VITE ADULT. Also, it has been reported that folic acid is unstable in the presence of calcium salts such as calcium gluconate. Direct addition to intravenous fat emulsions is not recommended. Consult appropriate references for listings of physical compatibility of solutions and drugs with the vitamin infusion. In such circumstances, admixture or Y-site administration with vitamin solutions should be avoided.
A number of interactions between vitamins and drugs have been reported which may affect the metabolism of either agent. The following are examples of these types of interactions.
Folic acid may lower the serum concentration of phenytoin resulting in increased seizure activity. Conversely, phenytoin may decrease serum folic acid concentrations and, therefore, should be avoided in pregnancy. Folic acid may decrease the patient’s response to methotrexate therapy.
Pyridoxine may decrease the efficacy of levodopa by increasing its metabolism. Concomitant administration of hydralazine or isoniazid may increase pyridoxine requirements.
In patients with pernicious anemia, the hematologic response to vitamin B12 therapy may be inhibited by concomitant administration of chloramphenicol.
Several vitamins have been reported to decrease the activity of certain antibiotics. Thiamine, riboflavin, pyridoxine, niacinamide, and ascorbic acid have been reported to decrease the antibiotic activity of erythromycin, kanamycin, streptomycin, doxycycline, and lincomycin. Bleomycin is inactivated in vitro by ascorbic acid and riboflavin.
Vitamin K may antagonize the hypoprothrombinemic effect of oral anticoagulants (see bolded statement above).
Consult appropriate references for additional specific vitamin-drug interactions.
Some of the vitamins in INFUVITE ADULT may react with vitamin K bisulfite or sodium bisulfite; if bisulfite solutions are necessary, patients should be monitored for vitamin A and thiamine deficiencies.
Drug-Laboratory Test Interactions:
Ascorbic acid in the urine may cause false negative urine glucose determinations.
Carcinogenesis, Mutagenesis, and Impairment of Fertility:
Carcinogenicity, mutagenicity, and fertility studies have not been performed with INFUVITE ADULT.
Pregnancy:
Pregnancy Category C:
Animal reproduction studies have not been conducted with INFUVITE ADULT (Multiple Vitamins for Infusion).
INFUVITE ADULT should be given to a pregnant woman only if clearly needed. Pregnant women should follow the U.S. Recommended Daily Allowances for their condition, because their vitamin requirements may exceed those of nonpregnant women. The use of INFUVITE ADULT has not been studied in human pregnancy.
Nursing Mothers:
Lactating women should follow the U.S. Recommended Daily Allowances for their condition, because their vitamin requirement may exceed those of nonlactating women. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when INFUVITE ADULT is administered to a nursing mother.
Pediatric Use:
Safety and effectiveness in children below the age of 11 years have not been established.
Adverse Reactions
There have been rare reports of anaphylactic reactions following parenteral multivitamin administration. Rare reports of anaphylactoid reactions have also been reported following large intravenous doses of thiamine. However, the risk is negligible if thiamine is coadminister |
