Ocoxin

An essential amino acid that is physiologically active in the L-form. [PubChem]

Each tablet contains Ascorbic acid (Ocoxin) 500 mg.

Ascorbic acid (Ocoxin) (Ascorbic acid (Ocoxin)) is a vitamin that is freely soluble in water. The superior formulation of Ascorbic acid (Ocoxin) (Ascorbic acid (Ocoxin)) assures substantial amounts per dose for prophylaxis and treatment of Ascorbic acid (Ocoxin) deficiencies. This preparation has a very delectable grape (Ascorbic acid (Ocoxin) Tablet) flavors.

A thiol-containing non-essential amino acid that is oxidized to form cystine. [PubChem]

Each 5 mL of syrup contains Zinc sulfate (Ocoxin) monohydrate 55 mg (equivalent to elemental zinc 20 mg).

Each mL of oral drops contains Zinc sulfate (Ocoxin) monohydrate 27.5 mg (equivalent to elemental zinc 10 mg).

Arginine (Ocoxin)® 10 is indicated as an intravenous stimulant to the pituitary for the release of

human growth hormone in patients where the measurement of pituitary reserve for HGH

can be of diagnostic usefulness. It can be used as a diagnostic aid in such conditions as

panhypopituitarism, pituitary dwarfism, chromophobe adenoma, postsurgical

craniopharyngioma, hypophysectomy, pituitary trauma, acromegaly, gigantism and

problems of growth and stature.

If the insulin hypoglycemia test has indicated a deficiency of pituitary reserve for HGH, a

test with Arginine (Ocoxin)® 10 is advisable to confirm the negative response. This can be done

after a waiting period of one day. As patients may not respond to Arginine (Ocoxin)® 10 (10%

Arginine (Ocoxin) Hydrochloride Injection, USP) during the first test, the unresponsive patient should be tested again to confirm the negative result. A second test can be performed

after a waiting period of one day. Some patients who respond to Arginine (Ocoxin)® 10 do not

respond to insulin and vice versa. The rate of false positive responses for Arginine (Ocoxin)® 10 is

approximately 32%, and the rate of false negatives is approximately 27%.

For systemic use of Ascorbic acid (Ocoxin) Atlantic Laboratories: prevention and treatment of hypo- and avitaminosis of Ascorbic acid (Ocoxin); providing increased need for Ascorbic acid (Ocoxin) during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.

For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.

Cysteine (Ocoxin) deficiency

Antioxidant Dietary supplement.

Oral

Zinc deficiency

Adult: 50 mg of elemental zinc tid.

Intravenous

Zinc deficiency

Adult: 6.5 mg elemental zinc (100 micromoles) daily.

Ophthalmic

Minor eye irritation

Adult: In combination with a vasoconstrictor, 1-2 drops are instilled into the eye 2-4 times daily.

Incompatibility: Mixing sodium borate, glycerin and methylcellulose with Zinc sulfate (Ocoxin) may cause preciptation.

Arginine (Ocoxin) injection is used to assess the function of the pituitary gland. It stimulates the pituitary gland to produce growth hormone for the diagnosis of certain conditions.

Arginine (Ocoxin) is to be given only by or under the direct supervision of your doctor.

Ascorbic acid (Ocoxin) (Ascorbic acid (Ocoxin)) occurs naturally in foods such as citrus fruit, tomatoes, potatoes, and leafy vegetables. Ascorbic acid (Ocoxin) is important for bones and connective tissues, muscles, and blood vessels. Ascorbic acid (Ocoxin) also helps the body absorb iron, which is needed for red blood cell production.

Ascorbic acid (Ocoxin) is used to treat and prevent Ascorbic acid (Ocoxin) deficiency.

Ascorbic acid (Ocoxin) may also be used for purposes not listed in this medication guide.

Cysteine (Ocoxin) injection is used to meet the nutritional requirements of newborn infants (including preterm babies) requiring total parenteral nutrition (TPN).

Cysteine (Ocoxin) injection is also given to adults and children with severe liver disease who may have impaired enzymatic processes and require TPN. Cysteine (Ocoxin) may be also used to provide a more complete profile of amino acids for protein synthesis.

Cysteine (Ocoxin) is to be given only by or under the direct supervision of your doctor.

The use of Green tea (Ocoxin) in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

Green tea (Ocoxin) is also known as Camellia sinensis.

Green tea (Ocoxin) has been used for stomach disorders, vomiting, diarrhea, to prevent dental cavities, to lower cholesterol levels, as an antioxidant, to reduce cancer, and as a stimulant.

Green tea (Ocoxin) has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of Green tea (Ocoxin) may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Green tea (Ocoxin) may also have uses other than those listed in this product guide.

Green tea (Ocoxin) has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of Green tea (Ocoxin) may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Zinc is a naturally occurring mineral. Zinc is important for growth and for the development and health of body tissues.

Zinc sulfate (Ocoxin) is used to treat and to prevent zinc deficiency.

Zinc sulfate (Ocoxin) may also be used for purposes not listed in this medication guide.

Adult Dosage

The recommended adult dose is 30 g Arginine (Ocoxin) hydrochloride (300 mL of Arginine (Ocoxin)) administered by intravenous infusion over 30 minutes. The total dose should not exceed 30 g Arginine (Ocoxin) hydrochloride. See Directions for Use for preparation instructions.

Pediatric Dosage

The recommended pediatric dose is 0.5 g/kg Arginine (Ocoxin) hydrochloride (5 mL/kg of Arginine (Ocoxin)) administered by intravenous infusion over 30 minutes. The total dose should not exceed 30 g Arginine (Ocoxin) hydrochloride.

• For patients weighing 59 kg or less, withdraw a weight based dose from a sealed Arginine (Ocoxin) bottle and place in a separate container for intravenous infusion to avoid the inadvertent delivery and administration of the total volume from the commercially available container. See Directions for Use for preparation instructions.
• For patients weighing 60 kg or more, the recommended dose is 30 g Arginine (Ocoxin) hydrochloride (300 mL of Arginine (Ocoxin)). See Directions for Use for preparation instructions

Test Procedure

The intravenous infusion of Arginine (Ocoxin) is a part of the test for measurement of pituitary reserve of human growth hormone and, for successful administration of the test, clinical conditions and procedures should be as follows:

1. The test should be scheduled in the morning following a normal night's sleep, and an overnight fast should continue through the test period.
2. Patients must be placed at bed rest for at least 30 minutes before the infusion begins. Care should be taken to minimize apprehension and distress. This is particularly important in children.
3. Arginine (Ocoxin) (Arginine (Ocoxin) Hydrochloride Injection, USP) is a hypertonic solution and should only be infused through an indwelling needle or soft catheter placed in an antecubital vein or other suitable vein. Blood samples should be taken by venipuncture from the contra-lateral arm.
4. A desirable schedule for drawing blood samples is at −30, 0, 30, 60, 90, 120 and 150 minutes.
5. Arginine (Ocoxin) should be infused beginning at zero time at a uniform rate which will permit the recommended dose to be administered over 30 minutes.
6. Blood samples should be promptly centrifuged and the plasma stored at −20°C until assayed by one of the published radioimmunoassay procedures.
7. Diagnostic test results showing a deficiency of pituitary reserve for HGH should be confirmed by a second test with Arginine (Ocoxin), or one may elect to confirm with the insulin hypoglycemia test. A waiting period of one day is advised between tests.

Directions for Use

Arginine (Ocoxin) is provided as a ready-to-use solution for patients weighing 60 kg (132 lbs) or more and should not be further diluted. For pediatric patients weighing 59 kg (130 lbs) or less a dose must be placed in a separate container. Follow the preparation instructions below.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.

For Pediatric Patients weighing 59 kg (130 lbs) or less

Withdraw a weight-based dose from an intact sealed bottle of Arginine (Ocoxin). The entire 300 mL bottle of Arginine (Ocoxin) for infusion is not intended for use in patients weighing 59 kg or less. The dose must be placed in a separate container, such as an evacuated sterile glass container designed for intravenous administration, using aseptic technique.

Additionally, Arginine (Ocoxin) is stable in polypropylene syringes and plastic containers made of either polyvinyl chloride (PVC) or ethylene vinyl acetate (EVA).

The post-penetration storage period is not more than 4 hours including infusion time at room temperature or 24 hours at refrigerated temperature (2-8°C).

The healthcare professional administering the dose should verify the accuracy of the dose prior to administration.

Use only if the solution is clear. Discard any unused drug product.

For Adults and Pediatric Patients weighing 60kg (132 lbs) or more

Follow these directions using aseptic technique. As Arginine (Ocoxin) for intravenous use is provided in glass containers, a standard air-inletting, air-filtering intravenous infusion set with a bacterial air filter is required.

1. Use only if solution is clear and seal is intact. Carefully examine bottle for evidence of damage, e.g., small cracks, dents in seal, or areas of dried powder on exterior. Do not administer contents if such damage is found.
2. Remove plastic flip off lid from bottle to expose rubber stopper, taking care that you do not contaminate the target site of the stopper with fingers, hair, clothing, etc. Immediately perform step #3.
3. With shut-off clamp closed, remove sterility protector from spike of administration set and immediately insert set with a quick thrust into center of stopper with bottle upright on table. (Push straight in — don't twist — twisting may cause stopper coring.)
4. Promptly invert bottle to automatically establish fluid level in drip chamber and to check for vacuum by observing rising filtered air bubbles. Discard bottle if there is no vacuum or if the solution is not clear.
5. Clear tubing of air. Proceed with infusion.

Important Preparation and Administration Instructions

• Ascorbic acid (Ocoxin) vials contain 25, 000 mg of Ascorbic acid (Ocoxin) and the largest recommended single dose is 200 mg. Do not give the entire contents of the vial to a single patient.
• Do not administer Ascorbic acid (Ocoxin) as an undiluted intravenous sensitive.
• Minimize exposure to light because Ascorbic acid (Ocoxin) is light sensitive.
• Ascorbic acid (Ocoxin) is supplied as a Pharmacy Bulk Package (PBP) which is intended for dispensing of single doses to multiple patients in a pharmacy admixture program and is restricted to the preparation of admixtures for infusion:

a. Use only in a suitable ISO Class 5 work area such as a laminar flow hood (or an equivalent clean air compounding area)

b. Penetrate each PBP vial closure only one time with a suitable sterile transfer device or dispensing set that allows measured dispensing of the contents. Given that pressure may develop within the vial during storage, excercise caution when withdrawing contents from the vial.

c. Once the closure system has been penetrated, complete all dispensing from the PBP vial within 4 hours. Each dose must be used immediately. Discard unused portion.

d. Prior to administration, Ascorbic acid (Ocoxin) must be diluted in a suitable infusion solution and the final solution for infusion must be isotonic (undiluted the osmolarity of Ascorbic acid (Ocoxin) is approximately 5,900 mOsmol/L). Prior to preparing the admixture for infusion, calculate the osmolarity of the intended admixture for infusion. Add one daily dose of Ascorbic acid (Ocoxin) directly to an appropriate volume of a suitable infusion solution (e.g., 5% Dextrose Injection, Sterile Water for Injection) and add appropriate solutes, as necessary, to make final solution isotonic. Sterile Water for Injection is highly hypotonic; adjust solute content, as necessary, to make thet final infusion solution isotonic prior to injection. Do not mix Ascorbic acid (Ocoxin) with solutions containing elemental compounds that can be reduced (e.g., copper). The concentration of Ascorbic acid (Ocoxin) in the final, admixture solution for infusion is to be the range of 1 to 25 mg of Ascorbic acid (Ocoxin) per mL. For example, for the largest recommended dose:

Add 200 mg of Ascorbic acid (Ocoxin) (equivalent to 0.4 mL of Ascorbic acid (Ocoxin)) to 7.5 mL of Sterile Water for Injection to produce an infusion solution having an approximate osmolarity of 290 mOsmol/L. In this specific example, addition of solute is NOT necessary because the solution is isotonic.

e. Prepare the recommended dose based on the patient population [ see Dosage and Administration (2.2), (2.3)].

f. Visually inspect for particulate matter and discoloration prior to administration (the diluted Ascorbic acid (Ocoxin) solution should appear colorless to pale yellow).

g. Immediately administer the admixture for infusion as a slow intravenous infusion [ see Recommended Dosage, (2.2)]

Recommended Dosage

Table 1 provides recommended doses of Ascorbic acid (Ocoxin) based on patient population and infusion rates of diluted Ascorbic acid (Ocoxin) solution.

The recommended maximum duration of daily treatment with Ascorbic acid (Ocoxin) is seven days. If no improvement in scorbutic symptoms is observed after one week of treatment, retreat until resolution of scorbutic symptoms is observed.

Repeat dosing is not recommended in pediatric patients less than 11 years of age.

Dosage Reductions in Specific Populations

Women who are pregnant or lactating and patients with glucose-6-dehydrogenase deficiency should not exceed the U.S. Recommended Dietary Allowance (RDA) or daily Adequate Intake (AI) level for Ascorbic acid (Ocoxin) for their age group and condition [ ​ see Warnings and Precautions (5.2) and Use in Specific Populations (8.1, 8.2)].

Dosage Forms

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

Capsule,

Oral [preservative free]:

Cystech: 500 mg [dye free]

Solution,

Intravenous, as hydrochloride:

Generic: 50 mg/mL (10 mL [DSC], 50 mL [DSC])

Solution,

Intravenous, as hydrochloride [preservative free]:

Elcys: 50 mg/mL (10 mL)

Dosing: Adult

Note: Correct severe fluid, electrolyte, and acid-base disorders prior to administration. Cysteine (Ocoxin) dose is based on recommended daily protein (as amino acid) requirement.

Component of parenteral nutrition: Elcys only: IV:

Maintenance (stable patients): 0.8 to 1 g amino acids/kg/day; 7 mg Cysteine (Ocoxin) hydrochloride/g amino acids (equivalent to 5 mg Cysteine (Ocoxin)/g amino acids).

Severe stress level (critically-ill patients): 1.5 to 2 g amino acids/kg/day; 7 mg Cysteine (Ocoxin) hydrochloride/g amino acids (equivalent to 5 mg Cysteine (Ocoxin)/g amino acids).

Dosing: Pediatric

Parenteral nutrition additive:

ASPEN Recommendations: Infants: IV: 30 to 40 mg of Cysteine (Ocoxin) hydrochloride per gram of amino acids; a dose as low as 20 mg of Cysteine (Ocoxin) hydrochloride per gram of amino acids may be adequate and should be used in times of Cysteine (Ocoxin) shortage (ASPEN [Corkins 2015]; Plogsted 2015); current practice suggests supplementation should be continued through the first year of life; practice varies widely (ASPEN [Corkins 2015]; ASPEN [Mirtallo 2004]); consult institution-specific policies.

Product-specific dosing:

L-Cysteine (Ocoxin): Infants: IV: 40 mg Cysteine (Ocoxin) hydrochloride per gram of amino acids.

Elcys:

Infants and Children ≤11 years: IV: 22 mg Cysteine (Ocoxin) hydrochloride per gram of amino acids.

Children ≥12 years and Adolescents: IV: 7 mg Cysteine (Ocoxin) per gram of amino acids.

Usual Adult Dose for Dietary Supplement

Recommended Dietary Allowance (RDA)-expressed as elemental zinc:

19 years and older:

Male: 11 mg (Upper intake limit: 34 mg)

Female: 9 mg (Upper intake limit: 34 mg)

Pregnancy: 11 mg (Upper intake limit: 40 mg)

Lactation: 12 mg (Upper intake limit: 40 mg)

Zinc sulfate (Ocoxin) injection: IV:

Metabolically stable adults receiving TPN: 2.5 to 4 mg zinc/day

Acute catabolic states on TPN: Additional 2 mg zinc per day is recommended.

Stable adult with fluid loss from the small bowel: Additional 12.2 mg zinc/liter of small bowel fluid lost, or an additional 17.1 mg zinc/kg of stool or ileostomy output is recommended.

Usual Pediatric Dose for Dietary Supplement

Recommended Dietary Allowance (RDA)-expressed as elemental zinc:

0 to 6 months:

Male: 2 mg (Upper intake limit: 4 mg)

Female: 2 mg (Upper intake limit: 4 mg)

7 to 12 months:

Male: 3 mg (Upper intake limit: 5 mg)

Female: 3 mg (Upper intake limit: 5 mg)

1 to 3 years:

Male: 3 mg (Upper intake limit: 7 mg)

Female: 3 mg (Upper intake limit: 7 mg)

4 to 8 years:

Male: 5 mg (Upper intake limit: 12 mg)

Female: 5 mg (Upper intake limit: 12 mg)

9 to 13 years:

Male: 8 mg (Upper intake limit: 23 mg)

Female: 8 mg (Upper intake limit: 23 mg)

14 to 18 years:

Male: 11 mg (Upper intake limit: 34 mg)

Female: 9 mg (Upper intake limit: 34 mg)

Pregnancy: 12 mg (Upper intake limit: 40 mg)

Lactation: 13 mg (Upper intake limit: 40 mg)

Zinc sulfate (Ocoxin) injection: IV:

Full term infants and children up to 5 years of age: 100 mcg zinc/kg/day is recommended.

Premature infants (birth weight less than 1500 g) up to 3 kg in body weight: 300 mcg zinc/kg/day is recommended.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.

Dialysis

Data not available

Other Comments

Zinc sulfate (Ocoxin) may be taken with food if stomach upset occurs.

Quinolone or tetracycline antibiotics should be taken 1 hour before or 4 to 6 hours after taking zinc.

Zinc can reduce the absorption and action of penicillamine. Zinc supplements should be taken at least 2 hours before or after taking penicillamine.

Thiazide diuretics increase urinary zinc excretion by as much as 60%. Prolonged use of thiazide diuretics could deplete zinc tissue levels, so healthcare providers should monitor zinc status in patients taking these medications.

Frequent monitoring of zinc blood levels is recommended for TPN patients receiving more than the usual maintenance dosage level of zinc.

Supplemental Arginine (Ocoxin) is contraindicated in those with the rare genetic disorder argininemia. It is also contraindicated in those hypersensitive to any component of an Arginine (Ocoxin)-containing preparation.

See also:
What is the most important information I should know about Ascorbic acid (Ocoxin)?

There are no contraindications to the administration of Ascorbic acid (Ocoxin).

Known hypersensitivity to one or more amino acids or any component of the formulation

L-Cysteine (Ocoxin) (generic): Additional contraindications: Hepatic coma; metabolic disorders involving impaired nitrogen utilization

Elcys: Additional contraindications: Inborn errors of amino acid metabolism; pulmonary edema or acidosis due to low cardiac output

See also:
What is the most important information I should know about Zinc sulfate (Ocoxin)?

Zinc sulfate (Ocoxin) insulin is contraindicated in cats sensitive to protamine zinc recombinant human insulin or any other ingredients in the Zinc sulfate (Ocoxin) product. Zinc sulfate (Ocoxin) insulin is contraindicated during episodes of hypoglycemia.

Use Ascorbic acid (Ocoxin) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Ascorbic acid (Ocoxin) may be taken with or without food.
• You may drop the dose of Ascorbic acid (Ocoxin) directly into your mouth or mix it with cereal, milk, or water.
• Take Ascorbic acid (Ocoxin) with a full glass of water (8 oz/240 mL). Do not lie down for 30 minutes after taking Ascorbic acid (Ocoxin).
• Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
• If you miss a dose of Ascorbic acid (Ocoxin), 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 Ascorbic acid (Ocoxin).

Use Green tea (Ocoxin) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Dosing depends on the use and the source of the product.
• Use as directed on the package, unless instructed otherwise by your doctor.
• If you miss taking a dose of Green tea (Ocoxin) for 1 or more days, there is no cause for concern. If your doctor recommended that you take it, try to remember your dose every day.

Ask your health care provider any questions you may have about how to use Green tea (Ocoxin).

Use Zinc sulfate (Ocoxin) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Zinc sulfate (Ocoxin) by mouth with a meal.
• Avoid taking Zinc sulfate (Ocoxin) at the same time as foods that contain bran, calcium, or phosphorus. They may decrease the amount of Zinc sulfate (Ocoxin) absorbed into the body.
• If you take eltrombopag, a quinolone antibiotic (eg, levofloxacin), or a tetracycline antibiotic (eg, doxycycline), ask your doctor or pharmacist how to take it with Zinc sulfate (Ocoxin).
• If you miss a dose of Zinc sulfate (Ocoxin), 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 Zinc sulfate (Ocoxin).

Use: Labeled Indications

Diagnostic aid: As an intravenous (IV) stimulant to the pituitary for the release of human growth hormone (hGH) in patients in whom the measurement of pituitary reserve for hGH can be of diagnostic usefulness. Used as a diagnostic aid in such conditions as panhypopituitarism, pituitary dwarfism, chromophobe adenoma, postsurgical craniopharyngioma, hypophysectomy, pituitary trauma, acromegaly, gigantism, and problems of growth and stature.

Off Label Uses

Hyperammonemia (acute) associated with urea cycle disorders

Data from an uncontrolled open-label study conducted over a 25 year period supports the use of intravenous Arginine (Ocoxin) (in combination with sodium benzoate, sodium phenylacetate and adequate caloric provision) for the treatment of acute hyperammonemia associated with urea-cycle disorders resulting in increased survival.

Based on the National Organization for Rare Disorders, the use of Arginine (Ocoxin) is effective and recommended for the management of patients with this condition.

Oral products available in the US are often marketed as dietary supplements. When using these products, patients should take care to ensure that they are receiving pharmaceutical grade supplements of Arginine (Ocoxin) and verify the formulation (free base vs Arginine (Ocoxin) HCl). The National Urea Cycle Disorders Foundation cautions against using oral dietary supplements of Arginine (Ocoxin) HCl (National Urea Cycles Disorder Foundation).

Ascorbic acid (Ocoxin) (Ascorbic acid (Ocoxin)) is used to prevent or treat low levels of Ascorbic acid (Ocoxin) in people who do not get enough of the vitamin from their diets. Most people who eat a normal diet do not need extra Ascorbic acid (Ocoxin). Low levels of Ascorbic acid (Ocoxin) can result in a condition called scurvy. Scurvy may cause symptoms such as rash, muscle weakness, joint pain, tiredness, or tooth loss.

Ascorbic acid (Ocoxin) plays an important role in the body. It is needed to maintain the health of skin, cartilage, teeth, bone, and blood vessels. It is also used to protect your body's cells from damage. It is known as an antioxidant.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This vitamin may also be used with other vitamins for a certain eye condition (macular degeneration).

How to use Ascorbic acid (Ocoxin)

Take this vitamin by mouth with or without food, usually 1 to 2 times daily. Follow all directions on the product package, or take as directed by your doctor.

If you are taking the extended-release capsules, swallow them whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Take this product with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise.

If you are taking the wafers or chewable tablets, chew them thoroughly and then swallow. If you are taking the lozenges, place the lozenge in your mouth and allow it to slowly dissolve.

If you are taking the powder, mix it thoroughly in the proper amount of liquid and stir well. Drink all of the liquid right away. Do not prepare a supply for future use. If you are using the liquid form of this vitamin, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

Dosage is based on your medical condition and response to treatment.

Use this vitamin regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

If you think you may have a serious medical problem, seek immediate medical attention.

Use: Labeled Indications

Component of parenteral nutrition: Additive to amino acid solutions to meet the nutritional requirements of the following patients requiring parenteral nutrition: Infants (L-Cysteine (Ocoxin) [generic] and Elcys) or adult and pediatric patients with severe liver disease who may have impaired enzymatic processes (Elcys only).

This medication is a mineral used to treat or prevent low levels of zinc.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to promote wound healing.

How to use Zinc sulfate (Ocoxin)

Take this medication by mouth as directed by your doctor or on the package.

Take this medication 1 hour before or 2 hours after meals. May be taken with food if it upsets your stomach. Best to swallow whole. Do not crush or chew.

Avoid milk, bran, grains, or cereals within 2 hours of taking this medicine.

Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day.

Cyclosporine - Arginine (Ocoxin) may counteract the antinaturetic effect of cyclosporin. Ibuprofen - Arginine (Ocoxin) may increase the absorption of ibuprofen if taken concomitantly. Organic nitrates - Arginine (Ocoxin) supplements theoretically may potentiate the effects of organic nitrates if taken concomitantly. Sildenafil citrate - Theoretically, Arginine (Ocoxin) supplements taken concomitantly with sildenafil citrate, may potentiate the effects of the drug.

See also:
What other drugs will affect Ascorbic acid (Ocoxin)?

In an application with barbiturates, primidone increases the excretion of Ascorbic acid (Ocoxin) in the urine.

With the simultaneous use of oral contraceptives reduces the concentration of Ascorbic acid (Ocoxin) in blood plasma.

In an application of Rhea Ascorbic acid (Ocoxin) with iron preparations Ascorbic acid (Ocoxin), due to its regenerative properties, transforms ferric iron in the bivalent, which improves its absorption.

Ascorbic acid (Ocoxin) in high doses can decrease urine pH that while the application reduces the tubular reabsorption of amphetamine and tricyclic antidepressants.

With the simultaneous use of aspirin reduces the absorption of Ascorbic acid (Ocoxin) by about a third.

Rhea Ascorbic acid (Ocoxin) in an application with warfarin may decrease effects of warfarin.

With the simultaneous application of Ascorbic acid (Ocoxin) increases the excretion of iron in patients receiving deferoxamine. In the application of Ascorbic acid (Ocoxin) at a dose of 500 mg / day possibly left ventricular dysfunction.

In an application with tetracycline is increased excretion of Ascorbic acid (Ocoxin) in the urine.

There is a described case of reducing the concentration of fluphenazine in plasma in patients treated with Ascorbic acid (Ocoxin) 500 mg 2 times / day.

May increase the concentration of ethinyl estradiol in the blood plasma in its simultaneous application in the oral contraceptives.

May increase zinc absorption. Ascorbic acid may inhibit the oxidation of L-Cysteine (Ocoxin) to L-cystine.

Lab Interference:

Produce a false-positive result in the nitroprusside test for ketone bodies used in diabetes & suspected hepatocellular injury.

See also:
What other drugs will affect Zinc sulfate (Ocoxin)?

Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Avoid combination

Bictegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Bictegravir. Management: Administer bictegravir under fasting conditions at least 2 hours before or 6 hours after polyvalent cation containing products. Coadministration of bictegravir with or 2 hours after most polyvalent cation products is not recommended. Consider therapy modification

Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Exceptions: Pamidronate; Zoledronic Acid. Consider therapy modification

Ceftibuten: Zinc Salts may decrease the serum concentration of Ceftibuten. Management: Consider administering oral zinc salts at least 3 hours after ceftibuten. Consider therapy modification

Cephalexin: Zinc Salts may decrease the absorption of Cephalexin. Management: Consider administering oral zinc salts at least 3 hours after cephalexin. Consider therapy modification

Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Consider therapy modification

Dolutegravir: Zinc Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral zinc salts. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral zinc salts. Consider therapy modification

Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Consider therapy modification

Elvitegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Elvitegravir. Management: Administer elvitegravir 2 hours before or 6 hours after the administration of polyvalent cation containing products. Consider therapy modification

PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Consider therapy modification

Quinolones: Zinc Salts may decrease the serum concentration of Quinolones. Management: Give oral quinolones at least several hours before (4 h for moxi- and sparfloxacin, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome-, 3 h for gemi-, and 2 h for levo-, nor-, pe- or ofloxacin or nalidixic acid) oral zinc salts. Exceptions: LevoFLOXacin (Oral Inhalation). Consider therapy modification

Raltegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Raltegravir. Management: Administer raltegravir 2 hours before or 6 hours after administration of the polyvalent cations. Dose separation may not adequately minimize the significance of this interaction. Consider therapy modification

Tetracyclines: Zinc Salts may decrease the absorption of Tetracyclines. Only a concern when both products are administered orally. Management: Consider doxycycline as a noninteracting tetracycline derivative. Separate dose administration of oral tetracycline derivative and oral zinc salts by at least 2 hours to minimize interaction. Exceptions: Doxycycline; Eravacycline. Consider therapy modification

Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour. Consider therapy modification

See also:
What are the possible side effects of Arginine (Ocoxin)?

Adverse reactions associated with 1670 infusions in premarketing studies were as follows:

Non-specific side effects consisting of nausea, vomiting, headache, flushing, numbness and local venous irritation were reported in approximately 3% of the patients.

One patient had an allergic reaction which was manifested as a confluent macular rash with reddening and swelling of the hands and face. The rash subsided rapidly after the infusion was terminated and 50 mg of diphenhydramine were administered. One patient had an apparent decrease in platelet count from 150,000 to 60,000. One patient with a history of acrocyanosis had an exacerbation of this condition following infusion of Arginine (Ocoxin).

Post Marketing Experience

The following adverse events have been reported during post-marketing use: extravasation leading to burn-like reaction and/or skin necrosis requiring surgical intervention, hypersensitivity reactions including anaphylaxis, and hematuria that in some cases occurred 1–2 days after an Arginine (Ocoxin) administration. Because these adverse events are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

See also:
What are the possible side effects of Ascorbic acid (Ocoxin)?

Applies to Ascorbic acid (Ocoxin): oral capsule, oral capsule extended release, oral capsule liquid filled, oral granule, oral liquid, oral lozenge/troche, oral powder, oral powder for solution, oral powder for suspension, oral solution, oral syrup, oral tablet, oral tablet chewable, oral tablet extended release, oral wafer

In addition to its needed effects, some unwanted effects may be caused by Ascorbic acid (Ocoxin) (the active ingredient contained in Ascorbic acid (Ocoxin)). 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 Ascorbic acid (Ocoxin), check with your doctor or nurse as soon as possible:

Less common or rare: - with high doses

• Side or lower back pain

Minor Side Effects

Some of the side effects that can occur with Ascorbic acid (Ocoxin) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common or rare: - with high doses

• Diarrhea
• dizziness or faintness (with the injection only)
• flushing or redness of skin
• headache
• increase in urination (mild)
• nausea or vomiting
• stomach cramps

See also:
What are the possible side effects of Cysteine (Ocoxin)?

May increase zinc absorption. Ascorbic acid may inhibit the oxidation of L-Cysteine (Ocoxin) to L-cystine.

See also:
What are the possible side effects of Green tea (Ocoxin)?

Symptoms of GIT upset may occur rarely as heartburn and

hyperacidity.

See also:
What are the possible side effects of Zinc sulfate (Ocoxin)?

Effectiveness Field Study

In a 45-day effectiveness field study, 176 cats received Zinc sulfate (Ocoxin) insulin. Hypoglycemia (defined as a blood glucose value of < 50 mg/dL) occurred in 71 of the cats at various times throughout the study. Clinical signs of hypoglycemia were generally mild in nature (described as lethargic, sluggish, weak, trembling, uncoordinated, groggy, glassy-eyed or dazed). In 17 cases, the veterinarian provided oral glucose supplementation or food as treatment. Most cases were not associated with clinical signs and received no treatment. One cat had a serious hypoglycemic event associated with stupor, lateral recumbency, hypothermia and seizures. All cases of hypoglycemia resolved with appropriate therapy and if needed, a dose reduction.

Three cats had injection site reactions which were described as either small, punctate, red lesions; lesions on neck; or palpable subcutaneous thickening. All injection site reactions resolved without cessation of therapy.

Four cats developed diabetic neuropathy during the study as evidenced by plantigrade stance. Three cats entered the study with plantigrade stance, one of which resolved by Day 45. Four cats were diagnosed with diabetic ketoacidosis during the study. Two were euthanized due to poor response to treatment. Five other cats were euthanized during the study, one of which had hypoglycemia. Four cats had received Zinc sulfate (Ocoxin) insulin for less than a week and were euthanized due to worsening concurrent medical conditions.

The following additional clinical observations or diagnoses were reported in cats during the effectiveness field study: vomiting, lethargy, diarrhea, cystitis/hematuria, upper respiratory infection, dry coat, hair loss, ocular discharge, abnormal vocalization, black stool, and rapid breathing.

Extended Use Field Study

Cats that completed the effectiveness study were enrolled into an extended use field study. In this study, 145 cats received Zinc sulfate (Ocoxin) insulin for up to an additional 136 days. Adverse reactions were similar to those reported during the 45-day effectiveness study and are listed in order of decreasing frequency: vomiting, hypoglycemia, anorexia/poor appetite, diarrhea, lethargy, cystitis/hematuria, and weakness. Twenty cats had signs consistent with hypoglycemia described as: sluggish, lethargic, unsteady, wobbly, seizures, trembling, or dazed. Most of these were treated by the owner or veterinarian with oral glucose supplementation or food; others received intravenous glucose. One cat had a serious hypoglycemic event associated with seizures and blindness. The cat fully recovered after supportive therapy and finished the study. All cases of hypoglycemia resolved with appropriate therapy and if needed, a dose reduction.

Fourteen cats died or were euthanized during the extended use study. In two cases, continued use of insulin despite anorexia and signs of hypoglycemia contributed to the deaths. In one case, the owner decided not to continue therapy after a presumed episode of hypoglycemia. The rest were due to concurrent medical conditions or worsening of the diabetes mellitus.

To report suspected adverse reactions, or to obtain a copy of the Material Safety Data Sheet (MSDS), call 1-866-638-2226.