MULTI-VIT WITH FLUORIDE AND IRON- vitamin a palmitate and ascorbic acid and cholecalciferol and .alpha.-tocopherol acetate, dl- and thiamine hydrochloride and riboflavin and niacinamide and pyridoxine hydrochloride and ferrous sulfate and sodium fluoride solution

Multi-Vit with Fluoride and Iron by

Drug Labeling and Warnings

Multi-Vit with Fluoride and Iron by is a Prescription medication manufactured, distributed, or labeled by Par Pharmaceutical. Drug facts, warnings, and ingredients follow.

Drug Details [pdf]

DESCRIPTION

Supplement Facts
Dosage Size 1 mL (Mark on Dropper)
Amount Per; 1 mL	% Daily Value
	Infants	Children Under; Age 4 Years
Vitamin A 1500 IU	100%	60%
Vitamin C 35 mg	100%	88%
Vitamin D 400 IU	100%	100%
Vitamin E 5 IU	100%	50%
Thiamin 0.5 mg	100%	71%
Riboflavin 0.6 mg	100%	75%
Niacin 8 mg	100%	89%
Vitamin B6 0.4 mg	100%	57%
Iron 10 mg	67%	100%
Fluoride 0.25 mg	*	*
*Daily Value (DV) not established

Active ingredient for caries prophylaxis:
Each 1 mL contains 0.25 mg fluoride as sodium fluoride.

Other ingredients:

ascorbic acid (Vitamin C), caramel color, cholecalciferol (Vitamin D3), citric acid, dl-alpha-tocopheryl acetate (Vitamin E), ferrous sulfate, flavors, glycerin, niacinamide, polysorbate 80, purified water, pyridoxine hydrochloride (Vitamin B6), riboflavin 5’-phosphate sodium (Vitamin B2), thiamine hydrochloride (Vitamin B1), vitamin A palmitate

CLINICAL PHARMACOLOGY:

It is well established that fluoridation of the water supply (1 ppm fluoride) during the period of tooth development leads to a significant decrease in the incidence of dental caries. Hydroxyapatite is the principal crystal for all calcified tissue in the human body. The fluoride ion reacts with the hydroxyapatite in the tooth as it is formed to produce the more caries-resistant crystal, fluorapatite. Three stages of fluoride deposition in tooth enamel can be distinguished:1 1) Small amounts (reflecting the low levels of fluoride in tissue fluids) are incorporated into the enamel crystals while they are being formed. 2) After enamel has been laid down, fluoride deposition continues in the surface enamel. Diffusion of fluoride from the surface inward is apparently restricted. 3) After eruption, the surface enamel acquires fluoride from water, food, supplementary fluoride, and smaller amounts from saliva.

INDICATIONS AND USAGE:

Supplementation of the diet with eight essential vitamins and iron. Supplementation of the diet with fluoride for caries prophylaxis. MULTI-VIT with FLUORIDE 0.25 mg and IRON drops provide fluoride in drop form for infants and young children from 6 months to 3 years of age in areas where the drinking water contains less than 0.3 ppm of fluoride and for children ages 3 to 6 years in areas where the drinking water contains 0.3 through 0.6 ppm of fluoride.2, 3 Each 1 mL supplies sodium fluoride (0.25 mg fluoride) plus eight essential vitamins and iron. MULTI-VIT with FLUORIDE 0.25 mg and IRON drops supply significant amounts of vitamins A, C, D, E, thiamin, riboflavin, niacin, vitamin B6 and iron to supplement the diet, and to help assure that deficiencies of these nutrients will not develop. Thus, in a single easy-to-use preparation, infants and children obtain eight essential vitamins and iron, plus fluoride.

WARNINGS

WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of the reach of children. In case of accidental overdose, call a doctor or poison control center immediately.

PRECAUTIONS:

The suggested dose should not be exceeded since dental fluorosis may result from continued ingestion of large amounts of fluoride. When prescribing MULTI-VIT with FLUORIDE 0.25 mg and IRON drops: 1) Determine the fluoride content of the drinking water from all major sources. 2) Make sure the child is not receiving significant amounts of fluoride from other sources such as medications and swallowed toothpaste. 3) Periodically check to make sure that the child does not develop significant dental fluorosis. MULTI-VIT with FLUORIDE 0.25 mg and IRON drops 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.)

ADVERSE REACTIONS:

Allergic rash and other idiosyncrasies have been rarely reported.

DOSAGE AND ADMINISTRATION:

1 mL daily, or as prescribed. May be dropped directly into mouth with dropper, or mixed with fruit juice, cereal or other food.

STORAGE AND HANDLING

DISPENSE in original container.

Occasional deepening of color has no significant effect on vitamin potency.

After opening, store away from direct light.

While taking drops with iron, a slight darkening of the teeth may occur. Brushing will minimize this temporary condition.

Your doctor or dentist is the best source of counsel and guidance in your child’s fluoride supplementation.

REFERENCES

1. Brudevold F, McCann HG. Fluoride and caries control - Mechanism of action. In: Nizel AE, ed. The Science of Nutrition and Its Application in Clinical Dentistry. Philadelphia: WB Saunders Co.; 1966;331-347.
2. American Academy of Pediatrics, Committee on Nutrition: Fluoride Supplementation for Children: Interim Policy Recommendations. AAP News, February 1995, pg 18.
3. American Dental Association Council on Dental Therapeutics. New Fluoride Schedule Adopted. ADA News. May 16, 1994;12-14.

SPL UNCLASSIFIED SECTION

Manufactured for:
QUALITEST PHARMACEUTICALS
130 VINTAGE DRIVE
HUNTSVILLE, AL 35811

8268032
Rev. 3/15 R10

PRINCIPAL DISPLAY PANEL - carton

PRINCIPAL DISPLAY PANEL - label

INGREDIENTS AND APPEARANCE

MULTI-VIT WITH FLUORIDE AND IRON 
vitamin a palmitate and ascorbic acid and cholecalciferol and .alpha.-tocopherol acetate, dl- and thiamine hydrochloride and riboflavin and niacinamide and pyridoxine hydrochloride and ferrous sulfate and sodium fluoride solution

Product Information
Product Type	HUMAN PRESCRIPTION DRUG	Item Code (Source)	NDC: 0603-1452
Route of Administration	ORAL

Active Ingredient/Active Moiety
Ingredient Name	Basis of Strength	Strength
VITAMIN A PALMITATE (UNII: 1D1K0N0VVC) (VITAMIN A - UNII:81G40H8B0T)	VITAMIN A	1500 [iU]  in 1 mL
ASCORBIC ACID (UNII: PQ6CK8PD0R) (ASCORBIC ACID - UNII:PQ6CK8PD0R)	ASCORBIC ACID	35 mg  in 1 mL
CHOLECALCIFEROL (UNII: 1C6V77QF41) (CHOLECALCIFEROL - UNII:1C6V77QF41)	CHOLECALCIFEROL	400 [iU]  in 1 mL
.ALPHA.-TOCOPHEROL ACETATE, DL- (UNII: WR1WPI7EW8) (.ALPHA.-TOCOPHEROL, DL- - UNII:7QWA1RIO01)	.ALPHA.-TOCOPHEROL, DL-	5 [iU]  in 1 mL
THIAMINE HYDROCHLORIDE (UNII: M572600E5P) (Thiamine ION - UNII:4ABT0J945J)	THIAMINE HYDROCHLORIDE	0.5 mg  in 1 mL
RIBOFLAVIN 5'-PHOSPHATE SODIUM (UNII: 20RD1DZH99) (FLAVIN MONONUCLEOTIDE - UNII:7N464URE7E)	FLAVIN MONONUCLEOTIDE	0.6 mg  in 1 mL
NIACINAMIDE (UNII: 25X51I8RD4) (NIACINAMIDE - UNII:25X51I8RD4)	NIACINAMIDE	8 mg  in 1 mL
PYRIDOXINE HYDROCHLORIDE (UNII: 68Y4CF58BV) (PYRIDOXINE - UNII:KV2JZ1BI6Z)	PYRIDOXINE HYDROCHLORIDE	0.4 mg  in 1 mL
FERROUS SULFATE (UNII: 39R4TAN1VT) (FERROUS CATION - UNII:GW89581OWR)	FERROUS CATION	10 mg  in 1 mL
SODIUM FLUORIDE (UNII: 8ZYQ1474W7) (FLUORIDE ION - UNII:Q80VPU408O)	FLUORIDE ION	0.25 mg  in 1 mL

Inactive Ingredients
Ingredient Name	Strength
ANHYDROUS CITRIC ACID (UNII: XF417D3PSL)
GLYCERIN (UNII: PDC6A3C0OX)
POLYSORBATE 80 (UNII: 6OZP39ZG8H)
WATER (UNII: 059QF0KO0R)
SODIUM HYDROXIDE (UNII: 55X04QC32I)

Product Characteristics
Color	BROWN (clear and brown)	Score
Shape		Size
Flavor		Imprint Code
Contains

Packaging
#	Item Code	Package Description	Marketing Start Date	Marketing End Date
1	NDC: 0603-1452-47	1 in 1 CARTON	01/07/1998	02/28/2021
1		50 mL in 1 BOTTLE, PLASTIC; Type 0: Not a Combination Product

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
UNAPPROVED DRUG OTHER		01/07/1998	02/28/2021

Labeler - Par Pharmaceutical (011103059)