Consists of Choline, Vitamin A, Vitamin B12, Vitamin D2
Choline (Ketovite Liquid) warnings
Avoid prolonged treatment in infants.
What happens if I overdose Vitamin A (Ketovite Liquid)?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of vitamin A can cause serious or life-threatening side effects.
Overdose symptoms may include nausea, vomiting, loss of appetite, vision changes, hair loss, peeling skin, cracked skin around your mouth, changes in menstrual periods, dizziness, drowsiness, tired feeling, bone or joint pain, severe headache, pain behind your eyes, severe stomach pain, dark urine, or jaundice (yellowing of the skin or eyes).
Overdose of Vitamin A (Ketovite Liquid) in details
The following amounts have been found to be toxic orally. Toxicity manifestations depend on the age, dosage, size, and duration of administration.
Acute toxicity — single dose (25,000 Units/kg body weight)
Infant: 350,000 Units
Adult: Over 2 million Units
Chronic toxicity (4,000 Units/kg body weight for 6 to 15 months)
Infants 3 to 6 months old: 18,500 Units (water dispersed)/day for 1 to 3 months.
Adult: 1 million Units daily for three days; 50,000 Units daily for longer than 18 months; 500,000 Units daily for two months.
Hypervitaminosis A Syndrome:
- 1.
- General manifestations:
Fatigue, malaise, lethargy, abdominal discomfort, anorexia, and vomiting.
- 2.
- Specific manifestations:
- a. Skeletal: hepatotoxicity, hard tender cortical thickening over the radius and tibia, migratory arthralgia, slow growth, and premature closure of the epiphysis leading to arrested bone growth in children.
b. Central Nervous System: irritability, headache, and increased intracranial pressure as manifested by bulging fontanels, papilledema, and exophthalmos.
c. Dermatologic: fissures of the lips, drying and cracking of the skin, alopecia, scaling, massive desquamation, and increased pigmentation.
d. Systemic: hypomenorrhea, hepatosplenomegaly, hepatotoxicity, jaundice, leukopenia, vitamin A plasma level over 1,200 Units/100 mL.
The treatment of hypervitaminosis A consists of immediate withdrawal of the vitamin along with symptomatic and supportive treatment.
What should I avoid while taking Vitamin A (Ketovite Liquid)?
Avoid taking orlistat (alli, Xenical) or mineral oil while you are taking vitamin A.
Vitamin A (Ketovite Liquid) warnings
Avoid overdosage. Keep out of the reach of children.
Pediatric Use: Polysorbates have been associated with E-Ferol syndrome (thrombocytopenia, renal dysfunction, hepatomegaly, cholestasis, ascites, hypotension and metabolic acidosis) in low birth-weight infants.
What should I discuss with my healthcare provider before taking Vitamin A (Ketovite Liquid)?
- If you have an allergy to vitamin A or any other part of Vitamin A (Ketovite Liquid) (vitamin A tablets and capsules).
- If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
- If you have too much vitamin A in the blood.
This medicine may interact with other drugs or health problems.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
Vitamin A (Ketovite Liquid) precautions
General: Protect from light. Prolonged daily dose administration over 25,000 Units vitamin A should be under close supervision. Blood level assays are not a direct measure of liver storage. Liver storage should be adequate before discontinuing therapy. Single vitamin A deficiency is rare. Multiple vitamin deficiency is expected in any dietary deficiency.
Drug Interactions: Women on oral contraceptives have shown a significant increase in plasma vitamin A levels.
Carcinogenesis: There are no studies that show that administration of vitamin A will cause or prevent cancer.
Pregnancy Category X:
Nursing Mothers: The U.S. Recommended Daily Allowance (RDA) of vitamin A (5,000 Units) is recommended for nursing mothers.
What happens if I miss a dose of Vitamin A (Ketovite Liquid)?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose Vitamin B12 (Ketovite Liquid)?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Vitamin B12 (Ketovite Liquid)?
Avoid drinking large amounts of alcohol while you are being treated with cyanocobalamin.
Vitamin B12 (Ketovite Liquid) warnings
General: Vitamin B12 (Ketovite Liquid) deficiency that is allowed to progress for longer than 3 months may produce permanent degenerative lesions of the spinal cord. Doses of folic acid greater than 0.1 mg per day may result in hematologic remission in patients with Vitamin B12 (Ketovite Liquid) deficiency. Neurologic manifestations will not be prevented with folic acid, and if not treated with Vitamin B12 (Ketovite Liquid), irreversible damage will result.
Doses of Cyanocobalamin exceeding 10 mcg daily may produce hematologic response in patients with folate deficiency. Indiscriminate administration may mask the true diagnosis.
Information for Patients: Patients with pernicious anemia should be informed that they will require monthly injections of Vitamin B12 (Ketovite Liquid) for the remainder of their lives. Failure to do so will result in return of the anemia and in development of incapacitating and irreversible damage to the nerves of the spinal cord. Also, patients should be warned about the danger of taking folic acid in place of Vitamin B12 (Ketovite Liquid), because the former may prevent anemia but allow progression of subacute combined degeneration.
A vegetarian diet which contains no animal products (including milk products or eggs) does not supply any Vitamin B12 (Ketovite Liquid). Patients following such a diet, should be advised to take oral Vitamin B12 (Ketovite Liquid) regularly. The need for Vitamin B12 (Ketovite Liquid) is increased by pregnancy and lactation. Deficiency has been recognized in infants of vegetarian mothers who were breast fed, even though the mothers had no symptoms of deficiency at the time.
Laboratory Tests: During the initial treatment of patients with pernicious anemia, serum potassium must be observed closely the first 48 hours and potassium replaced if necessary.
Hematocrit, reticulocyte count, Vitamin B12 (Ketovite Liquid), folate and iron levels should be obtained prior to treatment. Hematocrit and reticulocyte counts should be repeated daily from the fifth to seventh days of therapy and then frequently until the hematocrit is normal. If folate levels are low, folic acid should also be administered. If reticulocytes have not increased after treatment or if reticulocyte counts do not continue at least twice normal as long as the hematocrit is less than 35%, diagnosis or treatment should be reevaluated. Repeat determinations of iron and folic acid may reveal a complicating illness that might inhibit the response of the marrow.
Patients with pernicious anemia have about 3 times the incidence of carcinoma of the stomach as the general population, so appropriate tests for this condition should be carried out when indicated.
Drug/Laboratory Test Interactions: Persons taking most antibiotics, methotrexate and pyrimethamine invalidate folic acid and Vitamin B12 (Ketovite Liquid) diagnostic blood assays.
Colchicine para-aminosalicylic acid and heavy alcohol intake for longer than 2 weeks may produce malabsorption of Vitamin B12 (Ketovite Liquid).
Carcinogenesis, Mutagenesis, Impairment of Fertility: Long term studies in animals to evaluate carcinogenic potential have not been done. There is no evidence from long-term use in patients with pernicious anemia that Cyanocobalamin is carcinogenic. Pernicious anemia is associated with an increased incidence of carcinoma of the stomach, but this is believed to be related to the underlying pathology and not to treatment with Cyanocobalamin.
Pregnancy: Teratogenic Effects. Pregnancy Category C: Adequate and well-controlled studies have not been done in pregnant women. However, Vitamin B12 (Ketovite Liquid) is an essential vitamin and requirements are increased during pregnancy. Amounts of Vitamin B12 (Ketovite Liquid) that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for pregnant women (4 mcg daily) should be consumed during pregnancy.
Nursing Mothers: Vitamin B12 (Ketovite Liquid) is known to be excreted in human milk. Amounts of Vitamin B12 (Ketovite Liquid) that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for lactating women (4 mcg daily) should be consumed during lactation.
Pediatric Use: Intake in children should be in the amount (0.5 to 3 mcg daily) recommended by the Food and Nutrition Board, National Academy of Science-National Research Council.
What should I discuss with my healthcare provider before taking Vitamin B12 (Ketovite Liquid)?
- If you have an allergy to undecylenic acid, its derivatives, or any other part of Vitamin B12 (Ketovite Liquid)
Vitamin B12 (Ketovite Liquid) precautions
Renal or hepatic impairment, history of liver disease or mental depression. Lactation. Perform blood counts & liver function tests during the 1st 6-12 wk if unexplained fever develops. May affect ability to drive or operate machinery.
What happens if I miss a dose of Vitamin B12 (Ketovite Liquid)?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose Vitamin D2 (Ketovite Liquid)?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of vitamin D can cause serious or life-threatening side effects.
Overdose symptoms may include headache, weakness, drowsiness, dry mouth, nausea, vomiting, constipation, muscle or bone pain, metallic taste in the mouth, weight loss, itchy skin, changes in heart rate, loss of interest in sex, confusion, unusual thoughts or behavior, feeling unusually hot, severe pain in your upper stomach spreading to your back, or fainting.
What should I avoid while taking Vitamin D2 (Ketovite Liquid)?
Do not take other vitamin or mineral supplements unless your doctor has told you to.
Avoid using calcium supplements or antacids without your doctor's advice. Use only the specific type of supplement or antacid your doctor recommends.
Vitamin D2 (Ketovite Liquid) warnings
Patient information for vitamin D analogues (Vitamin D2 (Ketovite Liquid), Vitamin D3, Calcitriol, and Calcidiol)/p>
The patient and his or her parents or s.o.s. should be informed about compliance with dosage instructions, adherence to instructions about diet and calcium supplementation and avoidance of the use of unapproved nonprescription drugs. Patients should also be carefully informed about the symptoms of hypercalcemia.
The effectiveness of vitamin D therapy is predicated on the assumption that each patient is receiving an adequate daily intake of calcium. Patients are advised to have a dietary intake of calcium at a minimum of 600 mg daily. The U.S. RDA for calcium in adults is 800 mg to 1200 mg.
What should I discuss with my healthcare provider before taking Vitamin D2 (Ketovite Liquid)?
Do not use this medication if you have ever had an allergic reaction to vitamin D, or if you have:
-
high levels of calcium in your blood (hypercalcemia);
-
high levels of vitamin D in your body (hypervitaminosis D); or
-
any condition that makes it hard for your body to absorb nutrients from food (malabsorption).
To make sure you can safely take ergocalciferol, tell your doctor if you have any of these other conditions:
-
heart disease;
-
coronary artery disease;
-
kidney disease; or
-
an electrolyte imbalance.
FDA pregnancy category C. It is not known whether ergocalciferol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.
Ergocalciferol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
What happens if I miss a dose of Vitamin D2 (Ketovite Liquid)?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
References
- DrugBank. "choline". http://www.drugbank.ca/drugs/DB00122 (accessed September 17, 2018).
- MeSH. "Nootropic Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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