Adult Infuvite Multiple Vitamins for Infusion

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Overview

What is Adult Infuvite Multiple Vitamins for Infusion?

INFUVITE

Each 5 mL of Vial 1 contains:

Ascorbic acid (Vitamin C) ....................................... 200 mg

Vitamin A* (as palmitate) ..................................... 3,300 IU

Vitamin D* (cholecalciferol) .................................. 200 IU

Thiamine (Vitamin B)(as the hydrochloride) .............................................. 6 mg

Riboflavin (Vitamin B)(as riboflavin 5-phosphate sodium)........................ 3.6 mg

Pyridoxine HCl (Vitamin B) ....................................... 6 mg

Niacinamide .............................................................. 40 mg

Dexpanthenol(as d-pantothenyl alcohol)...................................... 15 mg

Vitamin E* (-α-tocopheryl acetate)..........................10 IU

Vitamin K* .......................................................... 150 mcg

Inactive ingredients: 1.4% polysorbate 80, sodium hydroxide and/or hydrochloric acid for pH adjustment, and water for injection.

*Polysorbate 80 is used to water solubilize the oil-soluble vitamins A, D, E, and K.

Each 5 mL of Vial 2 contains:

Folic acid............................................................... 600 mcg

Biotin....................................................................... 60 mcg

Vitamin B (cyanocobalamin).................................. 5 mcg

Inactive ingredients: 30% propylene glycol, citric acid and/or sodium citrate for pH adjustment, and water for injection.

“Aqueous” multiple vitamin preparation for intravenous infusion:

INFUVITE

Contains no more than 70 mcg/L of aluminum (combined Vials 1 and 2).

What does Adult Infuvite Multiple Vitamins for Infusion look like?

What are the available doses of Adult Infuvite Multiple Vitamins for Infusion?

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What should I talk to my health care provider before I take Adult Infuvite Multiple Vitamins for Infusion?

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How should I use Adult Infuvite Multiple Vitamins for Infusion?

INFUVITE

INFUVITE

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

INFUVITE

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.

Some patients do not maintain adequate levels of certain vitamins when a multiple vitamin preparation, such as , in recommended amounts, is the sole source of vitamins. Blood levels of vitamins A, C, D, and folic acid may decline in patients receiving parenteral multivitamins as their sole source of vitamins for 4 to 6 months. Therefore, in patients for whom total parenteral nutrition will be continued for long periods of time blood vitamin concentrations should be monitored to ensure maintenance of adequate levels. 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.

INFUVITE

INFUVITE

For intravenous feeding, one daily dose of INFUVITE (5 mL of Vial 1 plus 5 mL of Vial 2) added directly to not less than 500 mL, and preferably 1,000 mL, of intravenous dextrose, saline or similar infusion solutions. Discard any unused portion.

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

After is diluted in an intravenous infusion, the resulting solution should be refrigerated unless it is to be used immediately. The solution should be used within 24 hours after dilution. Some of the vitamins in this product, particularly A, D, and riboflavin, are light sensitive, therefore, exposure to light should be minimized.

What interacts with Adult Infuvite Multiple Vitamins for Infusion?

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What are the warnings of Adult Infuvite Multiple Vitamins for Infusion?

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What are the precautions of Adult Infuvite Multiple Vitamins for Infusion?

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What are the side effects of Adult Infuvite Multiple Vitamins for Infusion?

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What should I look out for while using Adult Infuvite Multiple Vitamins for Infusion?

INFUVITE

Allergic reactions have been known to occur following intravenous administration of thiamine and vitamin K. The formulation is contraindicated prior to blood sampling for detection of megaloblastic anemia, as the folic acid and the cyanocobalamin in the vitamin solution can mask serum deficits.

This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solution, which contain aluminum.

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

What might happen if I take too much Adult Infuvite Multiple Vitamins for Infusion?

The fat-soluble vitamins A, D, and E can accumulate to harmful levels. The possibility of hypervitaminosis A or D should be borne in mind. Clinical manifestations of hypervitaminosis A have been reported in patients with renal failure receiving 1.5 mg/day retinol. Therefore, vitamin A supplementation of renal failure patients should be undertaken with caution.

Water-soluble vitamins are readily excreted in the urine. Treatment of vitamin overdosage usually consists of withdrawal of the vitamin.

How should I store and handle Adult Infuvite Multiple Vitamins for Infusion?

Store at 20°-25°C (68°-77°F) [see USP Controlled Room Temperature].Dispense in a tight, light-resistant container as defined in the USP/NF with a child-resistant closure.A Schedule CIII Narcotic.Store at 20°-25°C (68°-77°F) [see USP Controlled Room Temperature].Dispense in a tight, light-resistant container as defined in the USP/NF with a child-resistant closure.A Schedule CIII Narcotic.Store at 20°-25°C (68°-77°F) [see USP Controlled Room Temperature].Dispense in a tight, light-resistant container as defined in the USP/NF with a child-resistant closure.A Schedule CIII Narcotic.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.INFUVITE Store under refrigeration, 2-8°C (36-46°F).Rx onlyManufactured by 145 Jules-Leger StreetBoucherville, QC, Canada J4B 7K8Distributed by Clintec Nutrition DivisionDeerfield, IL 60015 USAPrinted in CanadaDRev. September 2007Sandoz Canada Inc.

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Clinical Information

Chemical Structure

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Clinical Pharmacology

Non-Clinical Toxicology

INFUVITE

Allergic reactions have been known to occur following intravenous administration of thiamine and vitamin K. The formulation is contraindicated prior to blood sampling for detection of megaloblastic anemia, as the folic acid and the cyanocobalamin in the vitamin solution can mask serum deficits.

This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solution, which contain aluminum.

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

Caution should be exercised when administering INFUVITE to patients on warfarin sodium-type anticoagulant therapy. In such patients, vitamin K may antagonize the hypoprothrombinemic response to anticoagulant drugs, such as warfarin and its congeners. Therefore, periodic monitoring of prothrombin/INR response is essential in determining the appropriate dosage of anticoagulant therapy.

INFUVITE

INFUVITE

A number of interactions between vitamins and drugs have been reported which may affect the metabolism of either agent. The following are examples of these types of interactions.

Folic acid may lower the serum concentration of phenytoin resulting in increased seizure activity. Conversely, phenytoin may decrease serum folic acid concentrations and, therefore, should be avoided in pregnancy. Folic acid may decrease the patient’s response to methotrexate therapy.

Pyridoxine may decrease the efficacy of levodopa by increasing its metabolism. Concomitant administration of hydralazine or isoniazid may increase pyridoxine requirements.

In patients with pernicious anemia, the hematologic response to vitamin B therapy may be inhibited by concomitant administration of chloramphenicol.

Several vitamins have been reported to decrease the activity of certain antibiotics. Thiamine, riboflavin, pyridoxine, niacinamide, and ascorbic acid have been reported to decrease the antibiotic activity of erythromycin, kanamycin, streptomycin, doxycycline, and lincomycin. Bleomycin is inactivated by ascorbic acid and riboflavin.

Vitamin K may antagonize the hypoprothrombinemic effect of oral anticoagulants .

Consult appropriate references for additional specific vitamin-drug interactions.

Some of the vitamins in may react with vitamin K bisulfite or sodium bisulfite; if bisulfite solutions are necessary, patients should be monitored for vitamin A and thiamine deficiencies.

If this formulation is the only source of vitamins for long periods of time, blood concentration of each of the vitamins should be monitored, particularly vitamins A, C, D, and folic acid, to determine if deficiencies are occurring. If deficiencies are developing or when long-standing vitamin deficiencies are present, it may be necessary to add therapeutic amounts of certain vitamins to supplement the maintenance vitamins provided in .

There have been rare reports of anaphylactic reactions following parenteral multivitamin administration. Rare reports of anaphylactoid reactions have also been reported following large intravenous doses of thiamine. However, the risk is negligible if thiamine is coadministered with other vitamins of the B group.

There have been rare reports of the following types of reactions:

Dermatologic – rash, erythema, pruritis

CNS – headache, dizziness, agitation, anxiety

Ophthalmic – diplopia

Allergic – urticaria, shortness of breath, wheezing and angioedema.

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72

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Interactions

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