NDC | 58657-327-50 |
Set ID | d5609742-e456-4409-bca9-706b0ea90d35 |
Category | HUMAN PRESCRIPTION DRUG LABEL |
Packager | Method Pharmaceuticals, LLC |
Generic Name | |
Product Class | |
Product Number | |
Application Number |
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SPL UNCLASSIFIED SECTION
Multi-Vitamin Drops with Fluoride and Iron 0.25 mg
Supplemental Facts
Percentage of U.S. Recommended Daily Allowance Each 1.0 mL supplies: Children 6 mos to 4 Years old Vitamin A (as Vitamin A Palmitate) 1500 IU 60% Vitamin C (as Ascorbic Acid) 35 mg 88% Vitamin D (as Cholecalciferol) 400 IU 100% Vitamin E (as D-Alpha-Tocopheryl Acid Succinate) 5 IU 50% Vitamin B1 (as Thiamine HCl) 0.5 mg 71% Vitamin B2 (as Riboflavin Phosphate Sodium) 0.6 mg 75% Niacin (as Niacinamide) 8 mg 89% Vitamin B6 (as Pyridoxine HCl) 0.4 mg 57% Iron (as Ferrous Sulfate) 10 mg 100% Fluoride (as Sodium Fluoride) 0.25 mg * *Daily Value not established.
See INDICATIONS AND USAGE section for use by children 6 months to 6 years of age.
This product does not contain the essential vitamin folic acid.
Active ingredient for caries prophylaxis: Fluoride as sodium fluoride. This product does not contain Folic Acid.
Other ingredients: Cherry Flavor, Citric Acid Anhydrous, Glycerin, Orange Flavor, Potassium Sorbate, Propylene Glycol, Purified Water, Sodium Benzoate, Sorbitol Solution, Sucralose.
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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 hydroxyapatite in the tooth as it is formed to produce the more caries-resistant crystal, fluorapatite.
The reaction may be expressed by the equation:
Three stages of fluoride deposition in tooth enamel can be distinguished:
- Small amounts (reflecting the low levels of fluoride in tissue fluids) are incorporated into the enamel crystals while they are being formed.
- After enamel has been laid down, fluoride deposition continues in the surface enamel. Diffusion of fluoride from the surface inward is apparently restricted.
- After eruption, the surface enamel acquires fluoride from water, food, supplementary fluoride and smaller amounts from saliva.
- Small amounts (reflecting the low levels of fluoride in tissue fluids) are incorporated into the enamel crystals while they are being formed.
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INDICATIONS AND USAGE
Supplementation of the diet with vitamins A, C and D.
Multi-Vitamin Drops with Fluoride and Iron 0.25 mg also provides fluoride for caries prophylaxis.
The American Academy of Pediatrics recommends that children up to age 16, in areas where drinking water contains less than optimal levels of fluoride, receive daily fluoride supplementation.
The American Academy of Pediatrics recommend that infants and young children 6 months to 3 years of age, in areas where the drinking water contains less than 0.3 ppm of fluoride, and children 3-6 years of age, in areas where the drinking water contains 0.3 through 0.6 ppm of fluoride, receive 0.25 mg of supplemental fluoride daily which is provided in a dose of 1 mL of Multi-Vitamin Drops with Fluoride 0.25 mg (See Dosage and Administration).
Multi-Vitamin Drops with Fluoride and Iron 0.25 mg supply significant amounts of vitamins A, C and D to supplement the diet, and to help assure that nutritional deficiencies of these vitamins will not develop.
Thus, in a single easy-to-use preparation, children obtain essential vitamins and fluoride.
- WARNINGS
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PRECAUTIONS
The suggested dose should not be exceeded since dental fluorosis may result from continued ingestion of large amounts of fluoride.
When prescribing vitamin fluoride products:
- Determine the fluoride content of the drinking water.
- Make sure the child is not receiving significant amounts of fluoride from other medications and swallowed toothpaste.
- Periodically check to make sure that the child does not develop significant dental fluorosis.
Multi-Vitamin Drops with Fluoride Iron 0.25 mg 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.)
Important Considerations When Using Dosage Schedule:
- If fluoride level is unknown, drinking water should be tested for fluoride content before supplements are prescribed. For testing of fluoride content, contact the local or state health department.
- All sources of fluoride should be evaluated with a thorough fluoride history. Patient exposure to multiple water sources can make proper prescribing complex.
- Ingestion of higher than recommended levels of fluoride by children has been associated with an increase in mild dental fluorosis in developing, unerupted teeth.
- Fluoride supplements require long-term compliance on a daily basis.
- Determine the fluoride content of the drinking water.
- ADVERSE REACTIONS
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DOSAGE AND ADMINISTRATION:
See following chart. May be dropped directly into the mouth with dropper; or mixed with cereal, fruit juice or other food.
Fluoride Ion Level in Drinking Water (ppm)* Age <0.3 ppm 0.3 - 0.6 ppm >0.6 ppm Birth - 6 months None None None 6 mos - 3 years 0.25 mg (1 mL) / day † None None 3 - 6 years 0.50 mg (2 mL) / day 0.25 mg (1 mL) / day None * 1.0 ppm = 1 mg/liter
† 2.2 mg sodium fluoride contains 1 mg fluoride ion.
- HOW SUPPLIED
- RECOMMENDED STORAGE
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REFERENCES
- Brudevoid 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, pp 331-347.
- American Academy of Pediatrics Committee on Nutrition: Fluoride supplementation,
Pediatrics
- American Dental Association Council on Dental Therapeutics:
Accepted Dental Therapeutics, ed 38, Chicago, 1979, p321.
- Hennon DK, Stookey GK, Muhler JC: The clinical anticariogenic effectiveness of supplementary fluoride-vitamin preparations - Results at the end of three years.
J Dent Children 1966; 33 January: 3-12.
- Hennon DK, Stookey GK, Muhler JC: The clinical anticariogenic effectiveness of supplementary fluoride-vitamin preparations - Results at the end of four years.
J Dent Children 1967; 34 November; 439- 443.
- Hennon DK, Stookey GK, Muhler JC: The clinical anticariogenic effectiveness of supplementary fluoride-vitamin preparations - Results at the end of five and a half years.
Phar and Ther in Dent 1970; 1:1.
- Hennon DK, Stookey GK, Beiswanger BB: Fluoride-vitamin supplements: Effects on dental caries and fluorosis when used in areas with suboptimum fluoride in the water supply. J Am Dent Assoc 1977; 95-965
1986; 77:758.
Distributed by:
Method Pharmaceuticals, LLC
Fort Worth, TX 76118877-250-3427
Rev. 01/17
Made in the USA
- Brudevoid 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, pp 331-347.
- PRINCIPAL DISPLAY PANEL
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INGREDIENTS AND APPEARANCE
MULTI-VITAMIN DROPS WITH FLUORIDE AND IRON
vitamin a, ascorbic acid, cholecalciferol, alpha-tocopherol acetate, thiamine hydrochloride, riboflavin 5-phosphate sodium, niacinamide, pyridoxine hydrochloride, ferrous sulfate and sodium fluoride liquidProduct Information Product Type HUMAN PRESCRIPTION DRUG Item Code (Source) NDC:58657-327 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 SUCCINATE, D- (UNII: LU4B53JYVE) (.ALPHA.-TOCOPHEROL, D- - UNII:N9PR3490H9) .ALPHA.-TOCOPHEROL SUCCINATE, D- 5 [iU] in 1 mL THIAMINE HYDROCHLORIDE (UNII: M572600E5P) (THIAMINE ION - UNII:4ABT0J945J) THIAMINE 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) POTASSIUM SORBATE (UNII: 1VPU26JZZ4) PROPYLENE GLYCOL (UNII: 6DC9Q167V3) WATER (UNII: 059QF0KO0R) SODIUM BENZOATE (UNII: OJ245FE5EU) SORBITOL (UNII: 506T60A25R) SUCRALOSE (UNII: 96K6UQ3ZD4) Product Characteristics Color Score Shape Size Flavor CHERRY, ORANGE Imprint Code Contains Packaging # Item Code Package Description Marketing Start Date Marketing End Date 1 NDC:58657-327-50 1 in 1 BOX 02/24/2017 1 50 mL in 1 BOTTLE, DROPPER; Type 0: Not a Combination Product Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date unapproved drug other 02/24/2017 Labeler - Method Pharmaceuticals, LLC (060216698)