and after pregnancy and lactation. Menorrhagia.

Children: All types of hypochromic anaemias and masked Iron (Actipro) deficiencies. Inappetence. Retarded growth. Weakness. Unsound dietary habits. To speed up restoration of depleted Iron (Actipro) reserves.

Phosphorus is a naturally occurring substance that is important in every cell in the body. The majority of phosphorus in the body is found in the bones. The potassium and sodium salt forms of phosphorus are called phosphates.

Potassium phosphate and sodium phosphate is used to acidify the urine and lower the urinary calcium concentration. This may reduce rash and odor caused by ammonium in the urine. Potassium phosphate and sodium phosphate may also increase the antibiotic effect of methenamine (Hiprex, Urex). Potassium phosphate and sodium phosphate is also used as a phosphorus supplement to prevent and/or treat a phosphorus deficiency.

Multivitamins (Actipro) is indicated for the distinct nutritional requirements of patients in need of folate and Vitamin D supplementation as determined by a licensed medical practitioner.

Multivitamins (Actipro) should be administered under the supervision of a licensed medical practitioner.

Nestlé Protein (Actipro) can be used as a full liquid diet or liquid supplement. It can be fed orally or by tubes (eg, nasogastric, nasoduodenal and nasojejunal feeding tubes) for paediatric patients with GI compromise eg, patients with critical illness eg, trauma, surgery, burns, GI surgery, pancreatitis, Protein (Actipro)-energy malnutrition, hypoalbuminaemia, chronic diarrhea, short bowel syndrome, HIV/AIDS, cystic fibrosis, Crohn's disease, elevated gastric residuals, oncology and radiation enteritis. Many paediatric patients experience malabsorption, diarrhea, GI tract atrophy and organ dysfunction. Enteral diets containing peptides have been associated with better Protein (Actipro) absorption, nitrogen retention and utilization, and better maintenance of the GI integrity, and better GI tolerance when compared with free amino acid or intact Protein (Actipro) diets.

hypoproteinaemia

Supplementing Iron (Actipro) in the diet and treating or preventing low levels of Iron (Actipro) in the blood. It may also be used for other conditions as determined by your doctor.

Iron (Actipro) is a mineral. It works by providing Iron (Actipro) to the body.

Multivitamins (Actipro) are a combination of many different vitamins that are normally found in foods and other natural sources.

Multivitamins (Actipro) are used to provide vitamins that are not taken in through the diet. Multivitamins (Actipro) are also used to treat vitamin deficiencies (lack of vitamins) caused by illness, pregnancy, poor nutrition, digestive disorders, and many other conditions.

Multivitamins (Actipro) may also be used for other purposes not listed in this medication guide.

Film-Coated Tablet: Treatment of Iron (Actipro) Deficiency with Reduced Number of Red Blood Cells in Adults and Children over 12 Years: 1 to 3 tablets once daily or divided into separate doses for about 3 to 5 months.

After normalisation of the red blood pigment (haemoglobin) value, continue with 1 tablet once daily for several weeks. This will replenish the Iron (Actipro) stores.

Treatment of Iron (Actipro) Deficiency with Reduced Number of Red Blood Cells in Pregnancy: 2 to 3 tablets once daily or divided into separate doses.

After normalisation of the red blood pigment value, continue with 1 tablet once daily until, at least, the end of pregnancy. This will replenish the Iron (Actipro) stores and provide the increased amount of Iron (Actipro) required during pregnancy.

Treatment of Iron (Actipro) Deficiency with Normal Number of Red Blood Cells in Adults, Pregnancy, and Children over 12 years, and Prevention of Iron (Actipro) Deficiency in Pregnancy: 1 tablet once daily for 1 to 2 months.

Syrup:

Children: 5 mL 1 to 2 times daily before meals.

Infants: Begin with 2.5 mL daily and gradually increase to 5 mL daily.

Drops: Adults: 20 drops 2 to 3 times daily during or after a meal.

Children: 20 drops 1 to 2 times daily during or after a meal.

Infants: Begin with 6 drops daily and gradually increase to 20 drops daily.

Iron (Actipro) may be mixed with fruit, vegetable juices or other liquids if desired.

Best results are obtained by adequate dosage and regular administration. It is recommended that the therapy in conformity to the degree of Iron (Actipro) deficiency should be continued for at least 1 to 2 months.

Administration: Take Iron (Actipro) during or immediately after meal.

Duration of use depends upon the degree of Iron (Actipro) deficiency.

Do not discontinue sooner than recommended as this may reduce the success of therapy.

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule,

Oral:

Generic: Folic acid 1 mg, cyanocobalamin 400 mcg, and pyridoxine hydrochloride 50 mg

Tablet,

Oral:

Airavite: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Av-VITE FB: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

CenFol: Folic acid 2.3 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 24.5 mg

Multivitamins (Actipro): Folic acid 2.2 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Folbee: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg [dye free, lactose free, and sugar free]

Folbic: Folic acid 2.5 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 25 mg

Folgard RX: Folic acid 2.2 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Folplex 2.2: Folic acid 2.2 mg, cyanocobalamin 500 mcg, and pyridoxine hydrochloride 25 mg

Foltabs 800: Folic acid 0.8 mg, cyanocobalamin 115 mcg, and pyridoxine hydrochloride 10 mg [gluten free]

Homocysteine Formula: Folic acid 0.8 mg, cyanocobalamin 100 mcg, and pyridoxine hydrochloride 50 mg

Multivitamins (Actipro): Folic acid 2.5 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 25 mg [DSC]

NuFol: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Virt-Gard: Folic acid 2.2 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Virt-Vite: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg [DSC]

Virt-Vite Forte: Folic acid 2.5 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 25 mg [DSC]

Vita-Respa: Folic acid 2.2 mg, cyanocobalamin 1300 mcg, and pyridoxine hydrochloride 25 mg [dye free and sugar free] [DSC]

Generic: Folic acid 0.5 mg, cyanocobalamin 200 mcg, pyridoxine hydrochloride 5 mg; Folic acid 0.8 mg, cyanocobalamin 100 mcg, and pyridoxine hydrochloride 50 mg; Folic acid 2.2 mg, cyanocobalamin 500 mcg, and pyridoxine hydrochloride 25 mg; Folic acid 2.5 mg, cyanocobalamin 200 mcg, and pyridoxine hydrochloride 25 mg

Dosing: Adult

Dietary supplement:

Oral: One tablet daily

Dosing: Geriatric

Refer to adult dosing.

To prepare a 230-mL feeding, put 195 mL of cooled or cold water in a glass. Gradually add 6 level scoops (scoop enclosed) or 53.5 g of powder, while stirring and mix until dissolved. When mixed as directed, Protein (Actipro) provides approximately 1 calorie/mL. A 1-kg can of powder yields approximately 18½ of 230-mL servings.

1 Serving size: 230 calories/230 mL when mixed as directed.

Tube Feeding or Sole Source of Nutrition: Follow physician's or dietitian's directions. When starting tube feeding, the flow rate, volume and dilution are dependent on patient's condition and tolerance. Care should be taken to avoid contamination of Protein (Actipro) during preparation and administration.

See also:
What is the most important information I should know about Iron (Actipro)?

All cases of Iron (Actipro) overload and disturbances in utilization of Iron (Actipro).

Film-Coated Tablet: Allergy to Iron (Actipro) (III)-hydroxide polymaltose complex or any of the other ingredients of Iron (Actipro).

An Iron (Actipro) overload in the body.

Disturbed use of Iron (Actipro) by the body.

Reduced number of red blood cells (anaemia), not caused by Iron (Actipro) deficiency, such as due to increased red blood cell breakdown, vitamin B₁₂ deficiency.

You cannot take potassium phosphate and sodium phosphate if you have

high levels of potassium in your body,

high levels of phosphorus in your body,

infected phosphate stones, or

severe kidney disease.

See also:
What is the most important information I should know about Multivitamins (Actipro)?

Known hypersensitivity to any of the ingredients of Multivitamins (Actipro).

Intolerance to any of the ingredients of Protein (Actipro).

Use Iron (Actipro) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Iron (Actipro) is absorbed better on an empty stomach but may be taken with food if it upsets your stomach. Some foods (eg, eggs, whole grain breads, cereal, dairy products, coffee, tea) may decrease the amount of Iron (Actipro) absorbed by your body. Talk with your doctor about the best way to take Iron (Actipro) with food if it upsets your stomach.
• Shake well before using.
• Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
• Take Iron (Actipro) with a full glass (8 oz [240 mL]) of water.
• Do not lie down for 30 minutes after taking Iron (Actipro).
• If you take an antacid, a bisphosphonate (eg, alendronate), cefdinir, eltrombopag, methyldopa, penicillamine, a quinolone antibiotic (eg, ciprofloxacin), or a tetracycline (eg, minocycline), ask your doctor or pharmacist how to take it with Iron (Actipro).
• If you miss a dose of Iron (Actipro), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Iron (Actipro).

Use Multivitamins (Actipro) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Multivitamins (Actipro) by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• If you are also taking eltrombopag, a quinolone antibiotic (eg, levofloxacin), or a tetracycline antibiotic (eg, doxycycline), ask your doctor how you should take it with Multivitamins (Actipro).
• If you miss a dose of Multivitamins (Actipro), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Multivitamins (Actipro).

This medication is a multivitamin product used to treat or prevent vitamin deficiency due to poor diet, certain illnesses, or during pregnancy. Vitamins are important building blocks of the body and help keep you in good health.

How to use Multivitamins (Actipro)

Take this medication by mouth, usually once daily or as directed. Follow all directions on the product package, or take as directed by your doctor. Do not take more than the recommended dosage. If you are uncertain about any of the information, consult your doctor or pharmacist.

Use a medication-measuring device to carefully measure the prescribed dose. Do not use a household spoon. If your liquid is a suspension, shake the bottle well before each dose.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.

Drug interactions were not noted and were not studied in clinical studies.

Feridex I.V. (ferumoxides injectable solution) administration provides elemental Iron (Actipro). In patients who are receiving supplemental Iron (Actipro) orally or parenterally, the dose of supplemental Iron (Actipro) may need to be decreased.

The effect of concomitant parenteral Iron (Actipro) on Feridex I.V. dosing is not known.

Laboratory Test Findings

Serum Iron (Actipro) levels may be above the normal range following Feridex I.V. (ferumoxides injectable solution) administration. Transient increases in serum Iron (Actipro) of 15–100% of baseline were observed 18 to 24 hours after Feridex I.V. (ferumoxides injectable solution) administration, and returned to normal in most patients by 7 days after administration. Increases in serum ferritin levels were seen 1 to 7 days after administration.

In a Phase 1 study in normal subjects, PTT was statistically significantly increased; however, all values were within the normal range and no subjects had a more than 40% increase from baseline. In clinical trials of patients who had baseline hematologic abnormalities associated with underlying liver disease, an effect of Feridex I.V. (ferumoxides injectable solution) on platelet or PTT was not demonstrated. In patients with low hematocrit and hemoglobin, over a period of 48 hours to 7 days after Feridex I.V. (ferumoxides injectable solution), the serum Iron (Actipro), the hematocrit and hemoglobin levels increase slightly.

Do not take antacids containing aluminum, calcium, or magnesium while taking potassium phosphate and sodium phosphate, except under the supervision of your doctor. Antacids may decrease phosphate absorption.

Before taking potassium phosphate and sodium phosphate, tell your doctor if you are taking any of the following medicines

calcium and/or vitamin D supplements;

potassium supplements or salt substitutes;

a diuretic (water pill) such as triamterene (Dyrenium, Dyazide, Maxzide), spironolactone (Aldactone), or amiloride (Midamor);

a heart medication such as guanethidine (Ismelin), diazoxide (Hyperstat, Proglycem), hydralazine (Apresoline), methyldopa (Aldomet), or reserpine (Ser-Ap-Es); or

a steroid medicine such as corticotropin (ACTH, Acthar), cortisone (Cortone), hydrocortisone (Cortef, others), prednisone (Orasone, Deltasone, others), prednisolone (Prelone, Pediapred, Delta-Cortef, others), methylprednisolone (Medrol, others), triamcinolone (Aristocort, Kenalog, Tri-Kort, Trilog, others), dexamethasone (Decadron), or betamethasone (Celestone).

You may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with potassium phosphate and sodium phosphate. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

See also:
What other drugs will affect Multivitamins (Actipro)?

Treatment with Levodopa for Parkinson is not recommended when taking Multivitamins (Actipro)

See also:
What are the possible side effects of Iron (Actipro)?

Applies to carbonyl Iron (Actipro): suspension

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; darkened or green stools; diarrhea; loss of appetite; nausea; stomach cramps, pain, or upset; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur while taking carbonyl Iron (Actipro):

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or tarry stools; blood or streaks of blood in the stool; fever; severe or persistent nausea, stomach pain, or vomiting; vomit that looks like blood or coffee grounds.

Stop taking potassium phosphate and sodium phosphate and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Other, less serious side effects may also to occur. Nausea, vomiting, stomach pain, and diarrhea are among the most common. These side effects usually lessen after a few days of therapy. Notify your doctor if you develop these side effects.

If you have kidney stones, there is a possibility that you will pass old stones after starting treatment with potassium phosphate and sodium phosphate.

Less commonly, the following side effects have been reported:

headache;

dizziness or confusion;

weakness or heaviness of the legs;

diarrhea;

seizures;

unusual tiredness or weakness;

muscle cramps;

numbness, tingling, pain, or weakness of the hands or feet;

swelling of the feet or lower legs;

unusual weight gain;

increased thirst;

decreased urine; or

bone or joint pain.

Notify your doctor if you develop any of the side effects listed above.

See also:
What are the possible side effects of Multivitamins (Actipro)?

Nausea, stomach upset, diarrhea, drowsiness, flushing, and numbness/tingling may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

If your doctor has prescribed this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes, unusual weakness.

A very serious allergic reaction to this product is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.