Appetite Plus

Capsule: Multivitamins + Buclizine Hydrochloride + Lysine Hydrochloride (Appetite Plus) is a light yellow to brownish yellow granular powder contained in empty gelatin capsule size #1 with scarlet opaque body and black opaque cap.
Each capsule contains: Buclizine hydrochloride 25 mg, Retinol acetate (Vitamin A) 3,000 IU, Cholecalciferol (Vitamin D₃) 300 IU, Thiamine hydrochloride (Vitamin B₁) 15 mg, Riboflavin hydrochloride (Vitamin B₂) 1 mg, Niacinamide (Vitamin B₃) 20 mg, Pyridoxine hydrochloride (Vitamin B₆) 5 mg, Cyanocobalamin (Vitamin B₁₂) 5 mcg, Ascorbic acid (Vitamin C) 150 mg, L-lysine hydrochloride 25 mg.
Syrup: Orange syrup with orange flavor and sweet to bitter aftertaste.
Each 5 mL (1 teaspoonful) contains: Thiamine hydrochloride, USP (Vitamin B₁) 15 mg, Riboflavin-5-Phosphate, USP (Vitamin B₂) 1 mg, Nicotinamide, USP (Vitamin B₃) 20 mg, Pyridoxine hydrochloride, USP (Vitamin B₆) 5 mg, Cyanocobalamin, USP (Vitamin B₁₂) 5 mcg, Ascorbic acid, USP (Vitamin C) 50 mg, L-lysine hydrochloride, USP 100 mg, Buclizine hydrochloride, BP 5 mg.

Syrup: Pharmacology: Pharmacodynamics: Thiamine is a vitamin required in cellular aerobic metabolism, cell growth, nerve impulse transmission and production of acetylcholine.
Riboflavin is an essential human nutrient that is a heat-stable and water-soluble flavin belonging to the vitamin B family. Riboflavin is a precursor of the coenzymes flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD). These coenzymes are of vital importance in normal tissue respiration, pyridoxine activation, tryptophan to niacin conversion, fat, carbohydrate, and protein metabolism, and glutathione reductase mediated detoxification. Riboflavin may also be involved in maintaining erythrocyte integrity. This vitamin is essential for healthy skin, nails, and hair.
Nicotinamide is the active form of vitamin B₃ and a component of the coenzyme nicotinamide adenine dinucleotide (NAD). Nicotinamide acts as a chemo- and radio-sensitizing agent by enhancing tumor blood flow, thereby reducing tumor hypoxia. This agent also inhibits poly (ADP-ribose) polymerases, enzymes involved in the rejoining of DNA strand breaks induced by radiation or chemotherapy.
Pyridoxine hydrochloride is the hydrochloride salt form of pyridoxine, a water-soluble vitamin B. Pyridoxine hydrochloride is converted into the active form, pyridoxal 5'-phosphate (PLP), an essential cofactor in many enzymatic activities including synthesis of amino acids, neurotransmitters, and sphingolipids. This vitamin is essential to red blood cell, nervous system, and immune systems functions and helps maintain normal blood glucose levels.
Cyanocobalamin (vitamin B₁₂) is a water-soluble organometallic compound containing a trivalent cobalt ion bound to a corrin ring. Vitamin B₁₂ is an essential coenzyme in nucleic acid synthesis as well as nerve functions and blood cell production. Adult recommended requirements are about 1 to 2 micrograms per day.
Ascorbic acid (Vitamin C) is a water-soluble vitamin which is vital in the production and integrity of collagen, the key protein component of connective tissues. It also has important antioxidant properties which protects the body tissues from the harmful effects of oxidative radicals.
Buclizine is a piperazine-derivative antihistamine used as an antivertigo/antiemetic agent. Buclizine is used in the prevention and treatment of nausea, vomiting, and dizziness associated with motion sickness. Additionally, it has been used in the management of vertigo in diseases affecting the vestibular apparatus.
Lysine belongs to one of the nine essential amino acids in humans. Amino acids serve as the building blocks of protein and are important for growth and tissue repair. Unlike the non-essential amino acids, essential amino acids are not synthesized by the human body and are usually supplied from dietary sources.
Pharmacokinetics: Absorption: Thiamine hydrochloride (Vitamin B₁): Small amounts of thiamine are well absorbed from the gastrointestinal tract after oral doses.
Riboflavin phosphate (Vitamin B₂): Riboflavin is readily absorbed from the gastrointestinal tract.
Nicotinamide (Vitamin B₃): Nicotinamide is readily absorbed from the gastrointestinal tract after oral doses.
Pyridoxine hydrochloride (Vitamin B₆): Pyridoxine is readily absorbed from the gastrointestinal tract after oral doses.
Cyanocobalamin (Vitamin B₁₂): Vitamin B₁₂ substances bind to intrinsic factor, a glycoprotein secreted by the gastric mucosa, and are then actively absorbed from the gastrointestinal tract.
Ascorbic acid (Vitamin C): Ascorbic acid is readily absorbed in the gastrointestinal tract. Plasma concentration elevates as oral dose is increased until a plateau is achieved with doses between 90 to 150 mg per day. The usual recommended daily intake for adults is about 30 to 100 mg.
Buclizine hydrochloride: Buclizine is rapidly absorbed following oral administration.
L-lysine hydrochloride: Free amino acids, including free lysine, are absorbed in the small intestines.
Free amino acids in the intestinal lumen are transported into the mucosal cells by an amino acid-specific carrier system. The amino acids are then secreted out to the portal circulation.
Distribution: Thiamine hydrochloride (Vitamin B₁): Thiamine is widely distributed to most body tissues and appears in breastmilk.
Riboflavin phosphate (Vitamin B₂): About 60% of FMN and FAD are bound to plasma proteins.
Nicotinamide (Vitamin B₃): Nicotinamide is widely distributed in the body tissues.
Pyridoxine hydrochloride (Vitamin B₆): Pyridoxine is mainly stored in the liver with lesser amounts in muscle & brain.
Cyanocobalamin (Vitamin B₁₂): Vitamin B₁₂ is released from food and salivary binding protein and bound to gastric intrinsic factor. When the vitamin B₁₂ intrinsic factor complex reaches the ileum, it interacts with the receptor on the mucosal cell surface and is actively transported into circulation.
Ascorbic acid (Vitamin C): Body vitamin C stores are about 1.5 g but additional amount may be stored with daily intake of more than 200 mg. Leukocytes and platelets contain higher concentrations compared to erythrocytes and plasma, thus during deficiency states, declines in leukocyte vitamin C concentration is considered a better criterion for evaluation than that of the plasma concentration. Vitamin C can cross the placenta.
Buclizine hydrochloride: Buclizine is rapidly absorbed following oral administration.
L-lysine hydrochloride: The free amino acids in the portal circulation will pass through the liver, a portion of which will be utilized. The remaining amino acids are then transported to the systemic circulation for utilization by the peripheral tissues.
Metabolism: Thiamine hydrochloride (Vitamin B₁): Thiamin from dietary supplements is absorbed by the small intestine through active transport at nutritional doses and by passive diffusion at pharmacologic doses.
Riboflavin phosphate (Vitamin B₂): Riboflavin is converted in the body to the coenzyme flavine mononucleotide and then to another coenzyme flavine adenine dinucleotide (FAD).
Nicotinamide (Vitamin B₃): Niacin is converted in the body to the amide, which is incorporated into niacinamide adenine dinucleotide (NAD).
Pyridoxine hydrochloride (Vitamin B₆): After oral administration of pyridoxine, it is converted into active forms pyridoxal phosphate and pyridoxamine phosphate. Pyridoxine is oxidized in the liver to form 4-pyridoxic acid and other inactive metabolites.
Cyanocobalamin (Vitamin B₁₂): Vitamin B₁₂ is extensively bound to plasma proteins transcobalamin; Transcobalamin II appears to be involved in the rapid transport of the cobalamins to tissues.
Ascorbic acid (Vitamin C): Ascorbic acid is reversibly oxidized to dehydroascorbic acid, others are metabolized to the inactive form ascorbate-2-sulfate as well as to oxalic acid.
Buclizine hydrochloride: Not available.
L-lysine hydrochloride: Lysine is metabolized via protein synthesis or oxidative catabolism. During protein synthesis, lysine is utilized for the formation of substances such as carnitine, collagen and elastin. With oxidative catabolism, lysine is broken down to products that can be further used for the biosynthetic pathways for glucose and fat.
Excretion: Thiamine hydrochloride (Vitamin B₁): In excess amount of thiamine in the body's requirement are excreted in the urine unchanged or as metabolites.
Riboflavin phosphate (Vitamin B₂): Riboflavin is excreted in urine, partly as metabolites.
Nicotinamide (Vitamin B₃): Small amount of nicotinamide is excreted unchanged in urine after therapeutic doses; The amount excreted unchanged is increased with larger doses.
Pyridoxine hydrochloride (Vitamin B₆) Pyridoxine is excreted in urine.
Cyanocobalamin (Vitamin B₁₂): Vitamin B₁₂ is excreted in the bile and undergoes extensive enterohepatic recycling and part of a dose is excreted in the urine.
Ascorbic acid (Vitamin C): Ascorbate-2-sulfate and oxalic acid, the metabolism products of ascorbic acid, are excreted through the urine. Ascorbic acid more than the body requirements (i.e., intakes above 100 mg per day) are excreted unchanged in the urine. Ascorbic acid is also removed by hemodialysis. Ascorbic acid is also excreted in the breast milk.
Buclizine hydrochloride: Not available.
L-lysine hydrochloride: Nitrogen is excreted through the urine mostly in the form of urea. Urea is the end product of amino acid catabolism.

Capsule: This medicine is used as a nutritional supplement to improve appetite and weight gain, and to support immune system function. For the prevention and treatment of deficiencies in vitamin C, vitamin B-complex, vitamin A, and vitamin D.
Syrup: As a nutritional supplement to improve appetite and weight gain, and to support immune system function. For the prevention and treatment of deficiencies in vitamin C and vitamin B-complex.

Capsule: Adult Dose: One (1) capsule twice a day. Dosage may be increased depending on the patient's need or as prescribed by a physician.
Syrup: For oral administration.
2-6 years old: 5 mL (1 teaspoonful).
7-14 years old: 10 mL (2 teaspoonfuls).
Above 14 years old: 15 mL (1 tablespoonful).
To be taken daily or as prescribed by the physician.
Missed dose: Capsule: If the patient missed a dose, just continue taking the recommended dose per day.

Capsule: Excessive intake of this medicine may cause rash, abdominal pain, vomiting, nausea, decreased appetite, fatigue, weight loss, constipation, dehydration, irritability, confusion, headache, difficulty in sleeping, increased heart rate, weakness, bright yellow urine, numbness, allergic reactions, diarrhea, acute renal failure, dizziness, and agitation.
Syrup: Acute intake of large doses of water-soluble vitamins are readily excreted in the urine. No emergency procedure or antidote is applicable, and any symptoms are rapidly reduced upon withdrawal of the preparation. However, the following adverse reactions have been reported: Thiamine hydrochloride (Vitamin B₁) Thiamine doses of 5 mg/day for 4 to 5 weeks has resulted in headache, insomnia, irritability, increased heart rate, and weakness.
Riboflavin phosphate (Vitamin B₂): Large doses of riboflavin result in a bright yellow discoloration of the urine that may interfere with certain laboratory tests.
Nicotinamide (Vitamin B₃): An intake of 3,000 mg/day of vitamin B₃ may cause nausea, vomiting and signs of liver toxicity.
Pyridoxine hydrochloride (Vitamin B₆): Reversible sensory neuropathy has been reported with chronic intake of high doses of vitamin B₆; the dose at which these occur is controversial.
Cyanocobalamin (Vitamin B₁₂): High doses of cyanocobalamin are generally not associated with toxicity although rare allergic and anaphylactic reactions and mild diarrhea have occurred.
Ascorbic acid (Vitamin C): Chronic excessive use and large IV doses can produce increased levels of the metabolite oxalic acid. Urinary acidification promotes calcium oxalate crystal formation, which can result in nephropathy or acute renal failure.
Buclizine hydrochloride: Antihistamine overdose in general can include dizziness, tachycardia, headache, drowsiness, or agitation. While the current generation of lesser sedating antihistamines do not affect the QT interval at normal doses, there are concerns there may be some effect in overdose.
When the patient has taken more than the recommended dosage: Capsule: Consult the doctor immediately if the patient experiences any of the signs and symptoms of overdose.

Capsule: Do not take this medicine if the patient has an allergy to any of the ingredients of this product.
Avoid taking this medicine if the patient has kidney stones, high calcium level in blood, or renal failure.
Syrup: Known hypersensitivity to the active components or any of the excipients.
Hyperoxaluria.
Patients with renal failure given aluminum antacids.

Capsule: Do not take more than the recommended dosage unless prescribed by a physician.
Consult the doctor first before taking this medicine if the patient has glucose-6-phosphate dehydrogenase deficiency (G6PD), gallbladder disease, or diabetes.
Avoid taking this medicine if the patient has severe peptic ulcer, or renal disease.
This medicine contains buclizine that may cause drowsiness. Avoid engaging in activities like driving and use of machineries while taking this drug.
Syrup: Vitamin C should be given with care to patients with history of hyperoxaluria or those who are prone to develop oxalate kidney stones.
Vitamin C should be used with caution on patients with iron overload requiring iron chelation therapy (e.g., thalassemia).
High doses of vitamin C may induce hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD).
Nicotinamide (Vitamin B₃) in large doses should be used with caution in patients with gallbladder disease or diabetes. Nicotinamide may elevate uric acid levels, use with caution in patients predisposed to gout. Nicotinamide should be avoided in most patients with severe peptic ulcer.
Buclizine may cause drowsiness and patients taking the drug should be cautioned against engaging in activities like driving and use of machineries.
Do not take more than the recommended dose.
When should a patient consult a doctor: Capsule: Consult the doctor if the patient experiences any undesirable effects.

Syrup: Pregnancy: Clinical data with use of buclizine in humans are not adequate to establish safety during pregnancy. Although experiments in some animals gave rise to adverse effects following the administration of buclizine to pregnant animals.
Lactation: Vitamins B and C are expressed in breastmilk. Very large doses of vitamin B₆ have been reported to suppress lactation.
Due to the limited safety information of this product during pregnancy and lactation, consider using this product only if the benefit outweighs the risk.

Capsule: Adverse events with vitamin C, vitamin B-complex, vitamin A, vitamin D, buclizine hydrochloride, and lysine hydrochloride are rare although numbness, hypersensitivity reactions, constipation, vomiting, abdominal pain, bright yellow urine, irritability, loss of appetite, increased calcium in urine and blood, diarrhea, drowsiness, dryness of mouth, headache, and jitteriness have been reported.
Syrup: The safety information is based on the individual components since there is limited information for the combination of multivitamins, buclizine hydrochloride, and lysine hydrochloride.
Vitamin C: Vitamin C is usually well tolerated with usual doses. Oral intake of high doses has been reported to cause diarrhea and other gastrointestinal disturbances as well as hyperoxaluria. Prolonged intake of large doses may also induce tolerance resulting in deficiency symptoms upon resuming intake of normal doses.
Vitamin B: Adverse events with B vitamins are rare although peripheral sensory neuropathy, hypersensitivity reactions, constipation, vomiting, abdominal pain, and yellow discoloration of urine have been reported.
Buclizine: Adverse drug reactions on buclizine includes drowsiness, dryness of mouth, headache, and jitteriness.

Capsule: Consult the doctor first if the patient is taking contraceptive pills, neomycin, blood-thinning medications, laxatives, calcium supplements, thiazide diuretics, anticonvulsants, fluorouracil, levodopa, altretamine, aspirin, proton pump inhibitors, H2-receptor antagonists, colchicine, chloramphenicol, iron supplements, iron chelating agents, aluminum antacids, oral citrate, analgesics, orlistat, bile acid sequestrants, alcohol, and central nervous system drugs.
Syrup: Thiamine hydrochloride (Vitamin B₁): Fluorouracil increases thiamin metabolism and block the formation of thiamin pyrophosphate that could further exacerbate preexisting thiamine deficiency in cancer patients.
Riboflavin phosphate (Vitamin B₂): There are no known drug interactions.
Nicotinamide (Vitamin B₃): There are no known drug interactions.
Pyridoxine hydrochloride (Vitamin B₆): Vitamin B₆ reduces the effects of levodopa, but this does not occur if a dopa decarboxylase inhibitor is also given.
High doses of vitamin B₆ can decrease serum concentration of phenytoin and phenobarbital.
Vitamin B₆ can reduce the effectiveness of altretamine (hexamethyl melamine).
Cyanocobalamin (Vitamin B₁₂): Aspirin, proton pump inhibitors, H2-receptor antagonists, neomycin, colchicine can reduce the absorption of vitamin B₁₂ from the gut, but no interaction is likely when B₁₂ is given by injection.
Intake of chloramphenicol may cause a milder, reversible bone marrow depression which can oppose the treatment of anemias with vitamin B₁₂.
Ascorbic acid (Vitamin C): Aspirin may reduce vitamin C intestinal absorption, although the clinical importance of this interaction is uncertain. Vitamin C does not seem to affect aspirin serum levels.
Proton pump inhibitors may affect the bioavailability of dietary vitamin C.
High doses of vitamin C may cause cardiac toxicity in patients with iron overload given deferoxamine. Ascorbic acid may increase the absorption of iron in iron-deficiency states. Other iron chelating agents are expected to interact similarly.
Concomitant intake of aluminum antacids and oral citrate among patients with renal failure may predispose to potentially fatal encephalopathy due to markedly increased blood aluminum levels. Evidence suggest that a similar interaction may occur with ascorbic acid.
Taking ascorbic acid with paracetamol can prolong the presence of paracetamol in the blood.
Ascorbic acid has been reported to interfere with blood-thinning treatments.
Buclizine hydrochloride: Buclizine may enhance the sedative effect of nervous depressants including alcohol, barbiturates, hypnotics, narcotics, analgesic, sedatives, and tranquilizers.
L-lysine hydrochloride: There are no known drug interactions.

Store at temperatures not exceeding 30°C.

Appetite Enhancers

R06AE51 - buclizine, combinations ; Belongs to the class of piperazine derivatives used as systemic antihistamines.

Cap: Non-Rx; Syr: Rx