Vivioptal Junior

Copper (Vivioptal Junior) 0.4 mg/mL (Cupric Chloride Injection, USP) is indicated for use as a supplement to intravenous solutions given for total parenteral nutrition (TPN). Administration helps to maintain Copper (Vivioptal Junior) serum levels and to prevent depletion of endogenous stores and subsequent deficiency symptoms.

Folic Acid (Vivioptal Junior) is used in the treatment and prevention of the folate deficiency state. It does not correct folate deficiency due to dihydrofolate reductase inhibitors. Folic Acid (Vivioptal Junior) is also used in women of child-bearing potential and pregnant women to protect against neural tube defects in their offspring. It is also used for the treatment of folate-deficient megaloblastic anaemia, chronic haemolytic states such as thalassaemia major or sickle-cell anaemia.

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

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

Drops: General: Hypochromic or masked Iron (Vivioptal Junior) 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 (Vivioptal Junior) deficiency due to menstruation. During and after pregnancy and lactation. Menorrhagia.

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

Supplemental L-Lysine (Vivioptal Junior) has putative anti-herpes simplex virus activity. There is preliminary research suggesting that it may have some anti-osteoporotic activity.

Magnesium (Vivioptal Junior) Sulfate Injection, USP is suitable for replacement therapy in Magnesium (Vivioptal Junior) deficiency, especially in acute hypomagnesemia accompanied by signs of tetany similar to those observed in hypocalcemia. In such cases, the serum Magnesium (Vivioptal Junior) (Mg++) level is usually below the lower limit of normal (1.5 to 2.5 mEq/liter) and the serum calcium (Ca++) level is normal (4.3 to 5.3 mEq/liter) or elevated.

In total parenteral nutrition (TPN), Magnesium (Vivioptal Junior) sulfate may be added to the nutrient admixture to correct or prevent hypomagnesemia which can arise during the course of therapy.

Magnesium (Vivioptal Junior) Sulfate Injection, USP is also indicated for the prevention and control of seizures (convulsions) in pre-eclampsia and eclampsia, respectively.

Manganese (Vivioptal Junior) 0.1 mg/mL (Manganese (Vivioptal Junior) Chloride Injection, USP) is indicated for use as a supplement to intravenous solutions given for total parenteral nutrition (TPN).

Administration helps to maintain Manganese (Vivioptal Junior) serum levels and to prevent depletion of endogenous stores and subsequent deficiency symptoms.

Royal Jelly (Vivioptal Junior) is a valuable biological secretion from the honey bees.

Royal Jelly (Vivioptal Junior) sustains youthfulness and promotes skin

Vitamin A (Vivioptal Junior) injection is effective for the treatment of Vitamin A (Vivioptal Junior) deficiency.

The parenteral administration is indicated when the oral administration is not feasible as in anorexia, nausea, vomiting, pre- and postoperative conditions, or it is not available as in the "Malabsorption Syndrome" with accompanying steatorrhea.

Pediatric Use: Vitamin A (Vivioptal Junior) treatment for deficiency states has been recognized as an especially effective and important therapy in the pediatric population.

Vitamin A (Vivioptal Junior) supplementation for deficiency states in this population has been addressed by the Committee on Clinical Practice Issues of the American Society for Clinical Nutrition, by the American Society for

Parenteral and Enteral Nutrition, and by the World Health Organization.

Vitamin B1 (Vivioptal Junior) deficiency

Pernicious anemia, both uncomplicated and accompanied by nervous system involvement.

Dietary deficiency of Vitamin B12 (Vivioptal Junior), occurring in strict vegetarians and in their breast-fed infants. (Isolated Vitamin B12 (Vivioptal Junior) deficiency is very rare).

Malabsorption of Vitamin B12 (Vivioptal Junior), resulting from structural or functional damage to the stomach, where intrinsic factor is secreted or to the ileum, where intrinsic factor facilitates Vitamin B12 (Vivioptal Junior) absorption. These conditions include tropical sprue, and nontropical sprue (idiopathic steatorrhea, gluten-induced enteropathy). Folate deficiency in these patients is usually more severe than Vitamin B12 (Vivioptal Junior) deficiency.

Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy). Total gastrectomy always produces Vitamin B12 (Vivioptal Junior) deficiency.

Structural lesions leading to Vitamin B12 (Vivioptal Junior) deficiency include regional ileitis, ileal resections, malignancies, etc.

Competition for Vitamin B12 (Vivioptal Junior) by intestinal parasites or bacteria.

The fish tapeworm (Diphyilobothrium latum) absorbs huge quantities of Vitamin B12 (Vivioptal Junior) and infested patients often have associated gastric atrophy. The blind-loop syndrome may produce deficiency of Vitamin B12 (Vivioptal Junior) or folate.

Inadequate utilization of Vitamin B12 (Vivioptal Junior). This may occur if antimetabolites for the vitamin are employed in the treatment of neoplasia.

For the Schilling Test.

Vitamin B2 (Vivioptal Junior) deficiency

Helps clear blemishes. Vitamin B3 (Vivioptal Junior) Moussant Soap-Free Cleansing Gel Purifies & cleanses the skin. Vitamin B3 (Vivioptal Junior) Oil-Free Cream Promotes oil-free skin. Vitamin B3 (Vivioptal Junior) Isocorrexion Use for acne prone skin. Reduces skin dryness & tightness caused by conventional acne treatment. Vitamin B3 (Vivioptal Junior) Lotion For body acne in chest & back. Vitamin B3 (Vivioptal Junior) UV High Protection Cream SPF 45 For sun protection for acne prone skin. Vitamin B3 (Vivioptal Junior) Gel For localized spots.

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 (Vivioptal Junior)), 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 (Vivioptal Junior) deficiency states

This medicine is indicated in all conditions where there is a disturbance of calcium metabolism due to impaired 1-α hydroxylation such as when there is reduced renal function. The main indications are:

a) Renal osteodystrophy

b) Hyperparathyroidism (with bone disease)

c) Hypoparathyroidism

d) Neonatal hypocalcaemia

e) Nutritional and malabsorptive rickets and osteomalacia

f) Pseudo-deficiency (D-dependent) rickets and osteomalacia

g) Hypophosphataemic Vitamin D (Vivioptal Junior) resistant rickets and osteomalacia

Oral

Vitamin E (Vivioptal Junior) 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.

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 (Vivioptal Junior) or where supplementation of these vitamins and Zinc (Vivioptal Junior) 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.

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Folic Acid (Vivioptal Junior) (vitamin B 9) is necessary for strong blood.

Lack of Folic Acid (Vivioptal Junior) may lead to anemia (weak blood). Your health care professional may treat this by prescribing Folic Acid (Vivioptal Junior) for you.

Some conditions may increase your need for Folic Acid (Vivioptal Junior). These include:

• Alcoholism
• Anemia, hemolytic
• Diarrhea (continuing)
• Fever (prolonged)
• Hemodialysis
• Illness (prolonged)
• Intestinal diseases
• Liver disease
• Stress (continuing)
• Surgical removal of stomach

In addition, infants smaller than normal, breast-fed infants, or those receiving unfortified formulas (such as evaporated milk or goat's milk) may need additional Folic Acid (Vivioptal Junior).

Increased need for Folic Acid (Vivioptal Junior) should be determined by your health care professional.

Some studies have found that Folic Acid (Vivioptal Junior) taken by women before they become pregnant and during early pregnancy may reduce the chances of certain birth defects (neural tube defects).

Claims that Folic Acid (Vivioptal Junior) and other B vitamins are effective for preventing mental problems have not been proven. Many of these treatments involve large and expensive amounts of vitamins.

Injectable Folic Acid (Vivioptal Junior) is given by or under the direction of your health care professional. Another form of Folic Acid (Vivioptal Junior) is available without a prescription.

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

Iron (Vivioptal Junior) suspension is a mineral. It works by providing Iron (Vivioptal Junior) to the body.

Lysine (Vivioptal Junior) is an essential amino acid. Essential means that it is not produced by the body and therefore it must be taken in either by diet or by taking supplements. Lysine (Vivioptal Junior) is found in foods such as lentils, red meat, pork, poultry, cod fish, sardines, nuts, eggs, soy beans, brewer's yeast, and dairy products.

Lysine (Vivioptal Junior) has been used in alternative medicine as an aid to prevent cold sores around the mouth (caused by the herpes simplex virus). This product may make cold sores occur less often and may reduce the number of days a cold sore lasts. Lysine (Vivioptal Junior) is not a cure for herpes.

Other uses for Lysine (Vivioptal Junior) include treating metabolic acidosis, improving athletic performance, and helping the body absorb calcium supplements.

Not all uses for Lysine (Vivioptal Junior) have been approved by the FDA. Lysine (Vivioptal Junior) should not be used in place of medication prescribed for you by your doctor.

Lysine (Vivioptal Junior) is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Lysine (Vivioptal Junior) may also be used for purposes not listed in this product guide

Magnesium (Vivioptal Junior) is used as a dietary supplement for individuals who are deficient in Magnesium (Vivioptal Junior). Although a balanced diet usually supplies all the Magnesium (Vivioptal Junior) a person needs, Magnesium (Vivioptal Junior) supplements may be needed by patients who have lost Magnesium (Vivioptal Junior) because of illness or treatment with certain medicines.

Lack of Magnesium (Vivioptal Junior) may lead to irritability, muscle weakness, and irregular heartbeat.

Injectable Magnesium (Vivioptal Junior) is given only by or under the supervision of a health care professional. Some oral Magnesium (Vivioptal Junior) preparations are available only with a prescription. Others are available without a prescription.

Manganese (Vivioptal Junior) supplements are used to prevent or treat Manganese (Vivioptal Junior) deficiency.

The body needs Manganese (Vivioptal Junior) for normal growth and health. For patients who are unable to get enough Manganese (Vivioptal Junior) in their regular diet or who have a need for more Manganese (Vivioptal Junior), Manganese (Vivioptal Junior) supplements may be necessary. Manganese (Vivioptal Junior) helps your body break down fats, carbohydrates, and proteins. It does so as part of several enzymes.

Manganese (Vivioptal Junior) deficiency has not been reported in humans. Lack of Manganese (Vivioptal Junior) in animals has been found to cause improper formation of bone and cartilage, may decrease the body's ability to use sugar properly, and may cause growth problems.

Injectable Manganese (Vivioptal Junior) supplements are given by or under the supervision of a health care professional.

Royal Jelly (Vivioptal Junior) is a milky-white secretion produced by worker bees that helps nurture development of the queen bee. Royal Jelly (Vivioptal Junior) is also known as Apis mellifera, Bee Saliva, Bee Spit, Gelée Royale, Honey Bee Milk, Honey Bee's Milk, Jalea Real, Lait des Abeilles, or Royal Bee Jelly.

Royal Jelly (Vivioptal Junior) should not be confused with apitherapy, bee pollen, or bee venom.

Royal Jelly (Vivioptal Junior) has been used in alternative medicine as a possibly effective aid in treating menopausal symptoms. Royal Jelly (Vivioptal Junior) may have been combined with other plants or extracts in a specific preparation to treat this condition.

Royal Jelly (Vivioptal Junior) has also been used to treat hay fever. However, research has shown that Royal Jelly (Vivioptal Junior) may not be effective in treating this condition.

Other uses not proven with research have included treating premenstrual syndrome, infertility, high cholesterol, diabetic foot ulcers, stomach ulcer, pancreatitis, liver or kidney disease, asthma, skin disorders, and many other conditions.

It is not certain whether Royal Jelly (Vivioptal Junior) is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Royal Jelly (Vivioptal Junior) should not be used in place of medication prescribed for you by your doctor.

Royal Jelly (Vivioptal Junior) is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Royal Jelly (Vivioptal Junior) may also be used for purposes not listed in this product guide.

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Vitamin A (Vivioptal Junior) is needed for night vision and for growth of skin, bones, and male and female reproductive organs. In pregnant women Vitamin A (Vivioptal Junior) is necessary for the growth of a healthy fetus.

Lack of Vitamin A (Vivioptal Junior) may lead to a rare condition called night blindness (problems seeing in the dark), as well as dry eyes, eye infections, skin problems, and slowed growth. Your health care professional may treat these problems by prescribing Vitamin A (Vivioptal Junior) for you.

Some conditions may increase your need for Vitamin A (Vivioptal Junior). These include:

• Diarrhea
• Eye diseases
• Intestine diseases
• Infections (continuing or chronic)
• Measles
• Pancreas disease
• Stomach removal
• Stress (continuing)

In addition, infants receiving unfortified formula may need Vitamin A (Vivioptal Junior) supplements.

Vitamin A (Vivioptal Junior) absorption will be decreased in any condition in which fat is poorly absorbed.

Increased need for Vitamin A (Vivioptal Junior) should be determined by your health care professional.

Claims that Vitamin A (Vivioptal Junior) is effective for treatment of conditions such as acne or lung diseases, or for treatment of eye problems, wounds, or dry or wrinkled skin not caused by lack of Vitamin A (Vivioptal Junior) have not been proven. Although Vitamin A (Vivioptal Junior) is being used to prevent certain types of cancer, some experts feel there is not enough information to show that this is effective, particularly in well-nourished individuals.

Injectable Vitamin A (Vivioptal Junior) is given by or under the supervision of a health care professional. Other forms of Vitamin A (Vivioptal Junior) are available without a prescription.

Thiamine is Vitamin B1 (Vivioptal Junior). Thiamine is found in foods such as cereals, whole grains, meat, nuts, beans, and peas. Thiamine is important in the breakdown of carbohydrates from foods into products needed by the body.

Thiamine is used to treat or prevent Vitamin B1 (Vivioptal Junior) deficiency. Thiamine injection is used to treat beriberi, a serious condition caused by prolonged lack of Vitamin B1 (Vivioptal Junior).

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

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

Cyanocobalamin is a man-made form of Vitamin B12 (Vivioptal Junior). Vitamin B12 (Vivioptal Junior) is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.

Cyanocobalamin is used to treat Vitamin B12 (Vivioptal Junior) deficiency in people with pernicious anemia and other conditions.

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

Riboflavin is Vitamin B2 (Vivioptal Junior). Vitamins are naturally occurring substances necessary for many processes in the body. Riboflavin is important in the maintenance of many tissues of the body.

Riboflavin is used to prevent and to treat deficiencies of riboflavin.

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

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

Pyridoxine is used to treat or prevent Vitamin B6 (Vivioptal Junior) 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.

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are available in the foods that you eat. Vitamin D (Vivioptal Junior) is necessary for strong bones and teeth.

Lack of Vitamin D (Vivioptal Junior) may lead to a condition called rickets, especially in children, in which bones and teeth are weak. In adults it may cause a condition called osteomalacia, in which calcium is lost from bones so that they become weak. Your doctor may treat these problems by prescribing Vitamin D (Vivioptal Junior) for you. Vitamin D (Vivioptal Junior) is also sometimes used to treat other diseases in which calcium is not used properly by the body.

Ergocalciferol is the form of Vitamin D (Vivioptal Junior) used in vitamin supplements.

Some conditions may increase your need for Vitamin D (Vivioptal Junior). These include:

• Alcoholism
• Intestine diseases
• Kidney disease
• Liver disease
• Overactivity of the parathyroid glands with kidney failure
• Pancreas disease
• Surgical removal of stomach

In addition, individuals and breast-fed infants who lack exposure to sunlight, as well as dark-skinned individuals, may be more likely to have a Vitamin D (Vivioptal Junior) deficiency. Increased need for Vitamin D (Vivioptal Junior) should be determined by your health care professional.

Alfacalcidol, calcifediol, calcitriol, and dihydrotachysterol are forms of Vitamin D (Vivioptal Junior) used to treat hypocalcemia (not enough calcium in the blood). Alfacalcidol, calcifediol, and calcitriol are also used to treat certain types of bone disease that may occur with kidney disease in patients who are undergoing kidney dialysis.

Claims that Vitamin D (Vivioptal Junior) is effective for treatment of arthritis and prevention of nearsightedness or nerve problems have not been proven. Some psoriasis patients may benefit from Vitamin D (Vivioptal Junior) supplements; however, controlled studies have not been performed.

Injectable Vitamin D (Vivioptal Junior) is given by or under the supervision of a health care professional. Some strengths of ergocalciferol and all strengths of alfacalcidol, calcifediol, calcitriol, and dihydrotachysterol are available only with your doctor's prescription. Other strengths of ergocalciferol are available without a prescription. However, it may be a good idea to check with your health care professional before taking Vitamin D (Vivioptal Junior) on your own. Taking large amounts over long periods may cause serious unwanted effects.

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

Vitamin E (Vivioptal Junior) is used to treat or prevent Vitamin E (Vivioptal Junior) deficiency. People with certain diseases may need extra Vitamin E (Vivioptal Junior).

Vitamin E (Vivioptal Junior) may also be used for purposes not listed in this medication guide.

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

Zinc (Vivioptal Junior) sulfate is used to treat and to prevent Zinc (Vivioptal Junior) deficiency.

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

Copper (Vivioptal Junior) 0.4 mg/mL (Cupric Chloride Injection, USP) contains 0.4 mg Copper (Vivioptal Junior)/mL and is administered intravenously only after dilution. The additive should be diluted in a volume of fluid not less than 100 mL. For the adult receiving TPN, the suggested additive dosage is 0.5 to 1.5 mg Copper (Vivioptal Junior)/day (1.25 to 3.75 mL/day). For pediatric patients, the suggested additive dosage is 20 mcg Copper (Vivioptal Junior)/kg/day (0.05 mL/kg/day). Infants weighing less than 1500 gm may have increased requirements because of their low body reserves and increased requirements for growth.

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

Usual Adult Dose for Megaloblastic Anemia

1 mg orally, intramuscularly, subcutaneously or IV once a day. May continue until clinical symptoms of folate deficiency and the hematological profile have normalized.

Usual Adult Dose for Folic Acid (Vivioptal Junior) Deficiency

400 to 800 mcg orally, intramuscularly, subcutaneously or IV once a day.

Women of childbearing age, pregnant, and lactating women: 800 mcg orally, intramuscularly, subcutaneously or IV once a day.

Usual Pediatric Dose for Folic Acid (Vivioptal Junior) Deficiency

Infant:

0.1 mg orally, intramuscularly, subcutaneously or IV once a day.

Child:

Less than 4 years: up to 0.3 mg orally, intramuscularly, subcutaneously or IV once a day.

4 years or older: 0.4 mg orally, intramuscularly, subcutaneously or IV once a day.

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Recommended daily allowance (RDA):

Premature neonates: 50 mcg/day (15 mcg/kg/day).

Full-term neonates and infants 1 to 6 months: 25 to 35 mcg/day.

Children:

1 to 3 years: 150 mcg/day.

4 to 8 years: 200 mcg/day.

9 to 13 years: 300 mcg/day.

14 years and older: 400 mcg/day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Rarely, a dosage of 2 mg/day may be required, particularly in patients with malabsorption, alcoholism, chronic hemolysis, chronic exfoliative skin disease or who are on concomitant anticonvulsant therapy.

Dialysis

Folic Acid (Vivioptal Junior) is removed by both hemodialysis and peritoneal dialysis. The amount removed varies with type equipment used.

Because folate may accumulate in patients with end-stage renal disease, side effects may be more likely in this patient who is undergoing dialysis. Once this patient's body stores of folate are replete, three times a week dosing may be just as beneficial as once daily dosing but should portend a lower risk of side effects.

Other Comments

The recommended daily allowance of Folic Acid (Vivioptal Junior) for adult males and females ranges from 150 to 200 and 150 to 180 mcg/day, respectively.

There is a potential danger in administering Folic Acid (Vivioptal Junior) to patients with undiagnosed anemia, since Folic Acid (Vivioptal Junior) may obscure the diagnosis of pernicious anemia by alleviating the hematologic manifestations of the disease while allowing the neurologic complications to progress.

Severe megaloblastic anemia may require therapy for 4 to 5 weeks. Once stabilized, if dietary intake is inadequate, maintenance therapy can be started.

Film-Coated Tablet: Treatment of Iron (Vivioptal Junior) 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 (Vivioptal Junior) stores.

Treatment of Iron (Vivioptal Junior) 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 (Vivioptal Junior) stores and provide the increased amount of Iron (Vivioptal Junior) required during pregnancy.

Treatment of Iron (Vivioptal Junior) Deficiency with Normal Number of Red Blood Cells in Adults, Pregnancy, and Children over 12 years, and Prevention of Iron (Vivioptal Junior) 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 (Vivioptal Junior) 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 (Vivioptal Junior) deficiency should be continued for at least 1 to 2 months.

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

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

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

Oral

Treatment and prophylaxis of herpes simplex

Adult: To treat symptoms: 3,000-9,000 mg/day in divided doses. To prevent recurrences: 500-1,500 mg/day.

Oral

Dietary supplementation

Adult: 500-1,000 mg/day.

Usual Adult Dose for Hypomagnesemia

500 to 1000 mg Magnesium (Vivioptal Junior) gluconate (27 to 54 mg elemental Magnesium (Vivioptal Junior)) orally 3 times a day.

Usual Adult Dose for Dietary Supplement

500 to 1000 mg Magnesium (Vivioptal Junior) gluconate (27 to 54 mg elemental Magnesium (Vivioptal Junior)) orally once a day.

Usual Pediatric Dose for Hypomagnesemia

10 to 20 mg/kg of elemental Magnesium (Vivioptal Junior) per dose orally 4 times a day. Use Magnesium (Vivioptal Junior) gluconate oral liquid preparations for more accurate measurement of dose.

Renal Dose Adjustments

Do not use without physician supervision in patients with renal impairment due to increased risk of hypermagnesemia. The use of Magnesium (Vivioptal Junior) salts are generally contraindicated in patients with severe renal dysfunction.

Liver Dose Adjustments

Data not available

Dose Adjustments

May increase by 500 to 1,000 mg/day (27 to 54 mg elemental Magnesium (Vivioptal Junior)) in order to achieve a normal serum Magnesium (Vivioptal Junior) level. Daily doses > 1,000 mg (54 mg elemental Magnesium (Vivioptal Junior)) should be given in 2 to 3 divided doses.

Precautions

Because Magnesium (Vivioptal Junior) is primarily eliminated by the kidney, there is significant risk of hypermagnesemia in patients with renal dysfunction.

Dialysis

Data not available; however, use of Magnesium (Vivioptal Junior) salts is generally contraindicated in renal failure.

Other Comments

Magnesium (Vivioptal Junior) supplements are often used with "low normal" serum Magnesium (Vivioptal Junior) levels in patients predisposed to hypomagnesemia (e.g., patients on diuretics).

Dosage Forms

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

Capsule,

Oral, as chelated:

MN-50: Elemental Manganese (Vivioptal Junior) 16.67 mg

Solution,

Intravenous, as chloride:

Generic: Elemental Manganese (Vivioptal Junior) 0.1 mg/mL (10 mL)

Solution,

Intravenous, as sulfate [preservative free]:

Generic: Elemental Manganese (Vivioptal Junior) 0.1 mg/mL (10 mL)

Tablet,

Oral, as aspartate:

Generic: 93 mg [elemental Manganese (Vivioptal Junior) 25 mg]

Tablet,

Oral, as chelated:

Manganese (Vivioptal Junior): Elemental Manganese (Vivioptal Junior) 10 mg [corn free, rye free, wheat free]

Generic: Elemental Manganese (Vivioptal Junior) 15 mg [DSC], Elemental Manganese (Vivioptal Junior) 50 mg

Tablet,

Oral, as gluconate:

Generic: 50 mg [elemental Manganese (Vivioptal Junior) 5.7 mg]

Dosing: Adult

Parenteral nutrition, maintenance requirement:

Expert recommendations favor the use of lower doses in the range of 60 to 100 mcg/day to avoid neurotoxicity with routine use and those with cholestatic jaundice. However, these recommendations are difficult to follow with the current sources of parenteral Manganese (Vivioptal Junior) (ASPEN [Vanek 2012]).

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Parenteral nutrition, maintenance requirement:

Expert recommendations suggest decreasing the daily dose for infants and children to 1 mcg/kg/day (up to a maximum of 50 mcg/day). However, these recommendations are difficult to follow with the current sources of parenteral Manganese (Vivioptal Junior) (ASPEN [Vanek 2012]).

Note: Use caution in premature neonates; Manganese (Vivioptal Junior) chloride solution for injection contains aluminum.

od or as directed by the physician.

Usual Adult Dose for Vitamin A (Vivioptal Junior) Deficiency

Initial dose: 100,000 Units intramuscularly once a day for 3 days

Maintenance dose: 50,000 Units intramuscularly once a day for 2 weeks

Use: Treatment of Vitamin A (Vivioptal Junior) deficiency when oral administration is not feasible or not available (e.g. anorexia, nausea, vomiting, pre- or post-operative conditions, "Malabsorption Syndrome" with accompanying steatorrhea)

Usual Adult Dose for Vitamin/Mineral Supplementation

US Recommended Dietary Allowance (RDA):

Adult male: 900 mcg retinol activity equivalents (RAE) (3000 international units [IU])

Tolerable Upper Intake Level (UL): 3000 mcg RAE (10,000 IU)

Adult female: 700 mcg RAE (2330 IU)

UL: 3000 mcg RAE (10,000 IU)

Comments:

-The Vitamin A (Vivioptal Junior) RDA is given as mcg of retinol activity equivalents (RAE) to account for the different bioactivities of retinol and provitamin A carotenoids.

-The body converts all dietary Vitamin A (Vivioptal Junior) into retinol; 2 mcg of beta-carotene from dietary supplements is converted to 1 mcg of retinol.

-The tolerable upper intake level is the maximum daily intake that is unlikely to have adverse health effects.

Usual Pediatric Dose for Vitamin A (Vivioptal Junior) Deficiency

Infants (under 1 year): 7500 to 15,000 Units intramuscularly once a day

Duration of therapy: 10 days

1 to 8 years: 17,500 to 35,000 Units intramuscularly once a day

Duration of therapy: 10 days

Adult dose:

Initial dose: 100,000 Units intramuscularly once a day for 3 days

Maintenance dose: 50,000 Units intramuscularly once a day for 2 weeks

Use: Treatment of Vitamin A (Vivioptal Junior) deficiency when oral administration is not feasible or not available (e.g. anorexia, nausea, vomiting, pre- or post-operative conditions, "Malabsorption Syndrome" with accompanying steatorrhea)

Usual Pediatric Dose for Vitamin/Mineral Supplementation

US Recommended Dietary Allowance (RDA):

0 to 6 months: 400 mcg retinol activity equivalents (RAE) (1332 international units [IU])

Tolerable Upper Intake Level (UL): 600 mcg RAE (2000 IU)

7 to 12 months: 500 mcg RAE (1665 IU)

UL: 600 mcg RAE (2000 IU)

1 to 3 years: 300 mcg RAE (1000 IU)

UL: 900 mcg RAE (3000 IU)

4 to 8 years: 400 mcg RAE (1332 IU)

UL: 900 mcg RAE (3000 IU)

9 to 13 years: 600 mcg RAE (2000 IU)

UL: 1700 mcg RAE (5667 IU)

14 to 18 years, male: 900 mcg RAE (3000 IU)

UL: 2800 mcg RAE (9333 IU)

14 to 18 years, female: 700 mcg RAE (2330 IU)

UL: 2800 mcg RAE (9333 IU)

Comments:

-The Vitamin A (Vivioptal Junior) RDA is given as mcg of retinol activity equivalents (RAE) to account for the different bioactivities of retinol and provitamin A carotenoids.

-The body converts all dietary Vitamin A (Vivioptal Junior) into retinol; 2 mcg of beta-carotene from dietary supplements is converted to 1 mcg of retinol.

-The tolerable upper intake level is the maximum daily intake that is unlikely to have adverse health effects.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

US Recommended Dietary Allowance (RDA):

Pregnancy:

14 to 18 years: 750 mcg retinol activity equivalents (RAE) (2500 international units [IU])

UL: 2800 mcg RAE (9333 IU)

18 to 50 years: 770 mcg RAE (2564 IU)

UL: 3000 mcg RAE (10,000 IU)

Lactation:

14 to 18 years: 1200 mcg RAE (2564 IU)

UL: 2800 mcg RAE (9333 IU)

18 to 50 years: 1300 mcg RAE (4329 IU)

UL: 3000 mcg RAE (10,000 IU)

Comments:

-The Vitamin A (Vivioptal Junior) RDA is given as mcg of retinol activity equivalents (RAE) to account for the different bioactivities of retinol and provitamin A carotenoids.

-The body converts all dietary Vitamin A (Vivioptal Junior) into retinol; 2 mcg of beta-carotene from dietary supplements is converted to 1 mcg of retinol.

-The tolerable upper intake level is the maximum daily intake that is unlikely to have adverse health effects.

Precautions

CONTRAINDICATIONS:

-Administration of the intramuscular formulation intravenously

-Hypervitaminosis A

-Hypersensitivity to any of the ingredients

-The safety of doses exceeding 6000 units Vitamin A (Vivioptal Junior) in pregnancy has not been established. Use of high doses in pregnancy or patients who may become pregnant is contraindicated. Doses above the recommended dietary allowance (RDA) may cause fetal harm; fetal abnormalities (central nervous system, eye, and palate malformations) were seen in animal overdose models. If patients become pregnant, apprise them of potential fetal harms.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Vitamin B12 (Vivioptal Junior) Atlantic Laboratories is used as injections SC, IV, IM, intralumbar, and also oral. With anemia associated with Vitamin B12 (Vivioptal Junior) deficiency is introduced on 100-200 mcg in 2 days. In anemia with symptoms of funicular myelosis and megalocytic anemia with diseases of the nervous system - 400-500 micrograms in the first 7 days daily, then 1 time every 5-7 days. In the period of remission in the absence of events funicular myelosis maintenance dose - 100 mcg 2 times a month, in the presence of neurological symptoms - at 200-400 mcg 2-4 times a month. In acute post-hemorrhagic anemia and iron anemia by 30-100 mcg 2-3 times a week. When aplastic anemia (especially in children) - 100 micrograms before clinical improvement. When nutritional anemia in infants and preterm - 30 mcg / day during 15 days.

In diseases of the central and peripheral nervous system and neurological diseases with a pain syndrome is administered in increasing doses - 200-500 mcg, with the improvement in the state - 100 mcg / day. The course of treatment with Vitamin B12 (Vivioptal Junior) Atlantic Laboratories is 2 weeks. In traumatic lesions of peripheral nervous system - at 200-400 mcg every other day for 40-45 days.

When hepatitis and cirrhosis - 30-60 mcg / day or 100 mg every other day for 25-40 days.

Dystrophy in young children, Down syndrome and cerebral palsy - by 15-30 mcg every other day.

When funicular myelosis, amyotrophic lateral sclerosis can be introduced into the spinal canal at 15-30 mcg, gradually increasing the dose of 200-250 micrograms.

In radiation sickness, diabetic neuropathy, sprue - by 60-100 mcg daily for 20-30 days.

When deficiency of Vitamin B12 (Vivioptal Junior) to prevent - IV or IM for 1 mg 1 time a month; for treatment - IV or IM for 1 mg daily for 1-2 weeks, the maintenance dose is 1-2 mg IV or IM from 1 per week, up to 1 per month. Duration of treatment is determined individually.

Vitamin B3 (Vivioptal Junior) Lotion: Apply to the areas being treated after cleansing twice a day, AM & PM.

Vitamin B3 (Vivioptal Junior) Isocorrexion & Vitamin B3 (Vivioptal Junior) Oil-Free Cream: Apply to the face and affected areas (neck, chest and back) after cleansing twice a day, AM & PM. Massage delicately to facilitate absorption.

Vitamin B3 (Vivioptal Junior) UV High Protection Cream SPF 45: Reapply every 2-3 hrs.

Vitamin B3 (Vivioptal Junior) Gel: Apply small amount of gel on affected areas by massaging gently in AM & PM.

Vitamin B3 (Vivioptal Junior) Moussant Soap Free Cleansing Gel: Apply in AM & PM to damp skin, face and affected areas (neck, chest and back) by massaging delicately. Rinse thoroughly and dry gently. May be used in shower.

Dosage Forms

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

Capsule,

Oral:

D3-50: 1.25 MG (50000 UT) [dairy free, egg free, fish derivative free, gluten free, kosher certified, no artificial color(s), nut free, soy free, sugar free, wheat free, yeast free]

Vitamin D (Vivioptal Junior): 1.25 MG (50000 UT) [contains fd&c yellow #10 (quinoline yellow), fd&c yellow #6 (sunset yellow), soybean oil]

Vitamin D (Vivioptal Junior): 250 MCG (10000 UT) [contains fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake, gelatin (bovine)]

Vitamin D (Vivioptal Junior): 625 MCG (25000 UT) [contains soybean oil]

Dialyvite Vitamin D (Vivioptal Junior) 5000: 125 MCG (5000 UT)

Pronutrients Vitamin D3: 25 MCG (1000 UT) [contains soybean oil]

Weekly-D: 1.25 MG (50000 UT) [contains fd&c red #40]

Generic: 1.25 MG (50000 UT), 250 MCG (10000 UT)

Capsule,

Oral [preservative free]:

Vitamin D (Vivioptal Junior): 125 MCG (5000 UT) [dairy free, dye free, egg free, gluten free, no artificial color(s), nut free, soy free, sugar free, wheat free, yeast free]

D3-50: 1.25 MG (50000 UT) [dairy free, egg free, fish derivative free, gluten free, kosher certified, no artificial color(s), nut free, soy free, sugar free, wheat free, yeast free]

Generic: 10,000 units, 125 MCG (5000 UT), 25 MCG (1000 UT), 50 MCG (2000 UT)

Liquid,

Oral:

Aqueous Vitamin D (Vivioptal Junior): 10 mcg/mL (50 mL) [gluten free, lactose free, sugar free; contains corn oil, methylparaben, polysorbate 80]

Bio-D-Mulsion: 10 mcg/0.03 mL (30 mL [DSC]) [contains sesame oil]

Bio-D-Mulsion Forte: 50 mcg/0.03 mL (30 mL [DSC]) [contains sesame oil]

BProtected Pedia D-Vite: 10 mcg/mL (50 mL) [alcohol free, sugar free; contains polysorbate 80, propylene glycol, sodium benzoate; cherry flavor]

Vitamin D (Vivioptal Junior): 10 mcg/mL (50 mL) [gluten free, lactose free, sugar free; contains polysorbate 80]

D-Vita: 10 mcg/mL (50 mL [DSC]) [alcohol free, gluten free, lactose free, sugar free; contains polysorbate 80, propylene glycol, sodium benzoate; fruit flavor]

D-Vite Pediatric: 10 mcg/mL (50 mL) [alcohol free, gluten free, lactose free, no artificial color(s), sugar free; contains disodium edta, polysorbate 80, propylene glycol, saccharin sodium, sodium benzoate]

D3 Vitamin: 10 mcg/mL (50 mL) [contains polysorbate 80, sodium benzoate]

Generic: 10 mcg/mL (50 mL, 52 mL)

Liquid,

Oral [preservative free]:

Generic: 125 mcg/mL (52 mL)

Liquid, Sublingual:

Generic: 5000 units/mL (60 mL)

Tablet,

Oral:

Delta D3: 10 MCG (400 UNIT) [gelatin free, gluten free, lactose free, no artificial color(s), no artificial flavor(s), starch free, sugar free, yeast free]

Dialyvite Vitamin D3 Max: 1.25 MG (50000 UT) [scored]

Vitamin D3 Super Strength: 50 MCG (2000 UT) [gluten free]

Vitamin D3 Ultra Potency: 1.25 MG (50000 UT)

Generic: 10 MCG (400 UNIT), 125 MCG (5000 UT), 20 MCG (800 UNIT), 25 MCG (1000 UT), 50 MCG (2000 UT), 75 MCG (3000 UT)

Tablet,

Oral [preservative free]:

Generic: 5000 units, 10 MCG (400 UNIT), 25 MCG (1000 UT), 50 MCG (2000 UT)

Tablet Chewable,

Oral:

Generic: 10 MCG (400 UNIT)

Tablet Chewable,

Oral [preservative free]:

Generic: 50 MCG (2000 UT)

Dosing: Adult

Note: 1 mcg = 40 units

Hypoparathyroidism (off-label use): Note: Active Vitamin D (Vivioptal Junior) preparations (ie, alfacalcidol, calcitriol) in conjunction with calcium supplementation are recommended therapy. Addition of cholecalciferol (or ergocalciferol) may be considered for supplemental therapy (Endocrine Society [Brandi 2016]).

Osteoporosis, prevention (off-label use): Adults ≥50 years of age:

Oral: 800 to 1,000 units/day is recommended, through dietary sources and/or supplementation if needed (NOF [Cosman 2014]).

Vitamin D (Vivioptal Junior) insufficiency/deficiency treatment (off-label use): Note: Repletion strategies may vary depending on desired target serum 25(OH)D levels as well as the clinical status of the patient. The optimal serum 25(OH)D level is controversial; the Institute of Medicine recommends a 25(OH)D level >20 ng/mL as sufficient in nearly all persons (IOM 2011), whereas others have suggested targeting a level of ~30 ng/mL to minimize the risk of fractures, particularly in patients with osteoporosis (AACE [Camacho 2016]; NOF [Cosman 2014]). However, some data suggest levels >40 ng/mL (median level in one trial: ~48 ng/mL) are associated with increased risk of falls in postmenopausal women (Sanders 2010; Smith 2017).

Therefore, some experts recommend a range of 20 to 40 ng/mL as a reasonable target in most patients (Dawson-Hughes 2018). In patients with normal absorption, for every 100 units/day of cholecalciferol, the serum 25(OH)D level is expected to increase by ~0.7 to 1 ng/mL after a few weeks (ASPEN [McKeever 2017]; Dawson-Hughes 2018). The dose-response declines as the 25(OH)D concentration increases above 40 ng/mL (100 nmol/L) (Dawson-Hughes 2018). The following recommendations are based primarily on expert opinion and clinical experience:

Initial dosing (according to baseline serum 25(OH)D level):

Serum 25(OH)D 20 to 30 ng/mL: Initial: Supplementation dosing:

Oral: 600 to 800 units once daily; a repeat serum 25(OH)D level is not required (Dawson-Hughes 2018) or 1,000 to 2,000 units once daily; may consider a repeat serum 25(OH)D level in ~3 months to determine if the target level has been achieved (Khan 2010).

Serum 25(OH)D 10 to <20 ng/mL: Initial:

Supplementation dosing:

Oral: 800 to 1,000 units once daily (Dawson-Hughes 2018)

OR

Therapeutic dosing (ie, high-dose cholecalciferol):

Oral: 50,000 units once

Serum 25(OH)D <10 ng/mL or in patients with deficiency symptoms: Initial: Therapeutic dosing (ie, high-dose cholecalciferol):

Oral: 50,000 units once

Maintenance dosing: Maintenance dosing is highly patient specific and dependent on target 25(OH)D level, and may range from: 600 to 800 units/day (Dawson-Hughes 2018) to 1,000 to 2,000 units/day (AACE [Camacho 2016]; NOF [Cosman 2014]).

Special populations (obese patients, patients on medications known to affect Vitamin D (Vivioptal Junior) metabolism, patients with malabsorption syndromes or gastrectomy): Higher doses or longer durations may be necessary for adequate repletion (AACE [Camacho 2016]; Dawson-Hughes 2018).

Vitamin D (Vivioptal Junior) deficiency/insufficiency in patients with chronic kidney disease (off-label use):

Oral:

Note: In patients without severe and progressive hyperparathyroidism, including chronic kidney disease stages G3 to G5 and dialysis or transplant patients, KDIGO guidelines recommend correcting Vitamin D (Vivioptal Junior) deficiency and insufficiency with treatment strategies recommended for the general population using cholecalciferol (or ergocalciferol) while avoiding hypercalcemia and ensuring phosphate levels are in the normal range. An individualized monitoring approach to direct treatment is also recommended (KDIGO 2009; KDIGO 2017). In patients in whom serum parathyroid hormone levels are progressively rising and remain persistently elevated despite correction of modifiable factors (eg, hyperphosphatemia, Vitamin D (Vivioptal Junior) deficiency), calcitriol or Vitamin D (Vivioptal Junior) analogs are suggested instead of cholecalciferol (or ergocalciferol) (KDOQI commentary [Uhlig 2010]).

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Vitamin D (Vivioptal Junior) deficiency, prevention (eg, Rickets prevention): (AAP [Folsom 2017]; AAP [Wagner 2008]; Munns 2016):

Oral:

Breast-fed infants (fully or partially):

Oral: 400 units/day beginning in the first few days of life. Continue supplementation until infant is weaned to ≥1,000 mL/day or 1 qt/day of Vitamin D (Vivioptal Junior)-fortified formula or whole milk (after 12 months of age)

Formula-fed infants ingesting <1,000 mL of Vitamin D (Vivioptal Junior)-fortified formula:

Oral: 400 units/day

Children and Adolescents without adequate intake:

Oral: 400 to 600 units/day.

Vitamin D (Vivioptal Junior) deficiency, treatment:

Oral:

Infants:

Oral: 2,000 units daily for 6 weeks to achieve a serum 25(OH)D level >20 ng/mL; followed by a maintenance dose of 400 to 1,000 units daily. Note: For patients at high risk of fractures a serum 25(OH)D level >30 ng/mL has been suggested (AAP [Golden 2014]).

Children and Adolescents:

Oral: 2,000 units daily for 6 to 8 weeks to achieve serum 25(OH)D level >20 ng/mL; followed by a maintenance dose of 600 to 1,000 units daily. Note: For patients at high risk of fractures a serum 25(OH)D level >30 ng/mL has been suggested (AAP [Golden 2014]).

Vitamin D (Vivioptal Junior) deficiency in cystic fibrosis, prevention and treatment:

Oral:

CF guidelines (Tangricha [CF Foundation] 2012):

Recommended initial daily intake to maintain serum 25(OH)D level ≥30 ng/mL:

Infants:

Oral: 400 to 500 units/day

Children ≤10 years:

Oral: 800 to 1,000 units/day

Children >10 years and Adolescents:

Oral: 800 to 2,000 units/day

Dosing adjustment for serum 25(OH)D level between 20 to 30 ng/mL and patient adherence established (Step 1 increase):

Infants:

Oral: 800 to 1,000 units/day

Children ≤10 years:

Oral: 1,600 to 3,000 units/day

Children >10 years and Adolescents:

Oral: 1,600 to 6,000 units/day

Dosing adjustment for serum 25(OH)D level <20 ng/mL or persistently between 20 to 30 ng/mL and patient adherence established (Step 2 increase):

Infants: Increase up to a maximum 2,000 units/day

Children ≤10 years: Increase to a maximum of 4,000 units/day

Children >10 years and Adolescents: Increase to a maximum of 10,000 units/day

Alternate dosing (Hall 2010):

Initial dose: Serum 25(OH)D level ≤30 ng/mL

Infants:

Oral: 8,000 units/

Children and Adolescents:

Oral: 800 units/day

Medium-dose regimen: Serum 25(OH)D level remains ≤30 ng/mL and patient compliance established

Infants and Children <5 years:

Oral: 12,000 units/week for 12 weeks

Children ≥5 years and Adolescents:

Oral: 50,000 units/week for 12 weeks

High-dose regimen: Repeat 25(OH)D level remains ≤30 ng/mL and patient compliance established

Infants and Children <5 years:

Oral: 12,000 units twice weekly for 12 weeks

Children ≥5 years and Adolescents:

Oral: 50,000 units twice weekly for 12 weeks

Vitamin D (Vivioptal Junior) insufficiency or deficiency associated with CKD (stages 2 to 5, 5D), treatment; serum 25 hydroxyvitamin D [25(OH)D] level ≤30 ng/mL (KDOQI Guidelines 2009):

Oral:

Serum 25(OH)D level 16 to 30 ng/mL: Infants, Children, and Adolescents: 2,000 units/day for 3 months or 50,000 units every month for 3 months

Serum 25(OH)D level 5 to 15 ng/mL: Infants, Children, and Adolescents: 4,000 units/day for 12 weeks or 50,000 units every other week for 12 weeks

Serum 25(OH)D level <5 ng/mL: Infants, Children, and Adolescents: 8,000 units/day for 4 weeks then 4,000 units/day for 2 months for total therapy of 3 months or 50,000 units/week for 4 weeks followed by 50,000 units 2 times/month for a total therapy of 3 months

Maintenance dose [once repletion accomplished; serum 25(OH)D level >30 ng/mL]: Infants, Children, and Adolescents: 200 to 1,000 units/day

Nutritional rickets, treatment: Limited data available (Munns 2016): Administer in combination with calcium supplementation:

Daily therapy (preferred):

Infants:

Oral: 2,000 units daily for ≥3 months, followed by maintenance dose of 400 units daily

Children:

Oral: 3,000 to 6,000 units daily for ≥3 months, followed by maintenance dose of 600 units daily

Adolescents:

Oral: 6,000 units daily for ≥3 months, followed by maintenance dose of 600 units daily

Single-dose therapy:

Infants ≥3 months:

Oral: 50,000 units once, or in divided doses over several days; after 3 months, initiate maintenance dose of 400 units daily

Children:

Oral: 150,000 units once, or in divided doses over several days; after 3 months, initiate maintenance dose of 600 units daily

Adolescents:

Oral: 300,000 units once, or in divided doses over several days; after 3 months, initiate maintenance dose of 600 units daily

Usual Adult Dose for Vitamin E (Vivioptal Junior) 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 (Vitamin E (Vivioptal Junior)): 200 units (10 mL) orally once daily.

Usual Pediatric Dose for Vitamin E (Vivioptal Junior) Deficiency

1 unit/kg/day orally of water-miscible Vitamin E (Vivioptal Junior).

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 Vitamin E (Vivioptal Junior) = 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., Vitamin E (Vivioptal Junior) 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 Vitamin E (Vivioptal Junior) preparation to low-birthweight infants has been associated with the development of necrotizing enterocolitis.

Dialysis

Data not available

Other Comments

The oral liquid formulation (Vitamin E (Vivioptal Junior) [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 (Vitamin E (Vivioptal Junior) [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.

Zinc (Vivioptal Junior) 1 mg/mL (Zinc (Vivioptal Junior) Chloride Injection, USP) contains 1 mg Zinc (Vivioptal Junior)/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 (Vivioptal Junior)/day (2.5 to 4 mL/day). An additional 2 mg Zinc (Vivioptal Junior)/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 (Vivioptal Junior)/liter of small bowel fluid lost (12.2 mL/liter of small bowel fluid lost), or an additional 17.1 mg Zinc (Vivioptal Junior)/kg of stool or ileostomy output (17.1 mL/kg of stool or ileostomy output) is recommended. Frequent monitoring of Zinc (Vivioptal Junior) blood levels is suggested for patients receiving more than the usual maintenance dosage level of Zinc (Vivioptal Junior).

For full term infants and children up to 5 years of age, 100 mcg Zinc (Vivioptal Junior)/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 (Vivioptal Junior)/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 (Vivioptal Junior) 1 mg/mL (Zinc (Vivioptal Junior) 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

Pregnancy or suspected malignant genital tumor of its existence, acute inflammation, subacute or chronic genital tract, congenital or acquired anatomic abnormalities of the uterus and cervix, endometriosis, malposition and malsituaciones accused the uterus, uterine hypoplasia, genital bleeding of unknown etiology blood clotting disorders, Wilson’s disease, allergy to Copper (Vivioptal Junior).

See also:
What is the most important information I should know about Folic Acid (Vivioptal Junior)?

Because it may mask the hematologic abnormalities while neurological damage progresses, Folic Acid (Vivioptal Junior) should not be used in the therapy of patients with vitamin B12 deficiency of any cause, unless there is associated folate deficiency. The Folic Acid (Vivioptal Junior) content of one tablet a day however, is unlikely to mask pernicious anemia should this condition be present. Also, pregnancy during pernicious anemia is very rare.

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

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

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

An Iron (Vivioptal Junior) overload in the body.

Disturbed use of Iron (Vivioptal Junior) by the body.

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

See also:
What is the most important information I should know about Lysine (Vivioptal Junior)?

L-Lysine (Vivioptal Junior) supplementation is contraindicated in those with the rare genetic disorder hyperlysinemia/hyperlysinuria.

See also:
What is the most important information I should know about Magnesium (Vivioptal Junior)?

Do NOT use Calcium Carbonate/Magnesium (Vivioptal Junior) Carbonate if:

you are allergic to any ingredient in Calcium Carbonate/Magnesium (Vivioptal Junior) Carbonate

you have an increased calcium level in your blood

Contact your doctor or health care provider right away if any of these apply to you.

There are no contraindications listed within the manufacturer's US labeling.

See also:
What is the most important information I should know about Royal Jelly (Vivioptal Junior)?

This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.

See also:
What is the most important information I should know about Vitamin A (Vivioptal Junior)?

The intravenous administration. Hypervitaminosis A. Sensitivity to any of the ingredients in this preparation. Use in Pregnancy: Safety of amounts exceeding 6,000 Units of Vitamin A (Vivioptal Junior) daily during pregnancy has not been established at this time. The use of Vitamin A (Vivioptal Junior) in excess of the recommended dietary allowance may cause fetal harm when administered to a pregnant woman. Animal reproduction studies have shown fetal abnormalities associated with overdosage in several species. Malformations of the central nervous system, the eye, the palate, and the urogenital tract are recorded. Vitamin A (Vivioptal Junior) in excess of the recommended dietary allowance is contraindicated in women who are or may become pregnant. If Vitamin A (Vivioptal Junior) is used during pregnancy, or if the patient becomes pregnant while taking Vitamin A (Vivioptal Junior), the patient should be apprised of the potential hazard to the fetus.

See also:
What is the most important information I should know about Vitamin B1 (Vivioptal Junior)?

Contraindications for Vitamin B1 (Vivioptal Junior) (Vitamin B1 (Vivioptal Junior))

Hypersensitivity to Vitamin B1 (Vivioptal Junior) or any component of a product containing Vitamin B1 (Vivioptal Junior).

See also:
What is the most important information I should know about Vitamin B12 (Vivioptal Junior)?

Hypersensitivity to the components of the formula. History of allergy to the cobalamins (Vitamin B12 (Vivioptal Junior) and similar substances). Malignant tumors. By stimulating the growth of tissues, the Cobamamide could increase the high rate of cell multiplication. Sensitivity to cobalt. History of allergies to cobalamin (Vitamin B12 (Vivioptal Junior) and related substances).

- Malignant tumor: Due to the action of Vitamin B12 (Vivioptal Junior) on the growth of tissue cell multiplication rate high, the risk of exacerbation should be taken into account.

- Children under 6 years because of the dosage form

See also:
What is the most important information I should know about Vitamin B2 (Vivioptal Junior)?

None well documented.

Contraindications for Vitamin B3 (Vivioptal Junior) (Vitamin B3 (Vivioptal Junior))

Nicotinic acid is contraindicated in patients with a known hypersensitivity to any component of this medication; significant or unexplained hepatic dysfunction; active peptic ulcer disease; or arterial bleeding.

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

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

Contraindications for Vitamin B6 (Vivioptal Junior) (Vitamin B6 (Vivioptal Junior))

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

See also:
What is the most important information I should know about Vitamin D (Vivioptal Junior)?

OTC labeling: Replesta products only: When used for self-medication, do not use if you have hypercalcemia, primary hyperparathyroidism, sarcoidosis, hypervitaminosis D, Williams syndrome, or are pregnant.

Documentation of allergenic cross-reactivity for Vitamin D (Vivioptal Junior) is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

See also:
What is the most important information I should know about Vitamin E (Vivioptal Junior)?

Hypersensitivity to Vitamin E (Vivioptal Junior) or any component of the formulation

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

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

Hypersensitivity to any of the ingredients of Zinc (Vivioptal Junior).

Use Folic Acid (Vivioptal Junior) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Folic Acid (Vivioptal Junior) may be administered as an injection by your health care professional.
• If you are using Folic Acid (Vivioptal Junior) at home, carefully follow the injection procedures taught to you by your health care provider. If the medicine contains particles, is discolored, or if the vial is cracked or damaged in any way, do not use it.
• Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for selecting an appropriate container and properly disposing of the container when full.
• If you miss a dose of Folic Acid (Vivioptal Junior), use 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 use 2 doses at once.

Ask your health care provider any questions you may have about how to use Folic Acid (Vivioptal Junior).

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

• Iron (Vivioptal Junior) suspension 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 (Vivioptal Junior) absorbed by your body. Talk with your doctor about the best way to take Iron (Vivioptal Junior) suspension 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 (Vivioptal Junior) suspension with a full glass (8 oz [240 mL]) of water.
• Do not lie down for 30 minutes after taking Iron (Vivioptal Junior) suspension.
• 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 (Vivioptal Junior) suspension.
• If you miss a dose of Iron (Vivioptal Junior) suspension, 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 (Vivioptal Junior) suspension.

Use Magnesium (Vivioptal Junior) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Magnesium (Vivioptal Junior) by mouth with food.
• If you miss a dose of Magnesium (Vivioptal Junior) and are using it regularly, take it as soon as possible. If it is almost time for the 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 Magnesium (Vivioptal Junior).

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.

Use: Labeled Indications

Trace element added to parenteral nutrition (PN) to prevent Copper (Vivioptal Junior) deficiency; orally as a dietary supplement

Folic Acid (Vivioptal Junior) is the man-made form of folate. Folate is a B-vitamin naturally found in some foods. It is needed to form healthy cells, especially red blood cells.

Folic Acid (Vivioptal Junior) supplements may come in different forms (such as L-methylfolate, levomefolate, methyltetrahydrofolate). They are used to treat or prevent low folate levels. Low folate levels can lead to certain types of anemia. Conditions that can cause low folate levels include poor diet, pregnancy, alcoholism, liver disease, certain stomach/intestinal problems, kidney dialysis, among others. Women of childbearing age should receive adequate amounts of Folic Acid (Vivioptal Junior) either through their diet or supplements to prevent infant spinal cord birth defects.

How to use Folic Acid (Vivioptal Junior)

Take this product by mouth with or without food as directed by your doctor, usually once daily. If you are taking the over-the-counter product, follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.

Dosage is based on your medical condition and response to treatment. Do not increase your dose or take this product more often than directed.

Take this product regularly to get the most benefit from it. To help you remember, take it at the same time each day. Follow the diet plan recommended by your doctor or dietician. See also Notes section.

If your condition persists or worsens, or if you think you may have a serious medical problem, get medical help right away.

Herpes simplex infections.

This medication is a mineral supplement used to prevent and treat low amounts of Magnesium (Vivioptal Junior) in the blood. Magnesium (Vivioptal Junior) is very important for the normal functioning of cells, nerves, muscles, bones, and the heart. Usually, a well-balanced diet provides normal blood levels of Magnesium (Vivioptal Junior). However, certain situations cause your body to lose Magnesium (Vivioptal Junior) faster than you can replace it from your diet. These situations include treatment with "water pills" (diuretics such as furosemide, hydrochlorothiazide), a poor diet, alcoholism, or other medical conditions (e.g., severe diarrhea/vomiting, stomach/intestinal absorption problems, poorly controlled diabetes).

How to use Magnesium (Vivioptal Junior) amino acid chelate

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.

It is best to take Magnesium (Vivioptal Junior) supplements with a meal to reduce stomach upset and diarrhea unless otherwise directed by the product instructions or your doctor.

Take each dose with a full glass (8 ounces or 240 milliliters) of water unless your doctor directs you otherwise. Swallow extended-release capsules and delayed-release/enteric coated tablets or capsules whole. Do not crush or chew extended-release or delayed-release/enteric coated 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.

If you are using a liquid product, use a medication measuring device to carefully measure the dose. Do not use a household spoon because you may not get the correct dose. If you are using a suspension, shake the bottle well before each dose.

Take this medication regularly in order to get the most benefit from it. Remember to take it at the same time(s) each day. Dosage is based on your medical condition and response to treatment. Do not increase your dose or take it more often than directed on the product package or by your doctor. Too much Magnesium (Vivioptal Junior) in the blood can cause serious side effects.

Tell your doctor if symptoms of low Magnesium (Vivioptal Junior) blood levels (e.g., muscle cramps, tiredness, irritability, depression) persist or worsen. If you think you may have a serious medical problem, seek immediate medical attention.

Use: Labeled Indications

Trace element added to parenteral nutrition (PN) to prevent Manganese (Vivioptal Junior) deficiency; orally as a dietary supplement

Vitamin A (Vivioptal Junior) is used to prevent or treat low levels of the vitamin in people who do not get enough of it from their diets. Most people who eat a normal diet do not need extra Vitamin A (Vivioptal Junior). However, some conditions (such as protein deficiency, diabetes, hyperthyroidism, liver/pancreas problems) can cause low levels of Vitamin A (Vivioptal Junior). Vitamin A (Vivioptal Junior) plays an important role in the body. It is needed for growth and bone development and to maintain the health of the skin and eyesight. Low levels of Vitamin A (Vivioptal Junior) may cause vision problems (such as night blindness) and permanent eye damage.

How to use Vitamin A (Vivioptal Junior)

Take this vitamin by mouth with or without food, usually once daily. Follow all directions on the product package, or take as directed by your doctor. If you are uncertain about any of the information, consult your doctor or pharmacist.

If you are using the liquid form of this medication, 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 age, 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 each day. Do not increase your dose or use this vitamin more often than recommended. Your condition will not improve any faster, and your risk of side effects will increase.

Tell your doctor if your condition persists or worsens. If you think you may have a serious medical problem, seek immediate medical attention.

Vitamin B2 (Vivioptal Junior) (riboflavin) supplementation is used to prevent and treat riboflavin deficiency. Vitamin B2 (Vivioptal Junior) may prevent migraine headaches at high doses and be useful for prevention of eye conditions such as cataract, glaucoma and tired eyes (fatigue). Vitamin B2 (Vivioptal Junior) is also used for boosting of immune system, and maintenance of healthy hair, skin, nails and mucous membranes.

Hypercholesterolaemia, hyperlipidemia, hypertriglyceridaemia, pellagra.

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

Vitamin D (Vivioptal Junior) (ergocalciferol-D2, cholecalciferol-D3, alfacalcidol) is a fat-soluble vitamin that helps your body absorb calcium and phosphorus. Having the right amount of Vitamin D (Vivioptal Junior), calcium, and phosphorus is important for building and keeping strong bones. Vitamin D (Vivioptal Junior) is used to treat and prevent bone disorders (such as rickets, osteomalacia). Vitamin D (Vivioptal Junior) is made by the body when skin is exposed to sunlight. Sunscreen, protective clothing, limited exposure to sunlight, dark skin, and age may prevent getting enough Vitamin D (Vivioptal Junior) from the sun.

Vitamin D (Vivioptal Junior) with calcium is used to treat or prevent bone loss (osteoporosis). Vitamin D (Vivioptal Junior) is also used with other medications to treat low levels of calcium or phosphate caused by certain disorders (such as hypoparathyroidism, pseudohypoparathyroidism, familial hypophosphatemia). It may be used in kidney disease to keep calcium levels normal and allow normal bone growth. Vitamin D (Vivioptal Junior) drops (or other supplements) are given to breast-fed infants because breast milk usually has low levels of Vitamin D (Vivioptal Junior).

How to use Vitamin D (Vivioptal Junior)

Take Vitamin D (Vivioptal Junior) by mouth as directed. Vitamin D (Vivioptal Junior) is best absorbed when taken after a meal but may be taken with or without food. Alfacalcidol is usually taken with food. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.

If your doctor has prescribed this medication, take as directed by your doctor. Your dosage is based on your medical condition, amount of sun exposure, diet, age, and response to treatment.

Measure the liquid medication with the dropper provided, or use a medication-measuring spoon/device to make sure you have the correct dose. If you are taking the chewable tablet or wafers, chew the medication thoroughly before swallowing. Do not swallow whole wafers.

Certain medications (bile acid sequestrants such as cholestyramine/colestipol, mineral oil, orlistat) can decrease the absorption of Vitamin D (Vivioptal Junior). Take your doses of these medications as far as possible from your doses of Vitamin D (Vivioptal Junior) (at least 2 hours apart, longer if possible). It may be easiest to take Vitamin D (Vivioptal Junior) at bedtime if you are also taking these other medications. Ask your doctor or pharmacist how long you should wait between doses and for help finding a dosing schedule that will work with all your medications.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day if you are taking it once a day. If you are taking this medication only once a week, remember to take it on the same day each week. It may help to mark your calendar with a reminder.

If your doctor has recommended that you follow a special diet (such as a diet high in calcium), it is very important to follow the diet to get the most benefit from this medication and to prevent serious side effects. Do not take other supplements/vitamins unless ordered by your doctor.

If you think you may have a serious medical problem, get medical help right away.

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

How to use Vitamin E (Vivioptal Junior)

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 Vitamin E (Vivioptal Junior) may increase your risk of side effects.

High doses of Vitamin E (Vivioptal Junior) (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 Vitamin E (Vivioptal Junior) 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 Vitamin E (Vivioptal Junior) supplements.

If your doctor prescribes this product for Vitamin E (Vivioptal Junior) 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.

Ascorbic Acid: Copper (Vivioptal Junior) may decrease the serum concentration of Ascorbic Acid. Management: To minimize the risk for ascorbic acid degradation, add multivitamin product to TPN solution immediately prior to infusion or administer multivitamin and Copper (Vivioptal Junior) in separate containers. Consider therapy modification

See also:
What other drugs will affect Folic Acid (Vivioptal Junior)?

Medications that interfere with your bodys ability to use folate may also increase the need for this vitamin. Medications can interfere with folate utilization, including: anticonvulsant medications (such as phenytoin, and primidone) metformin (sometimes prescribed to control blood sugar in type 2 diabetes) sulfasalazine (used to control inflammation associated with Crohns disease and ulcerative colitis) triamterene (a diuretic) Methotrexate There has been concern about the interaction between vitamin B12 and Folic Acid (Vivioptal Junior). Folic Acid (Vivioptal Junior) supplements can correct the anemia associated with vitamin B12 deficiency. Unfortunately, Folic Acid (Vivioptal Junior) will not correct changes in the nervous system that result from vitamin B12 deficiency. Permanent nerve damage could theoretically occur if vitamin B12 deficiency is not treated. Therefore, intake of supplemental Folic Acid (Vivioptal Junior) should not exceed 1000 micrograms (g, sometimes mcg) per day to prevent Folic Acid (Vivioptal Junior) from masking symptoms of vitamin B12 deficiency. It is important for older adults to be aware of the relationship between Folic Acid (Vivioptal Junior) and vitamin B12 because they are at greater risk of having a vitamin B12 deficiency. If you are 50 years of age or older, ask your physician to check your B12 status before you take a supplement that contains Folic Acid (Vivioptal Junior).

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

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

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

Laboratory Test Findings

Serum Iron (Vivioptal Junior) levels may be above the normal range following Feridex I.V. (ferumoxides injectable solution) administration. Transient increases in serum Iron (Vivioptal Junior) 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 (Vivioptal Junior), the hematocrit and hemoglobin levels increase slightly.

See also:
What other drugs will affect Lysine (Vivioptal Junior)?

Since Lysine (Vivioptal Junior) does not alter clonixinate coagulation, no interaction with anticoagulant drugs and do not require dose adjustments. Concomitant use of anticholinergic drugs to be avoided by the possibility that they enhance their effects atropine.

See also:
What other drugs will affect Magnesium (Vivioptal Junior)?

Alfacalcidol: May increase the serum concentration of Magnesium (Vivioptal Junior) Salts. Consider therapy modification

Alpha-Lipoic Acid: Magnesium (Vivioptal Junior) Salts may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Magnesium (Vivioptal Junior) Salts. Consider therapy modification

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

Calcitriol (Systemic): May increase the serum concentration of Magnesium (Vivioptal Junior) Salts. Management: Consider using a non-Magnesium (Vivioptal Junior)-containing antacid or phosphate-binding product in patients also receiving calcitriol. If Magnesium (Vivioptal Junior)-containing products must be used with calcitriol, serum Magnesium (Vivioptal Junior) concentrations should be monitored closely. Consider therapy modification

Calcium Channel Blockers: May enhance the adverse/toxic effect of Magnesium (Vivioptal Junior) Salts. Magnesium (Vivioptal Junior) Salts may enhance the hypotensive effect of Calcium Channel Blockers. Monitor therapy

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

Doxercalciferol: May enhance the hypermagnesemic effect of Magnesium (Vivioptal Junior) Salts. Management: Consider using a non-Magnesium (Vivioptal Junior)-containing antacid or phosphate-binding product in patients also receiving doxercalciferol. If Magnesium (Vivioptal Junior)-containing products must be used with doxercalciferol, serum Magnesium (Vivioptal Junior) concentrations should be monitored closely. 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

Gabapentin: Magnesium (Vivioptal Junior) Salts may enhance the CNS depressant effect of Gabapentin. Specifically, high dose intravenous/epidural Magnesium (Vivioptal Junior) sulfate may enhance the CNS depressant effects of gabapentin. Magnesium (Vivioptal Junior) Salts may decrease the serum concentration of Gabapentin. Management: Administer gabapentin at least 2 hours after use of a Magnesium (Vivioptal Junior)-containing antacid. Monitor patients closely for evidence of reduced response to gabapentin therapy. Monitor for CNS depression if high dose IV/epidural Magnesium (Vivioptal Junior) sulfate is used. Consider therapy modification

Levothyroxine: Magnesium (Vivioptal Junior) Salts may decrease the serum concentration of Levothyroxine. Management: Separate administration of oral levothyroxine and oral Magnesium (Vivioptal Junior) salts by at least 4 hours. Consider therapy modification

Multivitamins/Fluoride (with ADE): Magnesium (Vivioptal Junior) Salts may decrease the serum concentration of Multivitamins/Fluoride (with ADE). Specifically, Magnesium (Vivioptal Junior) salts may decrease fluoride absorption. Management: To avoid this potential interaction separate the administration of Magnesium (Vivioptal Junior) salts from administration of a fluoride-containing product by at least 1 hour. Consider therapy modification

Mycophenolate: Magnesium (Vivioptal Junior) Salts may decrease the serum concentration of Mycophenolate. Management: Separate doses of mycophenolate and oral Magnesium (Vivioptal Junior) salts. Monitor for reduced effects of mycophenolate if taken concomitant with oral Magnesium (Vivioptal Junior) salts. Consider therapy modification

Neuromuscular-Blocking Agents: Magnesium (Vivioptal Junior) Salts may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Monitor therapy

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

Phosphate Supplements: Magnesium (Vivioptal Junior) Salts may decrease the serum concentration of Phosphate Supplements. Management: Administer oral phosphate supplements as far apart from the administration of an oral Magnesium (Vivioptal Junior) salt as possible to minimize the significance of this interaction. Exceptions: Sodium Glycerophosphate Pentahydrate. Consider therapy modification

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

Raltegravir: Magnesium (Vivioptal Junior) Salts may decrease the serum concentration of Raltegravir. Management: Avoid the use of oral / enteral Magnesium (Vivioptal Junior) salts with raltegravir. No dose separation schedule has been established that adequately reduces the magnitude of interaction. Avoid combination

Tetracyclines: Magnesium (Vivioptal Junior) Salts may decrease the absorption of Tetracyclines. Only applicable to oral preparations of each agent. Management: Avoid coadministration of oral Magnesium (Vivioptal Junior) salts and oral tetracyclines. If coadministration cannot be avoided, administer oral Magnesium (Vivioptal Junior) at least 2 hours before, or 4 hours after, oral tetracyclines. Monitor for decreased tetracycline therapeutic effects. Exceptions: 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

There are no known significant interactions.

See also:
What other drugs will affect Royal Jelly (Vivioptal Junior)?

none known

See also:
What other drugs will affect Vitamin A (Vivioptal Junior)?

The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.

To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.

Some products that may interact with this vitamin include: acitretin, alitretinoin, bexarotene, cholestyramine, isotretinoin, tretinoin, other products that contain Vitamin A (Vivioptal Junior) (such as multivitamins), warfarin.

Avoid taking Vitamin A (Vivioptal Junior) at the same time as you take neomycin, orlistat, and mineral oil. If you take any of these medications, separate your doses from your dose of Vitamin A (Vivioptal Junior) by at least 2 hours.

This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

See also:
What other drugs will affect Vitamin B1 (Vivioptal Junior)?

Interactions for Vitamin B1 (Vivioptal Junior) (Vitamin B1 (Vivioptal Junior))

Loop Diuretics,

Oral Contraceptives, Stavudine, Tricyclic Antidepressants

See also:
What other drugs will affect Vitamin B12 (Vivioptal Junior)?

In an application of Vitamin B12 (Vivioptal Junior) Atlantic Laboratories with hormonal contraceptives for oral administration may decrease the concentration of cyanocobalamin in plasma.

In an application with anticonvulsant drugs decreased cyanocobalamin absorption from the gut.

In an Vitamin B12 (Vivioptal Junior) Atlantic Laboratories application with neomycin, aminosalicylic acid, colchicine, cimetidine, ranitidine, drugs potassium decreased cyanocobalamin absorption from the gut.

Cyanocobalamin may exacerbate allergic reactions caused by thiamine.

When parenteral application of chloramphenicol may decrease the hematopoietic effects of cyanocobalamin with anemia.

See also:
What other drugs will affect Vitamin B2 (Vivioptal Junior)?

Interactions for Vitamin B2 (Vivioptal Junior) (Vitamin B2 (Vivioptal Junior))

Alcohol - impairs the intestinal absorption of riboflavi

Antidepressants (tricyclics or phenothiazines) - requirements for riboflavin may be increased in patients receiving these medications

Probenecid - concurrent use decreases gastrointestinal absorption of riboflavin; requirements for riboflavin may be increased in patients receiving probenecid.

Interactions for Vitamin B3 (Vivioptal Junior) (Vitamin B3 (Vivioptal Junior))

Antihypertensive Therapy: Nicotinic acid may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension

Aspirin: Concomitant aspirin may decrease the metabolic clearance of nicotinic acid. The clinical relevance of this finding is unclear

Other: Concomitant alcohol or hot drinks may increase the side effects of flushing and pruritus and should be avoided at the time of drug ingestion.

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 (Vivioptal Junior)?

Interactions for Vitamin B6 (Vivioptal Junior) (Vitamin B6 (Vivioptal Junior))

Amiodarone: Concomitant use of Vitamin B6 (Vivioptal Junior) and amiodarone may enhance amiodarone-induced photosensitivity reactions. Doses of Vitamin B6 (Vivioptal Junior) 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 (Vivioptal Junior) deficiency Ethionamide: The use of ethionamide may increase Vitamin B6 (Vivioptal Junior) requirements Fosphenytoin: High doses of Vitamin B6 (Vivioptal Junior) may lower plasma levels of phenytoin. Fosphenytoin is a prodrug of phenytoin Hydralazine: The use of hydralazine may increase Vitamin B6 (Vivioptal Junior) requirements Isoniazid: (isonicotinic acid, INH). Isoniazid reacts with pyridoxal 5-phosphate to form a metabolically inactive hydrazone, which may result in functional Vitamin B6 (Vivioptal Junior) deficiency Levodopa: Concomitant use of levodopa and Vitamin B6 (Vivioptal Junior) in doses of 5 milligrams or more daily may reverse the therapeutic effects of levodopa. Vitamin B6 (Vivioptal Junior) 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 (Vivioptal Junior) 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 (Vivioptal Junior) deficiency Phenelzine: Phenelzine may react with pyridoxal 5-phosphate to yield a metabolically inactive hydrazone compound Phenobarbital: High doses of Vitamin B6 (Vivioptal Junior) may lower plasma levels of phenobarbital Phenytoin: High doses of Vitamin B6 (Vivioptal Junior) 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.

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What other drugs will affect Vitamin D (Vivioptal Junior)?

Aluminum Hydroxide: Vitamin D (Vivioptal Junior) Analogs may increase the serum concentration of Aluminum Hydroxide. Specifically, the absorption of aluminum may be increased, leading to increased serum aluminum concentrations. Avoid combination

Bile Acid Sequestrants: May decrease the serum concentration of Vitamin D (Vivioptal Junior) Analogs. More specifically, bile acid sequestrants may impair absorption of Vitamin D (Vivioptal Junior) Analogs. Management: Avoid concomitant administration of Vitamin D (Vivioptal Junior) analogs and bile acid sequestrants (eg, cholestyramine). Separate administration of these agents by several hours to minimize the potential risk of interaction. Monitor plasma calcium concentrations. Consider therapy modification

Calcium Salts: May enhance the adverse/toxic effect of Vitamin D (Vivioptal Junior) Analogs. Monitor therapy

Cardiac Glycosides: Vitamin D (Vivioptal Junior) Analogs may enhance the arrhythmogenic effect of Cardiac Glycosides. Monitor therapy

Danazol: May enhance the hypercalcemic effect of Vitamin D (Vivioptal Junior) Analogs. Monitor therapy

Erdafitinib: Serum Phosphate Level-Altering Agents may diminish the therapeutic effect of Erdafitinib. Management: Avoid coadministration of serum phosphate level-altering agents with erdafitinib before initial dose increase period based on serum phosphate levels (Days 14 to 21). Consider therapy modification

Mineral Oil: May decrease the serum concentration of Vitamin D (Vivioptal Junior) Analogs. More specifically, mineral oil may interfere with the absorption of Vitamin D (Vivioptal Junior) Analogs. Management: Avoid concomitant, oral administration of mineral oil and Vitamin D (Vivioptal Junior) analogs. Consider separating the administration of these agents by several hours to minimize the risk of interaction. Monitor plasma calcium concentrations. Consider therapy modification

Multivitamins/Fluoride (with ADE): May enhance the adverse/toxic effect of Vitamin D (Vivioptal Junior) Analogs. Avoid combination

Multivitamins/Minerals (with ADEK, Folate, Iron): May enhance the adverse/toxic effect of Vitamin D (Vivioptal Junior) Analogs. Avoid combination

Orlistat: May decrease the serum concentration of Vitamin D (Vivioptal Junior) Analogs. More specifically, orlistat may impair absorption of Vitamin D (Vivioptal Junior) Analogs. Management: Monitor clinical response (including serum calcium) to oral Vitamin D (Vivioptal Junior) analogs closely if used with orlistat. If this combination must be used, consider giving the Vitamin D (Vivioptal Junior) analog at least 2 hrs before or after orlistat. Consider therapy modification

Sucralfate: Vitamin D (Vivioptal Junior) Analogs may increase the serum concentration of Sucralfate. Specifically, the absorption of aluminum from sucralfate may be increased, leading to an increase in the serum aluminum concentration. Avoid combination

Thiazide and Thiazide-Like Diuretics: May enhance the hypercalcemic effect of Vitamin D (Vivioptal Junior) Analogs. Monitor therapy

Vitamin D (Vivioptal Junior) Analogs: May enhance the adverse/toxic effect of other Vitamin D (Vivioptal Junior) Analogs. Avoid combination

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What other drugs will affect Vitamin E (Vivioptal Junior)?

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

Anticoagulants: Vitamin E (Vivioptal Junior) (Systemic) may enhance the anticoagulant effect of Anticoagulants. Monitor therapy

CycloSPORINE (Systemic): Vitamin E (Vivioptal Junior) (Systemic) may decrease the serum concentration of CycloSPORINE (Systemic). Monitor therapy

Ibrutinib: Vitamin E (Vivioptal Junior) (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 Vitamin E (Vivioptal Junior) (Systemic). Management: Patients taking tipranavir oral solution are advised to avoid taking additional Vitamin E (Vivioptal Junior), beyond the amounts contained in a multivitamin product. This interaction does not apply to tipranavir capsules. Consider therapy modification

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.

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What other drugs will affect Zinc (Vivioptal Junior)?

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 Zinc (Vivioptal Junior) in anaemia.

Folate deficiency states may be produced by a number of drugs including antiepileptics, oral contraceptives, antituberculous drugs, alcohol and Zinc (Vivioptal Junior) antagonists eg, aminopterin, methotrexate, pyrimethamine, trimethoprim and sulphonamides; Zinc (Vivioptal Junior) 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 (Vivioptal Junior) may be reduced by iron supplements, penicillamine, phosphorus-containing preparations and tetracyclines. Zinc (Vivioptal Junior) supplements reduce the absorption of Zinc (Vivioptal Junior), ciprofloxacin, iron, norfloxacin, penicillamine and tetracyclines.

Adverse Reactions

Generally well tolerated; excessive Copper (Vivioptal Junior) levels may result in the following adverse effect.

Hepatic: Hepatic insufficiency (including hepatic necrosis)

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What are the possible side effects of Folic Acid (Vivioptal Junior)?

Allergic sensitization has been reported following both oral and parenteral administration of Folic Acid (Vivioptal Junior).

Folic Acid (Vivioptal Junior) is relatively nontoxic in man. Rare instances of allergic responses to Folic Acid (Vivioptal Junior) preparations have been reported and have included erythema, skin rash, itching, general malaise, and respiratory difficulty due to bronchospasm. One patient experienced symptoms suggesting anaphylaxis following injection of the drug. Gastrointestinal side effects, including anorexia, nausea, abdominal distention, flatulence, and a bitter or bad taste, have been reported in patients receiving 15 mg Folic Acid (Vivioptal Junior) daily for 1 month. Other side effects reported in patients receiving 15 mg daily include altered sleep patterns, difficulty in concentrating, irritability, overactivity, excitement, mental depression, confusion, and impaired judgment. Decreased vitamin B12 serum levels may occur in patients receiving prolonged Folic Acid (Vivioptal Junior) therapy.

In an uncontrolled study, orally administered Folic Acid (Vivioptal Junior) was reported to increase the incidence of seizures in some epileptic patients receiving phenobarbital, primidone, or diphenylhydantoin. Another investigator reported decreased diphenylhydantoin serum levels in folate-deficient patients receiving diphenylhydantoin who were treated with 5 mg or 15 mg of Folic Acid (Vivioptal Junior) daily.

CALL YOUR DOCTOR FOR MEDICAL ADVICE ABOUT SIDE EFFECTS. YOU MAY REPORT SIDE EFFECTS TO THE FDA AT 1-800-FDA-1088 OR LEADING PHARMA, LLC AT 844-740-7500.

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What are the possible side effects of Iron (Vivioptal Junior)?

Applies to carbonyl Iron (Vivioptal Junior): 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 (Vivioptal Junior):

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.

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What are the possible side effects of Lysine (Vivioptal Junior)?

Adverse effects associated with the mechanics of retrograde genitourinary procedures include injury to the urethra, bladder, and ureter, and introduction of infection. {03} {06} {31}

Systemic adverse effects, similar to those that occur with direct intravascular injection of the diatrizoate salts, may also occur with intravesical or intraureteral instillation as a result of inadvertent intravascular entry of the contrast solution due to either bladder absorption or pyelorenal backflow. {06} {31}

Systemic adverse effects, although rare, are possible with intrauterine instillation if medium is absorbed systemically after being retained in the uterine cavity or spilled into the peritoneal cavity. {06} {34}

The following side/adverse effects have been selected on the basis of their potential clinical significance (possible signs and symptoms in parentheses where appropriate)—not necessarily inclusive

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What are the possible side effects of Magnesium (Vivioptal Junior)?

The adverse effects of parenterally administered Magnesium (Vivioptal Junior) usually are the result of Magnesium (Vivioptal Junior) intoxication. These include flushing, sweating, hypotension, depressed reflexes, flaccid paralysis, hypothermia, circulatory collapse, cardiac and central nervous system depression proceeding to respiratory paralysis. Hypocalcemia with signs of tetany secondary to Magnesium (Vivioptal Junior) sulfate therapy for eclampsia has been reported.

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What are the possible side effects of Manganese (Vivioptal Junior)?

None known.

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What are the possible side effects of Royal Jelly (Vivioptal Junior)?

No health hazards or side effects are known in conjunction with the

proper administration of designed therapeutic dose.

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What are the possible side effects of Vitamin A (Vivioptal Junior)?

This vitamin usually has no side effects when used in recommended doses. If you have any unusual effects, contact your doctor or pharmacist promptly.

A very serious allergic reaction to this vitamin is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: 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.

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What are the possible side effects of Vitamin B1 (Vivioptal Junior)?

Applies to thiamine: capsule, solution, tablet, tablet enteric coated

As well as its needed effects, thiamine (the active ingredient contained in Vitamin B1 (Vivioptal Junior)) may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking thiamine, check with your doctor immediately:

Rare - Soon after receiving injection only

• Coughing
• difficulty in swallowing
• hives
• itching of skin
• swelling of face, lips, or eyelids
• wheezing or difficulty in breathing

See also:
What are the possible side effects of Vitamin B12 (Vivioptal Junior)?

Applies to cyanocobalamin: intramuscular solution

Other dosage forms:

• nasal gel/jelly, nasal spray

As well as its needed effects, cyanocobalamin (the active ingredient contained in Vitamin B12 (Vivioptal Junior)) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking cyanocobalamin, check with your doctor or nurse immediately:

Incidence not known:

• Abdominal or stomach pain
• bleeding from the gums or nose
• blue lips and fingernails
• chest pain
• cough
• coughing that sometimes produces a pink frothy sputum
• decreased urine output
• difficult, fast, noisy breathing, sometimes with wheezing
• difficulty with swallowing
• dilated neck veins
• dizziness
• extreme fatigue
• eye pain
• fast heartbeat
• headache
• hives, itching, or skin rash
• increased sweating
• irregular breathing
• irregular heartbeat
• pale skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• ringing in the ears
• swelling of the face, fingers, feet, or lower legs
• tightness in the chest
• unusual tiredness or weakness
• weight gain

Minor Side Effects

Some cyanocobalamin side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Incidence not known:

• Diarrhea
• skin rash with a general disease

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What are the possible side effects of Vitamin B2 (Vivioptal Junior)?

Genitourinary

Yellow-orange discoloration of urine.

Allergic sensitization has been reported rarely following oral and parenteral administration of Vitamin B3 (Vivioptal Junior).

At recommended doses, nicotinamide is expected to be well tolerated. Gastrointestinal distress such as nausea or vomiting have been associated with the administration of nicotinamide or zinc at doses greater than the recommended dose of nicotinamide

Nicotinamide: Dizziness, headache, hyperglycemia, nausea, vomiting, diarrhea, elevations in liver function tests, hepatotoxicity, blurred vision, flushing, rash.

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 B5 (Vivioptal Junior), Vitamin B5 (Vivioptal Junior), and Vitamin B5 (Vivioptal Junior) 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 (Vivioptal Junior)?

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 (Vivioptal Junior)) 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

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What are the possible side effects of Vitamin D (Vivioptal Junior)?

Vitamin D (Vivioptal Junior) at normal doses usually has no side effects. If you have any unusual effects, contact your doctor or pharmacist promptly.

If your doctor has directed you to take 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.

Too much Vitamin D (Vivioptal Junior) can cause harmful high calcium levels. Tell your doctor right away if any of these signs of high Vitamin D (Vivioptal Junior)/calcium levels occur: nausea/vomiting, constipation, loss of appetite, increased thirst, increased urination, mental/mood changes, unusual tiredness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: 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.

See also:
What are the possible side effects of Vitamin E (Vivioptal Junior)?

Applies to Vitamin E (Vivioptal Junior): 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 Vitamin E (Vivioptal Junior) (the active ingredient contained in Centrum Singles-Vitamin E (Vivioptal Junior)). 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 Vitamin E (Vivioptal Junior), 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

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 (Vivioptal Junior)?

Applies to Zinc (Vivioptal Junior) 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 (Vivioptal Junior) sulfate (the active ingredient contained in Zinc (Vivioptal Junior))

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.

Copper (Vivioptal Junior) has been designed for the demands of modern life. With a wide range of nutrients and trace minerals, Copper (Vivioptal Junior) gives nutritional support to the area of health which are most relevance to women.

Each cap contains starflower oil 100 mg, evening primrose oil 100 mg, citrus bioflavonoids 10 mg, natural mixed carotenoids 2 mg, vitamin D (as D3 200 IU) 5 mcg, vitamin E 30 mg, vitamin C 60 mg, vitamin K 90 mcg, thiamin (vitamin B1) 10 mg, riboflavin (vitamin B2) 5 mg, niacin (vitamin B3) 36 mg, vitamin B6 10 mg, folic acid 400 mcg, vitamin B12 20 mcg, biotin 50 mcg, pantothenic acid 6 mg, magnesium 100 mg, iron 12 mg, zinc 12 mg, Copper (Vivioptal Junior) 1500 mcg, manganese 2.5 mg, selenium 100 mcg, chromium 50 mcg, para-aminobenzoic acid (PABA) 30 mg.

No artificial colours, gluten, presevatives, starch or sugar, salt or yeast.

Copper (Vivioptal Junior) has not been tested on animals.

A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses (poaceae). Folic Acid (Vivioptal Junior) is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [PubChem]

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 (Vivioptal Junior) 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 (Vivioptal Junior) is the ideal cure to facilitate digestion and to strengthen the GIT.

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

L-Lysine (Vivioptal Junior) (abbreviated as Lys or K) is an α-amino acid with the chemical formula HO2CCH(NH2)(CH2)4NH2. This amino acid is an essential amino acid, which means that humans cannot synthesize it. Its codons are AAA and AAG. L-Lysine (Vivioptal Junior) is a base, as are arginine and histidine. The ε-amino group often participates in hydrogen bonding and as a general base in catalysis. Common posttranslational modifications include methylation of the ε-amino group, giving methyl-, dimethyl-, and trimethyllysine. The latter occurs in calmodulin. Other posttranslational modifications include acetylation. Collagen contains hydroxylysine which is derived from Lysine (Vivioptal Junior) by lysyl hydroxylase. O-Glycosylation of Lysine (Vivioptal Junior) residues in the endoplasmic reticulum or Golgi apparatus is used to mark certain proteins for secretion from the cell.

Manganese (Vivioptal Junior) is a transition metal with a molar mass of 54.94g/mol. Manganese (Vivioptal Junior) is considered critical for human health, and plays important roles in development, metabolism, and the antioxidant system. That said, excessive Manganese (Vivioptal Junior) intake is associated with manganism, a neurodegenerative disorder that causes dopaminergic neuronal death and parkinsonian-like symptoms.

Vitamin A (Vivioptal Junior) (Glucoenergan, Reactivan) is a stimulant which was developed in the 1960s as an appetite suppressant, but was later withdrawn for this application due to problems with dependence and abuse. It is around half the potency of dexamphetamine, and is prescribed at a dose of 10-60mg, although abusers of the drug tend to rapidly develop tolerance and escalate their dose. Reactivan is still rarely used for treating depressive day-time fatigue, lack of concentration and lethargy, particularly in individuals who have chronic medical conditions, as its favourable safety profile makes it the most suitable drug in some cases.

3-((4-Amino-2-methyl-5-pyrimidinyl)methyl)-5-(2- hydroxyethyl)-4-methylthiazolium chloride.

Vitamin B12 (Vivioptal Junior) (commonly known as Vitamin B12 (Vivioptal Junior)) is the most chemically complex of all the vitamins. Vitamin B12 (Vivioptal Junior)'s structure is based on a corrin ring, which, although similar to the porphyrin ring found in heme, chlorophyll, and cytochrome, has two of the pyrrole rings directly bonded. The central metal ion is Co (cobalt). Vitamin B12 (Vivioptal Junior) cannot be made by plants or by animals, as the only type of organisms that have the enzymes required for the synthesis of cyanocobalamin are bacteria and archaea. Higher plants do not concentrate cyanocobalamin from the soil and so are a poor source of the substance as compared with animal tissues. Vitamin B12 (Vivioptal Junior) is naturally found in foods including meat (especially liver and shellfish), eggs, and milk products.

Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as flavin mononucleotide and flavin-adenine dinucleotide.

Vitamin B3 (Vivioptal Junior) Lotion: Helps to reduce the appearance of blemishes on larger areas (back and upper chest). It absorbs easily to the skin and does not bleach clothes. Non-photosensitizing, fragrance-free and paraben-free.

Vitamin B3 (Vivioptal Junior) Isocorrexion Hydrating Cream: Specially formulated for acne prone skin. Nicotinamide and Anti-Bacterial Adhesive substance (ABA's) helps to clear blemishes. Biophytosebum provides a moisturizing effect, reducing dryness and skin tightness caused by conventional acne treatment.

Vitamin B3 (Vivioptal Junior) Oil-Free Cream: An oil-free formula enriched with mattifying agents. It helps to clear blemishes by promoting oil-free skin.

Vitamin B3 (Vivioptal Junior) UV High Protection Cream SPF 45: Protects acne-prone skin from daily sun-induced irritation and damage, keeping the skin hydrated and blemish-free at the same time. Non-sensitizing, non-comodogenic, fragrance-free and paraben-free.

Vitamin B3 (Vivioptal Junior) Gel: Provides intensive anti-blemish skin care for localized spots and promotes disappearance on the face or other small areas. It is non-sensitizing, fragrance-free and paraben-free.

Vitamin B3 (Vivioptal Junior) Moussant Soap Free Cleansing Gel: Helps clear blemishes by purifying and cleansing the skin gently.

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).

A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Vitamin E (Vivioptal Junior)&

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

Zinc (Vivioptal Junior) Syrup: Each 5 mL contains Zinc (Vivioptal Junior) 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.