Valcatil Plus

Cystine (Valcatil Plus) deficiency

Hemostasis

Gelatin (Valcatil Plus) Sterile Powder, saturated with sterile sodium chloride solution, is indicated in surgical procedures, including those involving cancellous bone bleeding, as a hemostatic device, when control of capillary, venous, and arteriolar bleeding by pressure, ligature, and other conventional procedures is either ineffective or impractical. Although not necessary, Gelatin (Valcatil Plus) can be used either with or without thrombin to obtain hemostasis.

Directions For Use

Gelatin (Valcatil Plus) Sterile Powder can be saturated with sterile, isotonic sodium chloride solution (sterile saline) or a solution of thrombin, before use as an adjunct to hemostasis. The envelope of Gelatin (Valcatil Plus) Sterile Powder should be opened and the contents (1 gram) poured carefully into a sterile beaker, avoiding contamination. Using sterile technique, a puttylike paste is prepared by adding a total of approximately 3-4 mL of sterile saline or thrombin solution1 to the Gelatin (Valcatil Plus). If a mixture of less viscosity is desired, 7-10 mL of sterile saline or thrombin solution may be utilized. Dispersion of the powder can be avoided by initially compressing it with the gloved fingers into the bottom of the beaker and then kneading it into the desired consistency. The resulting doughy paste may be smeared or pressed against the bleeding surface to control bleeding. When bleeding stops the excess should be removed.

Use only the minimum amount of Gelatin (Valcatil Plus), necessary to produce hemostasis. The Gelatin (Valcatil Plus) may be left in place at the bleeding site, when necessary. Since Gelatin (Valcatil Plus) causes little more cellular reaction than does the blood clot, the wound may be closed over it. Gelatin (Valcatil Plus) may be left in place when applied to mucosal surfaces until it liquefies. For use with thrombin, consult the thrombin insert for complete prescribing information and proper sample preparation.

It is used to make the urine more acidic. Making the urine more acidic helps to relieve skin irritation in incontinent (loss of bladder control) adults and diaper rash in infants. This medicine also helps to control strong urine odor.

Coenzyme A (metabolite of dexpanthenol) is important for deep penetrating moisturizer; stimulates epithelization; has wound healing effect; has an anti-inflammatory effect.

Only the D-Panthenol is the provitamin of D-Pantothenic acid (Vitamin B5 (Valcatil Plus)), not the L-Panthenol.

A cream with dexpanthenol regularly applied to the skin improves the moisture content of dry skin significantly.

A cream with 5% dexpanthenol accelerates the healing of superficial wounds by approximately 30%.

An ointment with dexpanthenol prevents erythema due to UV light.

Dexpanthenol ointment also protects the lips against solar herpes, Sun burns, mild burns, skin irritations, dry or cracked skin, cosmetic or shaving rashes, post chemical peeling treatment, post laser resurfacing treatment ( 11th -15th day).

Dexpanthenol is effective for preventing / treating nappy dermatitis in infants.

* Sideroblastic anaemia

* Treatment and prophylaxis of Vitamin B6 (Valcatil Plus) deficiency states

is recommended for first-line treatment of weak, brittle, splitting, or soft nails.

therapy should be taken regularly as directed to maintain strong, healthy nails. Clinical improvement is generally realized within 3 to 6 months. 1-3 Cessation of therapy may result in deterioration of nail health within 6 to 9 months.

Patients with deficiency of B-complex vitamins, vitamin C and Zinc (Valcatil Plus) or where supplementation of these vitamins and Zinc (Valcatil Plus) can be beneficial. Such patients and conditions include: Patients who are on prolonged antibiotic therapy; those who are suffering from infection, injuries, burns, fever, illness; patients with diarrhoea and GI disorders; patients who have undergone surgical operations; patients on diet restrictions eg, in diabetes, anorexia and alcoholism and in elderly persons; pregnant and lactating women due to increased nutritional needs.

Racemethionine is used to make the urine more acidic. Making the urine more acidic helps to relieve skin irritation in incontinent (loss of bladder control) adults and diaper rash in infants. Methionine (Valcatil Plus) also helps to control strong urine odor.

Racemethionine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, racemethionine may be used to treat acetaminophen poisoning when the preferred medicine for treatment is not available.

Pyridoxine is Vitamin B6 (Valcatil Plus). Vitamins occur naturally in foods such as meat, poultry, nuts, whole grains, bananas, and avocados. Vitamin B6 (Valcatil Plus) is important for many processes in the body.

Pyridoxine is used to treat or prevent Vitamin B6 (Valcatil Plus) deficiency. It is also used to treat a certain type of anemia (lack of red blood cells). Pyridoxine injection is also used to treat some types of seizure in babies.

Pyridoxine taken by mouth (oral) is available without a prescription. Injectable pyridoxine must be given by a healthcare professional.

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

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

Zinc (Valcatil Plus) sulfate is used to treat and to prevent Zinc (Valcatil Plus) deficiency.

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

Directions For Use

To prepare for use, immerse absorbable Gelatin (Valcatil Plus) film in sterile saline solution and allow it to soak until it becomes quite pliable; it may then be cut to desired size and shape without difficulty and applied as follows:

For covering dural defects, Gelatin (Valcatil Plus) Sterile Film is placed over the surface of the brain, the edges of the implant tucked beneath the dura and the wound then closed in the usual manner. If desired, the Gelatin (Valcatil Plus) can be sutured loosely to the dura. Care must be exercised, however, because moist film tears easily. For covering pleural defects, Gelatin (Valcatil Plus) Sterile Film is placed over the defect and anchored in place by small interrupted sutures.

For use as a seton in iridencleisis, a small piece of Gelatin (Valcatil Plus) Sterile Ophthalmic Film (approximately 4 x 10 mm) is placed over the prolapsed iris pillar parallel to the limbus; Tenon's capsule and the conjunctiva are then closed with continuous absorbable sutures spaced to insure tight closure.

In diathermy or scleral “buckling” operations, Gelatin (Valcatil Plus) Sterile Ophthalmic Film may be placed over the sclera, the muscle and the conjunctiva then sutured over the underlying Gelatin (Valcatil Plus).

In extraocular muscle surgery, Gelatin (Valcatil Plus) Sterile Ophthalmic Film may be placed over and beneath the muscle before Tenon's capsule and the conjunctiva are closed in layers.

How supplied

Gelatin (Valcatil Plus) Sterile Film and Gelatin (Valcatil Plus) Sterile Ophthalmic Film are supplied in the following packages:

Gelatin (Valcatil Plus) Sterile Film, for use in neurosurgery and thoracic surgery, sterile envelopes, one per carton, GTIN 00300090283018 (0009-0283-01).

Gelatin (Valcatil Plus) Sterile Ophthalmic Film, for use in ocular surgery, sterile envelopes, six per carton, GTIN 00300090297039 (0009-0297-03).

Storage And Handling

Gelatin (Valcatil Plus) Sterile Film and Gelatin (Valcatil Plus) Sterile Ophthalmic Film should be stored at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Once the envelopes have been opened, contents are subject to contamination. To insure sterility, it is recommended that absorbable Gelatin (Valcatil Plus) film be used immediately after withdrawal from the envelope.

This product is prepackaged sterile and intended only for single use. Reuse can result in transmission of bloodborne pathogens (including HIV and hepatitis), potentially endangering patients and health care providers. Adherence to the principles of aseptic technique when using this product is essential.

Warning: To prevent contamination, employ aseptic procedure in opening envelope and withdrawing Gelatin (Valcatil Plus) Sterile Film and Gelatin (Valcatil Plus) Sterile Ophthalmic Film. If the envelope is torn or punctured, the contained Gelatin (Valcatil Plus) Sterile Film and Gelatin (Valcatil Plus) Sterile Ophthalmic Film should not be used.

Caution

Federal law restricts this device to sale by or on the order of a physician.

Manufactured by: Pharmacia and Upjohn Company, 7000 Portage Road, Kalamazoo, Michigan 49001, USA, 1-800-253-8600, Revised: December 2014. Distributed by: Pharmacia & Upjohn Co., Division of Pfizer Inc., New York, NY 10017

Zinc (Valcatil Plus) 1 mg/mL (Zinc (Valcatil Plus) Chloride Injection, USP) contains 1 mg Zinc (Valcatil Plus)/mL and is administered intravenously only after dilution. The additive should be diluted prior to administration in a volume of fluid not less than 100 mL. For the metabolically stable adult receiving TPN, the suggested intravenous dosage is 2.5 to 4 mg Zinc (Valcatil Plus)/day (2.5 to 4 mL/day). An additional 2 mg Zinc (Valcatil Plus)/day (2 mL/day) is suggested for acute catabolic states. For the stable adult with fluid loss from the small bowel, an additional 12.2 mg Zinc (Valcatil Plus)/liter of small bowel fluid lost (12.2 mL/liter of small bowel fluid lost), or an additional 17.1 mg Zinc (Valcatil Plus)/kg of stool or ileostomy output (17.1 mL/kg of stool or ileostomy output) is recommended. Frequent monitoring of Zinc (Valcatil Plus) blood levels is suggested for patients receiving more than the usual maintenance dosage level of Zinc (Valcatil Plus).

For full term infants and children up to 5 years of age, 100 mcg Zinc (Valcatil Plus)/kg/day

(0.1 mL/kg/day) is recommended. For premature infants (birth weight less than 1500 g) up to 3 kg in body weight, 300 mcg Zinc (Valcatil Plus)/kg/day (0.3 mL/kg/day) is suggested.

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

How supplied

Zinc (Valcatil Plus) 1 mg/mL (Zinc (Valcatil Plus) Chloride Injection, USP) is supplied in 10 mL Plastic Vials (List No. 4090).

Store at 20 to 25°C (68 to 77°F).

HOSPIRA, INC., LAKE FOREST, IL 60045 USA. Revised: October, 2004

Gelatin (Valcatil Plus) should not be used in closure of skin incisions because it may interfere with healing of the skin edges. This is due to mechanical interposition of Gelatin (Valcatil Plus) and is not secondary to intrinsic interference with wound healing.

Gelatin (Valcatil Plus) should not be placed in intravascular compartments, because of the risk of embolization.

Do not use Gelatin (Valcatil Plus) Sterile Powder in patients with known allergies to porcine collagen.

See also:
What is the most important information I should know about Methionine (Valcatil Plus)?

L-Methionine (Valcatil Plus) is contraindicated in those with the genetic disorder homocystinuria. It is also contraindicated in those who are hypersensitive to any component of a Methionine (Valcatil Plus)-containing product.

Haemophiliacs, patients with ileus (due to mechanical obstruction).

See also:
What is the most important information I should know about Vitamin B6 (Valcatil Plus)?

Contraindications for Vitamin B6 (Valcatil Plus) (Vitamin B6 (Valcatil Plus))

Vitamin B6 (Valcatil Plus) is contraindicated in those hypersensitive to any component of a Vitamin B6 (Valcatil Plus)-containing product.

contraindicated in patients allergic or hypersensitive to any of its ingredients.

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

Hypersensitivity to any of the ingredients of Zinc (Valcatil Plus).

Use Methionine (Valcatil Plus) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Methionine (Valcatil Plus) with or following a meal.
• If you have difficulty swallowing the capsules, they may be dissolved in juice, water, or warm milk.
• If you miss a dose of Methionine (Valcatil Plus), 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 Methionine (Valcatil Plus).

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Pyridoxine tablets are taken by mouth. Injectable pyridoxine is injected into a muscle or into a vein through an IV. You may be shown how to use injections at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

The recommended dietary allowance of pyridoxine increases with age. Follow your healthcare provider's instructions. You may also consult the Office of Dietary Supplements of the National Institutes of Health, or the U.S. Department of Agriculture (USDA) Nutrient Database (formerly "Recommended Daily Allowances") listings for more information.

Pyridoxine is only part of a complete program of treatment that may also include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat or avoid to help control your condition.

Store at room temperature away from moisture and heat.

It is used for the treatment and prevention of Vitamin B6 (Valcatil Plus) deficiency. It is important for the breakdown of protein, fats, and carbohydrates from foods.

May increase zinc absorption. Ascorbic acid may inhibit the oxidation of L-cysteine to L-Cystine (Valcatil Plus).

Lab Interference:

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

Pharmacological interactions are not known.

Account should be taken of incompatibilities that may occur in combination with other drugs. Fat emulsions must not be added to Gelatin (Valcatil Plus).

Results of compatibility tests will be provided on request.

Effects on Diagnostic Methods: Gelatin (Valcatil Plus) may have an influence on the following clinical-chemical tests, leading to falsely high values: Erythrocyte sedimentation rate, specific gravity of urine, nonspecific plasma protein assays eg, by the Biuret method.

Acetaminophen and methotrexate - L-Methionine (Valcatil Plus) may decrease hepatic toxicity in those with acetaminophen overdosage or in those taking methotrexate. Theoretically, it may decrease hepatic toxicity in the case of other potential hepatotoxic drugs, as well. Gentamicin - Methionine (Valcatil Plus) may protect against the ototoxic effects of gentamicin.

Dextropanthenyl alcohol in combination with hydrocortisone may be more effective than topical hydrocortisone alone in some dermatoses.

See also:
What other drugs will affect Vitamin B6 (Valcatil Plus)?

Interactions for Vitamin B6 (Valcatil Plus) (Vitamin B6 (Valcatil Plus))

Amiodarone: Concomitant use of Vitamin B6 (Valcatil Plus) and amiodarone may enhance amiodarone-induced photosensitivity reactions. Doses of Vitamin B6 (Valcatil Plus) greater than 5-10 milligrams/day should be avoided by those taking amiodarone Carbamazepine: Chronic use of carbamazepine may result in a significant decrease in plasma pyridoxal 5-phosphate levels Cycloserine: Cycloserine may react with pyridoxal 5-phosphate to form a metabolically inactive oxime, which may result in a functional Vitamin B6 (Valcatil Plus) deficiency Ethionamide: The use of ethionamide may increase Vitamin B6 (Valcatil Plus) requirements Fosphenytoin: High doses of Vitamin B6 (Valcatil Plus) may lower plasma levels of phenytoin. Fosphenytoin is a prodrug of phenytoin Hydralazine: The use of hydralazine may increase Vitamin B6 (Valcatil Plus) requirements Isoniazid: (isonicotinic acid, INH). Isoniazid reacts with pyridoxal 5-phosphate to form a metabolically inactive hydrazone, which may result in functional Vitamin B6 (Valcatil Plus) deficiency Levodopa: Concomitant use of levodopa and Vitamin B6 (Valcatil Plus) in doses of 5 milligrams or more daily may reverse the therapeutic effects of levodopa. Vitamin B6 (Valcatil Plus) does not reverse the therapeutic effects of levodopa if levodopa is taken concurrently with the levodopa decarboxylase inhibitor carbidopa. Levodopa is typically administered as a combination product with carbidopa

Oral contraceptives: The use of oral contraceptives may increase Vitamin B6 (Valcatil Plus) requirements. This was more the case with the older oral contraceptive agents with high-dose estrogen/progestin. It appears to be less the case with the newer low-dose estrogen/progestin products Penicillamine: Penicillamine may react with pyridoxal 5-phosphate to form a metabolically inactive thiazolidine, which may result in a functional Vitamin B6 (Valcatil Plus) deficiency Phenelzine: Phenelzine may react with pyridoxal 5-phosphate to yield a metabolically inactive hydrazone compound Phenobarbital: High doses of Vitamin B6 (Valcatil Plus) may lower plasma levels of phenobarbital Phenytoin: High doses of Vitamin B6 (Valcatil Plus) may lower plasma levels of phenytoin Theophylline: Theophylline may react with pyridoxal 5-phosphate leading to low plasma levels of the coenzyme. This may increase the risk of theophylline-induced seizures Valproic acid: Chronic use of valproic acid may result in a significant decrease in plasma pyridoxal 5-phosphate levels.

The anticonvulsants carbamazepine, phenytoin, Phenobarbital, and primidone may accelerate biotin metabolism, leading to a reduction in available biotin. Chronic use of these drugs has been associated with decreased plasma concentrations of biotin.

The use of antibiotics may reduce the contribution of biotin made by bacteria within the large intestine.

See also:
What other drugs will affect Zinc (Valcatil Plus)?

Pyridoxine reduces the effects of levodopa (but this does not occur if a dopa decarboxylase is also given); decreases serum concentrations of phenobarbitone. Concurrent administration of drugs eg, isoniazid, penicillamine and oral contraceptives increase the requirement for pyridoxine.

Absorption of cyanocobalamin from the GIT may be reduced by neomycin, aminosalicylic acid, histamine H₂-receptor antagonists and colchicine. Serum concentrations may be decreased by concurrent administration of oral contraceptives. Many of these interactions are unlikely to be of clinical significance but should be taken into account when performing assays for blood concentrations.

Parenteral chloramphenicol may attenuate the effect of vitamin B12 in anaemia.

Folate deficiency states may be produced by a number of drugs including antiepileptics, oral contraceptives, antituberculous drugs, alcohol and folic acid antagonists eg, aminopterin, methotrexate, pyrimethamine, trimethoprim and sulphonamides; folic acid may decrease serum-phenytoin concentrations.

There may be an increased risk of myopathy or rhabdomyolysis when nicotinic acid is used concurrently with statins. Nicotinamide may increase the requirements for insulin or oral hypoglycaemics.

Ascorbic acid may increase the absorption of iron-deficiency states.

Ascorbic acid is often given in addition to desferrioxamine to patients with iron overload (thalassemia) to achieve better iron excretion. However, early on in treatment when there is excess tissue iron, there is some evidence that ascorbic acid may worsen the iron toxicity, particularly to the heart. Thus, ascorbic acid should not be given for the first month after starting desferrioxamine treatment.

The absorption of Zinc (Valcatil Plus) may be reduced by iron supplements, penicillamine, phosphorus-containing preparations and tetracyclines. Zinc (Valcatil Plus) supplements reduce the absorption of copper, ciprofloxacin, iron, norfloxacin, penicillamine and tetracyclines.

There have been reports of fever associated with the use of Gelatin (Valcatil Plus), without demonstrable infection. Gelatin (Valcatil Plus) may serve as a nidus for infection and abscess formation

Foreign body reactions, “encapsulation” of fluid and hematoma have also been reported.

When Gelatin (Valcatil Plus) was used in laminectomy operations, multiple neurologic events were reported, including but not limited to cauda equina syndrome, spinal stenosis, meningitis, arachnoiditis, headaches, paresthesias, pain, bladder and bowel dysfunction, and impotence.

Excessive fibrosis and prolonged fixation of a tendon have been reported when absorbable Gelatin (Valcatil Plus) products were used in severed tendon repair.

Toxic shock syndrome has been reported in association with the use of Gelatin (Valcatil Plus) in nasal surgery.

Fever, failure of absorption, and hearing loss have been reported in association with the use of Gelatin (Valcatil Plus) during tympanoplasty.

Adverse Reactions Reported From Unapproved Uses

Gelatin (Valcatil Plus) is not recommended for use other than as an adjunct for hemostasis. While some adverse medical events following the unapproved use of Gelatin (Valcatil Plus) have been reported to Pharmacia & Upjohn Company, other hazards associated with such use may not have been reported.

When Gelatin (Valcatil Plus) has been used during intravascular catheterization for the purpose of producing vessel occlusion, the following adverse events have been reported; fever, duodenal and pancreatic infarct, embolization of lower extremity vessels, pulmonary embolization, splenic abscess, necrosis of specific anatomic areas, asterixis, and death.

These adverse medical events have been associated with the use of Gelatin (Valcatil Plus) for repair of dural defects encountered during laminectomy and craniotomy operations: fever, infection, leg paresthesias, neck and back pain, bladder and bowel incontinence, cauda equina syndrome, neurogenic bladder, impotence, and paresis.

Adverse Events Associated With Bone Hemostasis

In a clinical study, 108 patients received Gelatin (Valcatil Plus) Sterile Powder on the cut surface of the sternum during cardiopulmonary bypass surgery, while 107 patients received no treatment on the cut surface of the bone. Table 1 is a summary of medical events reported by at least 1.0% of patients in a treatment group. The most frequently reported events were atrial fibrillation, perioperative event, and wound infection. Events occurring in less than 1.0% of the patients were as follows: anaphylaxis, cardiogenic shock, delirium tremens, infection at the vascular catheter site, unevaluable reaction, sepsis, angina pectoris, atrial arrhythmia, nodal arrhythmia, arteriosclerosis, cardiac insufficiency, cardiac tamponade, cardiomyopathy, deep vein thrombosis, mitral valve disorder, endocarditis, ventricular extrasystoles, heart arrest, hypotension, mesenteric occlusion, superventricular tachycardia, thrombophlebitis, thrombosis, gastrointestinal disorder, gastrointestinal bleeding, increased serum creatinine, dehydration, anemia, thrombocytopenia, abnormal healing, hypovolemia, hypoxia, metabolic acidosis, cerebral infarction, visual hallucinations, stupor, aspiration pneumonia, chest congestion, pleural effusion, pulmonary infiltration, retinal artery occlusion, anuria, UG disorder, abnormal kidney function and menorrhagia.

Table 1: Summary of Medical Events for Gelatin (Valcatil Plus) Sterile Powder when used as a Bone Hemostatic Agent During Cardiopulmonary Bypass Surgery

In general, the following adverse events have been reported with the use of absorbable porcine Gelatin (Valcatil Plus)-based hemostatic agents:

• Gelatin (Valcatil Plus)-based hemostatic agents may serve as a nidus for infection and abscess formation and have been reported to potentiate bacterial growth.
• Giant cell granulomas have been observed at implant sites when used in the brain.
• Compression of the brain and spinal cord resulting from the accumulation of sterile fluid has been observed.
• Multiple neurologic events were reported when absorbable Gelatin (Valcatil Plus)-based hemostatic agents were used in laminectomy operations, including cauda equina syndrome, spinal stenosis, meningitis, arachnoiditis, headaches, paresthesias, pain, bladder and bowel dysfunction, and impotence and paresis.
• The use of absorbable Gelatin (Valcatil Plus)-based hemostatic agents have been associated with paralysis, due to device migration into foramina in the bone around the spinal cord, and blindness due to device migration in the orbit of the eye, during lobectomy, laminectomy and repair of a frontal skull fracture and lacerated lobe.
• Foreign body reactions, “encapsulation” of fluid, and hemotoma have been observed at implant sites.
• Excessive fibrosis and prolonged fixation of a tendon have been reported when absorbable Gelatin (Valcatil Plus)-based sponges were used in severed tendon repair.
• Toxic shock syndrome was reported in association with the use of absorbable Gelatin (Valcatil Plus)-based hemostats in nasal surgery.
• Fever, failure of absorption, and hearing loss have been observed when absorbable hemostatic agents were used during tympanoplasty.

See also:
What are the possible side effects of Methionine (Valcatil Plus)?

Along with its needed effects, a medicine may cause some unwanted effects. Side effects that may occur during racemethionine therapy usually do not need medical attention. They may go away during treatment as your body adjusts to the medicine. Check with your doctor if any of the following side effects continue or are bothersome:

More common

Drowsiness; nausea and vomiting

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

No serious side effects have been reported, even at intakes of up to 10,000 mg (10 grams) per day. Very large amounts of pantothenic acid (several grams per day) can cause diarrhea.

Pantothenic acid works together with vitamin B1, vitamin B2, and vitamin B3 to help make the fuel our bodies run on—ATP.

There is one report of a 76-year-old woman who developed a life-threatening condition (eosinophilic pleuropericardial effusion) while taking 300 mg of pantothenic acid per day and 10 mg of biotin per day.2 However, it is not clear whether the vitamins caused the problem.

See also:
What are the possible side effects of Vitamin B6 (Valcatil Plus)?

Applies to pyridoxine: capsule, injectable, solution, tablet, tablet enteric coated, tablet extended release

As well as its needed effects, pyridoxine (the active ingredient contained in Vitamin B6 (Valcatil Plus)) may cause unwanted side effects that require medical attention.

Severity: Moderate

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

With large doses

• Clumsiness
• numbness of hands or feet

Adverse reactions associated with biotin supplementation are rare in the medical literature; however, urticaria and gastrointestinal upset have been reported. As with any oral treatment, if patients experience any adverse reactions or side effects, they should inform their physicians immediately and discontinue use.

See also:
What are the possible side effects of Zinc (Valcatil Plus)?

Applies to Zinc (Valcatil Plus) sulfate: capsules, tablets

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

Nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur while taking Zinc (Valcatil Plus) sulfate (the active ingredient contained in Zinc (Valcatil Plus))

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); severe vomiting; unusual restlessness; very dry mouth, eyes, or skin.

Gelatin (Valcatil Plus) sterile sponge is a medical device intended for application to bleeding surfaces as a hemostatic. It is a water-insoluble, off-white, nonelastic, porous, pliable product prepared from purified pork skin Gelatin (Valcatil Plus) granules and water for injection. It may be cut without fraying and is able to absorb and hold within its interstices, many times its weight of blood and other fluids.

A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals.

The 4-methanol form of vitamin B 6 which is converted to pyridoxal phosphate which is a coenzyme for synthesis of amino acids, neurotransmitters (serotonin, norepinephrine), sphingolipids, aminolevulinic acid. Although pyridoxine and Vitamin B 6 are still frequently used as synonyms, especially by medical researchers, this practice is erroneous and sometimes misleading (EE Snell; Ann NY Acad Sci, vol 585 pg 1, 1990).

Zinc (Valcatil Plus) Capsule: Each capsule contains Zinc (Valcatil Plus) sulphate monohydrate 54.93 mg, thiamine nitrate 10 mg, riboflavin 10 mg, pyridoxine hydrochloride 3 mg, vitamin B12 (coated) equivalent to cyanocobalamin 15 mcg, ascorbic acid 150 mg, folic acid 1 mg, nicotinamide 50 mg and calcium pantothenate 12.5 mg.

Zinc (Valcatil Plus) Syrup: Each 5 mL contains Zinc (Valcatil Plus) gluconate 34.9 mg, thiamine mononitrate 2.5 mg, riboflavin 2.5 mg, pyridoxine hydrochloride 1 mg, cyanocobalamin 3 mcg, ascorbic acid 50 mg, d-panthenol 12.5 mg and niacinamide 25 mg in a flavoured liquid glucose sorbitol syrup base.