ALPHA.-TOCOPHEROL, D-: 586 Adverse Event Reports & Safety Profile

DESCRIPTION: Active Ingredients: Amount Per Serving: Vitamin A (as Retinyl Acetate).................................... 900 mcg RAE Vitamin C (as Ascorbic Acid)............................................... 200 mg Vitamin D3 (as Cholecalciferol)............................................ 10 mcg Vitamin E (as D-Alpha Tocopheryl Acetate)............................ 30 mg Thiamin (as Thiamine Mononitrate)...................................... 1.2 mg Riboflavin ............................................................................. 1.3 mg Niacin (as Niacinamide)........................................................... 8 mg Vitamin B6 (as Pyridoxine Hydrochloride)............................ 1.7 mg Folate (as L-5-Methyltetrahydrofolate calcium salt)...1700 mcg DFE (1000 mcg of L-5-Methylfolate) Vitamin B12 (as Methylcobalamin and Hydroxocobalamin)...2.4 mcg Biotin (as D-Biotin)............................................................... 30 mcg Pantothenic Acid (as D-Calcium Pantothenate)........................ 5 mg Choline (as Choline Bitartrate)............................................. 200 mg Calcium (as Calcium Citrate)................................................ 200 mg Magnesium (as Magnesium Citrate).................................... 100 mg Zinc (as Zinc Picolinate)........................................................... 2 mg Inulin (as Helianthus Tuberosus Root Extract)..................... 500 mg Other Ingredients: Aqua (Water), Organic Agave Syrup, Carrageenan, Citrus Extract, Flavor, Glycerin, Hydroxocobalamin Acetate, Potassium Sorbate, Organic Stevia Rebaudiana Leaf Extract.

INDICATIONS AND USAGE Supplementation of the diet with vitamins A, C and D. Multi-Vitamin Drops with Fluoride and Iron 0.25 mg also provides fluoride for caries prophylaxis.

The American

Academy of Pediatrics recommends that children up to age 16, in areas where drinking water contains less than optimal levels of fluoride, receive daily fluoride supplementation.

The American

Academy of Pediatrics recommend that infants and young children 6 months to 3 years of age, in areas where the drinking water contains less than 0.3 ppm of fluoride, and children 3-6 years of age, in areas where the drinking water contains 0.3 through 0.6 ppm of fluoride, receive 0.25 mg of supplemental fluoride daily which is provided in a dose of 1 mL of Multi-Vitamin Drops with Fluoride 0.25 mg (See Dosage and Administration ). Multi-Vitamin Drops with Fluoride and Iron 0.25 mg supply significant amounts of vitamins A, C and D to supplement the diet, and to help assure that nutritional deficiencies of these vitamins will not develop. Thus, in a single easy-to-use preparation, children obtain essential vitamins and fluoride.

DOSAGE AND ADMINISTRATION: See following chart. May be dropped directly into the mouth with dropper; or mixed with cereal, fruit juice or other food.

Fluoride Ion

Level in Drinking Water (ppm) * A g e <0.3 ppm 0.3 - 0.6 ppm >0.6 ppm Birth - 6 months None None None 6 mos - 3 years 0.25 mg (1 mL) / day † None None 3 - 6 years 0.50 mg (2 mL) / day 0.25 mg (1 mL) / day None * 1.0 ppm = 1 mg/liter † 2.2 mg sodium fluoride contains 1 mg fluoride ion.

CONTRAINDICATIONS STROVITE ® ONE is contraindicated in patients with hypersensitivity to any of its components.

Folic

Acid is contraindicated in patients with untreated and uncomplicated pernicious anemia, and in those with anaphylactic sensitivity to folic acid. Cyanocobalamin is contraindicated in patients with sensitivity to cobalt or to cyanocobalamin (Vitamin B12).

Adverse Reactions: Folate: Allergic sensitizations have been reported following both oral and parenteral administration of folate. Adverse reactions have been reported with specific vitamins and minerals but generally at levels substantially higher than those contained herein. However, allergic, and idiosyncratic reactions are possible at lower levels.

WARNING: In case of accidental overdose, seek professional assistance or contact a Poison Control Center immediately.

Precaution Section

Folate doses above 0.1 mg daily may obscure pernicious anemia, in that hematologic remission can occur while neurological manifestations remain progressive. There is a potential danger in administering folate to patients with undiagnosed anemia since folate may obscure the diagnosis of pernicious anemia by alleviating the hematologic manifestations of the disease while allowing the neurologic complications to progress. This may result in severe nervous system damage before the correct diagnosis is made. Adequate doses of vitamin B12 may prevent, halt, or improve the neurologic changes caused by pernicious anemia. The patient’s medical conditions and consumption of other drugs, herbs, and/or supplements should be considered. For use on the order of a licensed healthcare practitioner. Call your doctor about side effects. To report side effects, call PureTek Corporation at 1-877-921-7873 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Adverse

Reactions: Folate: Allergic sensitizations have been reported following both oral and parenteral administration of folate. Adverse reactions have been reported with specific vitamins and minerals but generally at levels substantially higher than those contained herein. However, allergic, and idiosyncratic reactions are possible at lower levels.

PRECAUTION S The suggested dose should not be exceeded since dental fluorosis may result from continued ingestion of large amounts of fluoride. When prescribing vitamin fluoride products: Determine the fluoride content of the drinking water. Make sure the child is not receiving significant amounts of fluoride from other medications and swallowed toothpaste. Periodically check to make sure that the child does not develop significant dental fluorosis. Multi-Vitamin Drops with Fluoride Iron 0.25 mg should be dispensed in the original plastic container, since contact with glass leads to instability and precipitation. (The amount of sodium fluoride in the 50 mL size is well below the maximum to be dispensed at one time according to recommendations of the American Dental Association.)

Important Considerations When Using Dosage

Schedule: If fluoride level is unknown, drinking water should be tested for fluoride content before supplements are prescribed. For testing of fluoride content, contact the local or state health department. All sources of fluoride should be evaluated with a thorough fluoride history. Patient exposure to multiple water sources can make proper prescribing complex. Ingestion of higher than recommended levels of fluoride by children has been associated with an increase in mild dental fluorosis in developing, unerupted teeth. Fluoride supplements require long-term compliance on a daily basis.

Drug Interactions High doses of folic acid may result in decreased serum levels of anticonvulsant drugs. Vitamin D supplementation should not be given with large amounts of calcium in those with hypercalcemia or conditions that may lead to hyper-calcemia such as hyperparathyroidism and those who form calcium-containing kidney stones. Zinc can inhibit the absorption of certain antibiotics; take at least 2 hours apart to minimize interactions. Consult appropriate references for additional specific vitamin-drug interactions.