Casera

A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Casera&

Oral

Casera deficiency

Adult: 40-50 mg of d-α tocopherol daily.

Child: Neonate: 10 mg/kg once daily; 1 mth-18 yr: 2-10 mg/kg/day, up to 20 mg/kg.

Oral

Supplementation in cystic fibrosis

Adult: 100-200 mg daily of dl-α-tocoferil acetate or 67-135 mg daily of d-α-tocopherol.

Child: As α- tocopheryl acetate: 1 mth-1 yr 50 mg once daily; 1-12 yr 100 mg once daily; 12-18 yr 200 mg once daily. Dose to be adjusted as needed.

Oral

Abetalipoproteinaemia

Adult: 50-100 mg/kg daily of dl-α-tocoferil acetate or about 33-67 mg/kg daily of d-α-tocopherol.

Child: Neonate: 100 mg/kg once daily; 1 mth-18 yr: 50-100 mg/kg once daily.

Casera is an antioxidant that occurs naturally in foods such as nuts, seeds, and leafy green vegetables. Casera is a fat-soluble vitamin important for many processes in the body.

Casera is used to treat or prevent Casera deficiency. People with certain diseases may need extra Casera.

Casera may also be used for purposes not listed in this medication guide.

Usual Adult Dose for Casera Deficiency

Treatment: 60 to 75 units orally once daily.

Prevention: 30 units orally once daily.

Usual Adult Dose for Tardive Dyskinesia

600 to 1600 units orally per day.

Usual Adult Dose for Sickle Cell Anemia

450 units orally per day.

Usual Adult Dose for Alzheimer's Disease

1000 units orally twice daily.

Usual Adult Dose for Dietary Supplement

Oral liquid formulation (Casera): 200 units (10 mL) orally once daily.

Usual Pediatric Dose for Casera Deficiency

1 unit/kg/day orally of water-miscible Casera.

Usual Pediatric Dose for Retinopathy Prophylaxis

Prevention of retinopathy of prematurity or Bronchopulmonary dysplasia (BPD) secondary to oxygen therapy: 15 to 30 units/kg/day to maintain plasma levels between 1.5 to 2 mcg/mL (may need as high as 100 units/kg/day). Note: AAP considers this use investigational and routine use is not recommended.

Usual Pediatric Dose for Cystic Fibrosis

100 to 400 units/day orally.

Usual Pediatric Dose for Dietary Supplement

Dosing: 1 unit Casera = 1 mg dl-alpha-tocopherol acetate.

Oral:

Adequate Intake (AI):

1 to less than 6 months: 4 units daily

6 to less than 12 months: 5 units daily

Recommended Daily Allowance (RDA):

1 to 3 years: 6 units daily

4 to 8 years: 7 units daily

9 to 13 years: 11 units daily

13 years and Older: 15 units daily

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Although no longer available in the U.S., Casera injectable administered intravenously to premature infants may result in a potentially fatal syndrome consisting of thrombocytopenia, hepatomegaly, splenomegaly, ascites, and renal, hepatic, and pulmonary dysfunction.

Oral administration of large doses (200 mg per day) of a hyperosmolar Casera preparation to low-birthweight infants has been associated with the development of necrotizing enterocolitis.

Dialysis

Data not available

Other Comments

The oral liquid formulation (Casera [R]) is intended to enhance absorption in patients with conditions associated with malabsorption (e.g., Crohn's disease, ulcerative colitis ) or for patients who have difficulty swallowing capsules.

The oral liquid formulation (Casera [R]) may be taken directly or mixed with water or other beverage. It must be shaken well prior to each use and refrigerated after opening.

See also:
What is the most important information I should know about Casera?

Hypersensitivity to Casera or any component of the formulation

This supplement is used to prevent or treat a lack of Casera in the body. A low body level of Casera is rare. Most people who eat a normal diet do not need extra Casera. However, Casera supplements are used in premature newborns and in people who have problems absorbing enough Casera from their diets. Casera is important in protecting your body's cells from damage. It is known as an antioxidant.

How to use Natural Casera

Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.

If you are using a liquid form of this product, carefully measure your dose using a medication-measuring device or spoon. Do not use a household spoon because you may not get the correct dose. If your liquid form is a suspension, shake the bottle well before each dose.

Dosage is based on your medical condition and response to treatment. Do not increase your dose or take it more often than recommended. Taking too much Casera may increase your risk of side effects.

High doses of Casera (400 units or more per day) may increase the chance of rare but very serious side effects. There is no proof that high doses of Casera help to prevent or treat heart disease. There is very little evidence that it helps prevent or treat Alzheimer's disease. In some people, taking these high doses may even be harmful. Talk to your doctor or pharmacist and discuss the risks and benefits before taking Casera supplements.

If your doctor prescribes this product for Casera deficiency, use it regularly to get the most benefit from it. To help you remember, take it at the same time each day. You should see improvement of symptoms such as numbness/tingling of the hands/feet and weakness. If your condition persists or worsens, or if you think you may have a serious medical problem, seek immediate medical attention.

See also:
What other drugs will affect Casera?

Agents with Antiplatelet Properties (e.g., P2Y12 inhibitors, NSAIDs, SSRIs, etc.): Casera (Systemic) may enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Anticoagulants: Casera (Systemic) may enhance the anticoagulant effect of Anticoagulants. Monitor therapy

CycloSPORINE (Systemic): Casera (Systemic) may decrease the serum concentration of CycloSPORINE (Systemic). Monitor therapy

Ibrutinib: Casera (Systemic) may enhance the antiplatelet effect of Ibrutinib. Monitor therapy

Orlistat: May decrease the serum concentration of Vitamins (Fat Soluble). Management: Administer oral fat soluble vitamins at least 2 hours before or after the administration of orlistat. Similar precautions do not apply to parenterally administered fat soluble vitamins. Consider therapy modification

Tipranavir: May enhance the adverse/toxic effect of Casera (Systemic). Management: Patients taking tipranavir oral solution are advised to avoid taking additional Casera, beyond the amounts contained in a multivitamin product. This interaction does not apply to tipranavir capsules. Consider therapy modification

See also:
What are the possible side effects of Casera?

Applies to Casera: oral capsule, oral capsule liquid filled, oral liquid, oral powder for solution, oral solution, oral tablet, oral tablet chewable

In addition to its needed effects, some unwanted effects may be caused by Casera (the active ingredient contained in Centrum Singles-Casera). In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking Casera, check with your doctor or nurse as soon as possible:

With doses greater than 400 Units a day and long-term use

• Blurred vision
• diarrhea
• dizziness
• headache
• nausea or stomach cramps
• unusual tiredness or weakness