Appetite With Iron

Nutritional supplement to improve appetite & wt gain. Prevention & treatment of deficiencies in vit B-complex & Fe; vit A & D (cap only).

Cap Adult 1 cap bid, may be increased depending on patient's needs. Syr Childn >14 yr 15 mL once daily, 7-14 yr 10 mL once daily, 2-6 yr 5 mL once daily.

Cap: Should be taken on an empty stomach: Take 1 hr before or 2 hr after meals for better Fe absorption. Take w/ food if stomach upset occurs.|Syr: Should be taken with food.

Hypersensitivity. Cap: Hypercalcemia. Patients w/ hemochromatosis, receiving blood transfusions; w/ peptic ulcer, ulcerative colitis, & regional enteritis. Severe renal impairment or failure. Vit A: Patients w/ renal disease.

Use cautiously in long-term therapy. Vit B₃: Caution in patients w/ gallbladder disease or diabetes (when used in large doses); predisposed to gout. Vit D: Caution in patients w/ renal impairment & monitor Ca & phosphate levels. Buclizine: May cause drowsiness; exercise caution against engaging in activities eg, driving & use of machineries. Fe: May cause GI irritation & abdominal pain w/ nausea, vomiting, diarrhea, or constipation. Avoid use for >6 mth except in patients w/ continued bleeding, menorrhagia, or repeated pregnancies. Consider use during pregnancy & lactation only if benefit outweighs risk.

Rarely, hypersensitivity reactions, constipation, vomiting, abdominal pain, black stool discoloration, drowsiness, dryness of mouth, headache, & jitteriness. Cap: Vit A: Vit A toxicity initially presenting w/ irritability, vomiting, loss of appetite & skin changes (especially in childn). Vit D₃: Hypercalcemia, hypercalciuria which could lead to nephrolithiasis, nephrotoxicity, & hyperphosphatemia. Vit B: Rarely, peripheral sensory neuropathy. Fe: Flatulence, diarrhea, nausea & vomiting, abdominal pain. Syr: Rarely, numbness, bright yellow urine.

Cap: Vit A: Raised plasma levels w/ contraceptive pills. Increased risk of hepatotoxicity w/ chronic excessive alcohol consumption. Reduced gut absorption w/ neomycin. Long-term use or high doses may increase risk of bleeding w/ blood-thinning medications particularly warfarin. GI absorption may be reduced w/ ion exchange resins (eg, cholestyramine) or laxatives (eg, paraffin oil). Vit D₃: Increased GI absorption of Ca. Not to be given w/ paricalcitol, calcipotriene, doxercalciferol, mineral oil, orlistat, & bile acid sequestrants (eg, colesevelam, colestipol, cholestyramine). Increased risk of hypercalcemia w/ benzothiadiazine derivatives (thiazide diuretics). Effect may be diminished w/ anticonvulsants (eg, phenytoin, phenobarb, primidone). Vit B₁: Increased metabolism & blocked formation of thiamine pyrophosphate w/ fluorouracil which could further exacerbate pre-existing thiamine deficiency in cancer patients. Vit B₆: Reduced effects of levodopa. High doses can decrease serum conc of phenytoin & phenobarb. Reduced effectiveness of altretamine (hexamethyl melamine). Vit B₁₂: Reduced gut absorption w/ aspirin, PPIs, H₂-receptor antagonists, neomycin, & colchicine. Fe: Reduced absorption of & expected hematological response to Fe w/ antacids. Absorption may be reduced w/ beverages high in polyphenolics & may be altered w/ neomycin. Reduced absorption of penicillamine, tetracycline, cefdinir, methyldopa, levodopa, quinolone antibiotics (eg, ciprofloxacin, ofloxacin, norfloxacin & moxifloxacin) & levothyroxine. Buclizine: May enhance sedative effect of nervous depressants including alcohol, barbiturates, hypnotics, narcotics, analgesics, sedatives & tranquilizers. Vit B₁₂ & Fe: May cause milder, reversible bone marrow depression w/ chloramphenicol. Syr: Patients taking fluorouracil, levodopa, anticonvulsants, altretamine, aspirin, PPIs, H₂-receptor antagonists, neomycin, colchicine, chloramphenicol, antacids, penicillamine, tetracycline, cefdinir, methyldopa, quinolone antibiotics, levothyroxine, & nervous depressants like alcohol, barbiturates, hypnotics, narcotics, analgesic, sedatives, & tranquilizers. Avoid drinking coffee, tea, or red wine while taking this medicine.

Appetite Enhancers

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

Cap: Rx; Syr: Non-Rx