Vita-Rx Diabetic Vitamin (Vitamin C, Vitamin D, Vitamin E, Thiamine, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Biotin, Pantothenic Acid, Chromium) Capsule, Gelatin Coated [Pure Sou -

VITA-RX DIABETIC VITAMIN (VITAMIN C, VITAMIN D, VITAMIN E, THIAMINE, RIBOFLAVIN, NIACIN, VITAMIN B6, FOLATE, VITAMIN B12, BIOTIN, PANTOTHENIC ACID, CHROMIUM) CAPSULE, GELATIN COATED [PURE SOU
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NDC	65121-301-01
Set ID	33f32537-b148-48f3-a732-1f7c2f092f00
Category	HUMAN PRESCRIPTION DRUG LABEL
Packager	Pure Source, LLC
Generic Name
Product Class
Product Number
Application Number

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DESCRIPTION

Vita-Rx

Diabetic Vitamin

with CoQ 10
INDICATIONS & USAGE

Suggest use: As a dietary supplement, adults take one (1) capsule daily preferably with a meal or as recommended by a physician.
WARNINGS AND PRECAUTIONS

KEEP OUT OF THE REACH OF CHILDREN

Store product at room temperature.

Do not expose to excessive heat or moisture.

Not for use by individuals under th eage of 18 years.

Do not use if you are pregnant or nursing.
DOSAGE & ADMINISTRATION

Suggest use: As a dietary supplement, adults take one (1) capsule daily preferably with a meal or as recommended by a physician.
PRINCIPAL DISPLAY PANEL

INGREDIENTS AND APPEARANCE

VITA-RX DIABETIC VITAMIN
vitamin c, vitamin d, vitamin e, thiamine, riboflavin, niacin, vitamin b6, folate, vitamin b12, biotin, pantothenic acid, chromium capsule, gelatin coated

Product Information
Product Type	HUMAN PRESCRIPTION DRUG	Item Code (Source)	NDC:65121-301
Route of Administration	ORAL

Ingredient Name	Basis of Strength	Strength
Active Ingredient/Active Moiety
ASCORBIC ACID (UNII: PQ6CK8PD0R) (ASCORBIC ACID - UNII:PQ6CK8PD0R)	ASCORBIC ACID	120 mg
CHOLECALCIFEROL (UNII: 1C6V77QF41) (CHOLECALCIFEROL - UNII:1C6V77QF41)	CHOLECALCIFEROL	0.0625 mg
.ALPHA.-TOCOPHEROL ACETATE (UNII: 9E8X80D2L0) (.ALPHA.-TOCOPHEROL - UNII:H4N855PNZ1)	.ALPHA.-TOCOPHEROL ACETATE	10 mg
THIAMINE MONONITRATE (UNII: 8K0I04919X) (THIAMINE ION - UNII:4ABT0J945J)	THIAMINE MONONITRATE	1.5 mg
RIBOFLAVIN (UNII: TLM2976OFR) (RIBOFLAVIN - UNII:TLM2976OFR)	RIBOFLAVIN	1.7 mg
NIACIN (UNII: 2679MF687A) (NIACIN - UNII:2679MF687A)	NIACIN	20 mg
PYRIDOXAL PHOSPHATE ANHYDROUS (UNII: F06SGE49M6) (PYRIDOXAL PHOSPHATE ANHYDROUS - UNII:F06SGE49M6)	PYRIDOXAL PHOSPHATE ANHYDROUS	12.5 mg
FOLIC ACID (UNII: 935E97BOY8) (FOLIC ACID - UNII:935E97BOY8)	FOLIC ACID	0.8 mg
METHYLCOBALAMIN (UNII: BR1SN1JS2W) (METHYLCOBALAMIN - UNII:BR1SN1JS2W)	METHYLCOBALAMIN	0.0025 mg
BIOTIN (UNII: 6SO6U10H04) (BIOTIN - UNII:6SO6U10H04)	BIOTIN	2.5 mg
CALCIUM PANTOTHENATE (UNII: 568ET80C3D) (PANTOTHENIC ACID - UNII:19F5HK2737)	PANTOTHENIC ACID	10 mg
CHROMIUM PICOLINATE (UNII: S71T8B8Z6P) (CHROMIC CATION - UNII:X1N4508KF1)	CHROMIC CATION	0.465 mg
THIOCTIC ACID (UNII: 73Y7P0K73Y) (THIOCTIC ACID - UNII:73Y7P0K73Y)	THIOCTIC ACID	150 mg
UBIDECARENONE (UNII: EJ27X76M46) (UBIDECARENONE - UNII:EJ27X76M46)	UBIDECARENONE	50 mg

Ingredient Name	Strength
Inactive Ingredients
SODIUM METAVANADATE TETRAHYDRATE (UNII: 2DO8B1WW6L)	1.8 mg
GELATIN (UNII: 2G86QN327L)
CELLULOSE, MICROCRYSTALLINE (UNII: OP1R32D61U)
MAGNESIUM STEARATE (UNII: 70097M6I30)
SILICON DIOXIDE (UNII: ETJ7Z6XBU4)

Product Characteristics
Color	white (clear)	Score	no score
Shape	CAPSULE	Size	9mm
Flavor		Imprint Code
Contains

#	Item Code	Package Description	Marketing Start Date	Marketing End Date
Packaging
1	NDC:65121-301-01	60 in 1 PACKAGE; Type 0: Not a Combination Product	08/11/2015

Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
Marketing Information
unapproved drug other		08/11/2015

Labeler - Pure Source, LLC (080354456)

Name	Address	ID/FEI	Business Operations
Establishment
Pure Source, LLC		080354456	manufacture(65121-301)

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Medic

VITA-RX DIABETIC VITAMIN (VITAMIN C, VITAMIN D, VITAMIN E, THIAMINE, RIBOFLAVIN, NIACIN, VITAMIN B6, FOLATE, VITAMIN B12, BIOTIN, PANTOTHENIC ACID, CHROMIUM) CAPSULE, GELATIN COATED [PURE SOU

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