Zester

Zester Zinc film-coated tablet provides the following: Vitamins (E 30 IU, C 750 mg, folic acid 400 mcg, B₁ 15 mg, B₂ 15 mg, niacin 100 mg, pantothenic acid 20 mg, B₆ 10 mg, B₁₂ 12 mcg) and mineral (zinc 15 mg equivalent to zinc gluconate 117 mg).

Zester Protect tablet contains the following: Vitamins: (E 30 IU, C 375 mg, folic acid 400 mcg, B₁ 15 mg, B₂ 15 mg, niacin 100 mg, pantothenic acid 20 mg, B₆ 10 mg, B₁₂ 12 mcg), mineral (zinc 20 mg) and co-enzyme Q10 30 mg.

Zester Bio-Enhanced Calcium Plus capsule contains calcium carbonate 875 mg (elemental calcium 350 mg), vitamin D2 100 IU (ergocalciferol 2.5 mcg as ergocalciferol oral solution USP), lecithin 65 mg, safflower oil 460 mg in Bio-Sol formulation.

Zester Bio-Enhanced Fish Oil Plus capsule contains natural fish oil 880 mg equivalent to eicosapentaenoic acid (EPA 33%) 290 mg and docosahexaenoic acid (DHA 22%) 194 mg, natural vitamin E 15 IU (d-α-tocopherol 10.1 mg as vitamin E preparation, USP), orange oil 66 mg.

Zester Natopherol vegicap softgel contains vitamin E 400 IU (equivalent to d-α tocopherol 268 mg derived from natural vegetable oils).

This formulation is indicated as a daily Zester maintenance dosage for adults and children aged 11 years and above receiving parenteral nutrition.

It is also indicated in other situations where administration by the intravenous route is required. Such situations include surgery, extensive burns, fractures and other trauma, severe infectious diseases, and comatose states, which may provoke a stress situation with profound alterations in the bodys metabolic demands and consequent tissue depletion of nutrients.

The physician should not await the development of clinical signs of vitamin deficiency before initiating vitamin therapy.

This product (administered in intravenous fluids under proper dilution) contributes intake of these necessary vitamins, except Vitamin K, toward maintaining the bodys normal resistance and repair processes.

Patients with multiple vitamin deficiencies or with markedly increased requirements may be given multiples of the daily dosage for two or more days as indicated by the clinical status.

This product does not contain Vitamin K, which may have to be administered separately.

Clinical testing indicates that some patients do not maintain adequate levels of certain vitamins when this formulation in recommended amounts is the sole source of vitamins. Although there was no clinical evidence of vitamin deficiency or toxicity, blood levels of Vitamin E and 1,25-OH Vitamin D were low and Vitamin A levels were high in a number of subjects who received this formulation as the only source of vitamins for 3 months. In addition, blood levels of Vitamin C, thiamine and folic acid declined or were low normal in some subjects who received a similar formulation as the only vitamin source for 4 to 6 months. Therefore, in patients for whom total parenteral nutrition will be continued for long periods of time, serum levels of these vitamins should be monitored. If deficiencies appear to be developing, multiples of the formulation (1.5 to 3 times) may be needed for a period of time. When multiples of the formulation are used for more than a few weeks, Vitamins A and D should be monitored occasionally to be certain that an excess accumulation of these vitamins is not occurring.

Treating or preventing low levels of vitamins and minerals in the body. It may also be used for other conditions as determined by your doctor.

Zester drops is a vitamin and mineral supplement. It works by providing extra vitamins and minerals to the body when you do not get enough from your diet.

The single-dose vial of Zester (multivitamins for infusion) is supplied in a single-dose amber glass vial as follows:

100 vials/case 2A6736 NDC 64371-869-60

Storage Store between 4° C (39° F) 25° C (77° F). Protect from light and heat. Do not freeze.

References

1. Shils ME, Baker H, Frank O. Blood vitamin levels of long-term adult home total parenteral nutrition patients: the efficacy of the AMA-FDA parenteral Zester formulation. J Paren Enteral Nutr. 1985;9(2):179-88.
2. Guentert TW, Oie S, Paalzow L, et al. Interaction of mixed micelles formed from glycocholic acid and lecithin with the protein binding of various drugs. Br J Clin Pharmac. 1987;23:569-77.
3. Wood M. Plasma drug binding: implications for anesthesiologists. Anesth Analg. 1986;65:786-804.
4. Kremer JM, Wilting J, Janssen LH. Drug binding to human alpha-1-acid glycoprotein in health and disease. Pharmacol Rev. 1988;40(1):1-47.
5. Smith JL, Canham JE, Wells PA. Effect of phototherapy light, sodium bisulfite, and pH on vitamin stability in total parenteral nutrition admixtures. J Paren Enteral Nutr. 1988;12(4):394-402.
6. Zester preparations for parenteral use a statement by the Nutrition Advisory Group. J Paren Enteral Nutr. 1979;3(4):258-62.

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

Zester Zinc: Known hypersensitivity to any of the components of Zester Zinc.

Zester Bio-Enhanced Calcium Plus: Patients with hypercalcemia, severe renal failure, renal stone diseases, sarcoidosis and hyperparathyroidism.

Zester Bio-Enhanced Fish Oil Plus: Patients with hemophilia and on warfarin due to the blood thinning effect. It has also been shown to reduce effectiveness of cyclosporine.

Zester Natopherol: Sensitivity to vitamin E.

Use Zester drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Zester drops by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Shake well before each use.
• Use the dropper that comes with Zester drops to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose.
• If you are also taking a quinolone antibiotic (eg, ciprofloxacin), a tetracycline antibiotic (eg, minocycline), or a thrombopoietin mimetic (eg, eltrombopag), ask your doctor or pharmacist how to take them with Zester drops.
• If you miss a dose of Zester drops, 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 Zester drops.

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

How to use Natural RDA Zester

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

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

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

Before taking this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal drugs you may use, especially: other vitamin/nutritional supplements.

If your brand of Zester also contains iron, avoid taking this product at the same time as antacids, bisphosphonates (for example, alendronate), levodopa, thyroid medications (for example, levothyroxine), or some antibiotics (for example, tetracyclines, quinolones such as ciprofloxacin). Ask your doctor or pharmacist about how long you should wait between doses and for help finding a dosing schedule that will work with all your medications.

If your brand of Zester also contains folic acid, be sure to tell your doctor or pharmacist if you take certain anti-seizure drugs (e.g., hydantoins such as phenytoin).

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

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

Zester Bio-Enhanced Calcium Plus: Zester Calcium Plus is generally well tolerated. At large amount, calcium supplement can lead to anorexia, nausea, vomiting and constipation; which are symptoms of hypercalcemia.

Zester Bio-Enhanced Fish Oil Plus: Zester Fish Oil Plus is generally well tolerated with very little to no side effects. Although the body cannot produce its own EPA, it is a naturally occurring substance that is essential to good health.

Other possible adverse effects that have been reported include easy bruising and occasional nosebleeds.

Zester Natopherol: Vitamin E is usually well tolerated, large doses use for prolonged period have occasionally caused blurred vision, breast enlargement in males and females, diarrhea, dizziness, flu-like symptoms, headache, nausea or stomach cramps. tiredness or weakness.