Duet DHA 25-1-400mg Pack
WARNING: Accidental overdose of drugs that have iron in them is a leading cause of deadly poisoning in children younger than 6 years of age. Keep away from children. If this drug is taken by accident, call a doctor or poison control center right away. @ COMMON USES: This vitamin is used to aid the diet needs before, during, and after pregnancy.
Drug Class
Nutritional Supplement; Prenatal Vitamin
Pharmacologic Class
Multivitamin; Mineral Supplement; Omega-3 Fatty Acid
Pregnancy Category
Not applicable (intended for use in pregnancy)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Duet DHA is a daily supplement for pregnant and breastfeeding women. It contains essential vitamins, minerals like iron and folic acid, and DHA (an omega-3 fat) to support your health and your baby's growth and development, especially for the brain and eyes.
How to Use This Medicine
Taking Your Medication Correctly
To ensure you get the most out of your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. Some medications are taken with food, while others should be taken on an empty stomach. If you're unsure, consult your pharmacist for guidance on the best way to take your medication.
When taking your medication, be sure to:
Take it with a full glass of water
Avoid taking antacids within 2 hours before or 2 hours after taking your medication
Do not consume dairy products with your medication, as they may reduce its effectiveness
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication:
Store it at room temperature, protected from light
Keep it in a dry place, away from bathrooms
Protect it from heat
* Keep all medications in a safe and secure location, out of the reach of children and pets
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
To ensure you get the most out of your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. Some medications are taken with food, while others should be taken on an empty stomach. If you're unsure, consult your pharmacist for guidance on the best way to take your medication.
When taking your medication, be sure to:
Take it with a full glass of water
Avoid taking antacids within 2 hours before or 2 hours after taking your medication
Do not consume dairy products with your medication, as they may reduce its effectiveness
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication:
Store it at room temperature, protected from light
Keep it in a dry place, away from bathrooms
Protect it from heat
* Keep all medications in a safe and secure location, out of the reach of children and pets
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
Lifestyle & Tips
- Take with food to minimize stomach upset and enhance absorption of fat-soluble vitamins.
- Maintain a balanced diet rich in fruits, vegetables, lean proteins, and whole grains.
- Stay hydrated by drinking plenty of water.
- Engage in regular, moderate exercise as advised by your doctor.
- Avoid alcohol, smoking, and illicit drugs during pregnancy and lactation.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
Typically one tablet/capsule daily, or as directed by a healthcare professional. Specific dosage for Duet DHA 25-1-400mg Pack refers to specific component amounts (e.g., 25mg Iron, 1mg Folic Acid, 400mg DHA).
Dose Range:
1 - 1 mg
Condition-Specific Dosing:
pregnancy:
One tablet/capsule daily.
lactation:
One tablet/capsule daily.
Pediatric Dosing
Neonatal:
Not established (intended for maternal use)
Infant:
Not established (intended for maternal use)
Child:
Not established (intended for maternal use)
Adolescent:
Not established (intended for maternal use, unless specific adolescent pregnancy guidance)
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment typically required for standard prenatal vitamin doses.
Moderate:
No specific adjustment typically required for standard prenatal vitamin doses. Caution with high doses of certain minerals (e.g., potassium, phosphorus) if present.
Severe:
Consult healthcare provider. Accumulation of certain water-soluble vitamins or minerals (e.g., potassium, phosphorus) may occur with severe impairment, though unlikely with standard prenatal doses.
Dialysis:
Consult healthcare provider. Specific supplementation may be needed based on individual nutritional status and dialysis regimen.
Hepatic Impairment:
Mild:
No specific adjustment typically required.
Moderate:
No specific adjustment typically required.
Severe:
No specific adjustment typically required. Caution with high doses of fat-soluble vitamins (A, D, E, K) if liver disease affects their metabolism or storage.
Pharmacology
Mechanism of Action
Duet DHA provides essential vitamins, minerals, and omega-3 fatty acids (DHA) necessary for maternal health during pregnancy and lactation, and for fetal/infant development. Folic acid is crucial for neural tube development. Iron supports increased maternal red blood cell mass and fetal iron needs. Calcium and Vitamin D are vital for bone health. DHA is critical for fetal brain and eye development.
Pharmacokinetics
Absorption:
Bioavailability:
Varies significantly by individual vitamin/mineral/DHA component and formulation (e.g., chelated minerals, esterified DHA). Generally good for most components.
Tmax:
Not available (varies widely by component)
FoodEffect:
Absorption of some components (e.g., iron) can be affected by food. Often recommended with food to reduce GI upset. Fat-soluble vitamins (A, D, E, K, DHA) require dietary fat for optimal absorption.
Distribution:
Vd:
Not available (varies widely by component)
ProteinBinding:
Not available (varies widely by component)
CnssPenetration:
Limited for most components, but specific nutrients (e.g., DHA, certain B vitamins) cross the blood-brain barrier to support neurological function.
Elimination:
HalfLife:
Not available (varies widely by component)
Clearance:
Not available (varies widely by component)
ExcretionRoute:
Varies by component (renal for water-soluble vitamins, biliary/fecal for some fat-soluble vitamins/metabolites).
Unchanged:
Not available (varies widely by component)
Pharmacodynamics
OnsetOfAction:
Gradual, as nutritional stores are built up and maintained. Benefits for fetal development are ongoing throughout pregnancy.
PeakEffect:
Not applicable in the traditional sense; sustained nutritional support.
DurationOfAction:
Daily supplementation provides continuous nutritional support.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Black, tarry, or bloody stools
Fever
Vomiting blood or material that looks like coffee grounds
Stomach cramps
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Constipation
Diarrhea
Stomach pain
Upset stomach
Vomiting
Heartburn
Change in stool color to green
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Black, tarry, or bloody stools
Fever
Vomiting blood or material that looks like coffee grounds
Stomach cramps
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Constipation
Diarrhea
Stomach pain
Upset stomach
Vomiting
Heartburn
Change in stool color to green
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe nausea or vomiting
- Severe constipation or diarrhea
- Allergic reaction symptoms (rash, itching, swelling, severe dizziness, trouble breathing)
- Unusual or severe abdominal pain
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following conditions to ensure safe use of this medication:
Any allergies you have, including allergies to this drug, its components, or other substances, and describe the symptoms you experienced.
If you have an excessive amount of iron in your body (iron overload).
If you have certain types of anemia, such as pernicious anemia, which is characterized by a lack of vitamin B12 in the body.
If you are currently taking mineral oil.
If you are taking levodopa.
If you are taking acitretin.
Additionally, if your medication contains omega-3 fatty acids, you should also inform your doctor if:
You are taking a blood thinner (anticoagulant).
You have bleeding problems or disorders.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your other drugs and health conditions. Never start, stop, or change the dose of any medication without consulting your doctor first.
It is essential to inform your doctor about the following conditions to ensure safe use of this medication:
Any allergies you have, including allergies to this drug, its components, or other substances, and describe the symptoms you experienced.
If you have an excessive amount of iron in your body (iron overload).
If you have certain types of anemia, such as pernicious anemia, which is characterized by a lack of vitamin B12 in the body.
If you are currently taking mineral oil.
If you are taking levodopa.
If you are taking acitretin.
Additionally, if your medication contains omega-3 fatty acids, you should also inform your doctor if:
You are taking a blood thinner (anticoagulant).
You have bleeding problems or disorders.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your other drugs and health conditions. Never start, stop, or change the dose of any medication without consulting your doctor first.
Precautions & Cautions
It is essential to inform all of your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This drug may interfere with certain laboratory tests, so be sure to notify all of your healthcare providers and laboratory personnel that you are taking it. If you have been diagnosed with phenylketonuria (PKU), consult with your doctor, as some formulations of this medication may contain phenylalanine. Additionally, if you are breastfeeding, discuss the potential risks to your baby with your doctor to determine the best course of action.
Overdose Information
Overdose Symptoms:
- Severe nausea, vomiting, diarrhea
- Abdominal pain
- Dizziness, weakness
- Metallic taste in mouth (iron overdose)
- Yellowing of skin or eyes (Vitamin A overdose)
- Confusion, headache (Vitamin D overdose)
- In severe cases, liver damage, kidney damage, coma, or death (especially with iron or fat-soluble vitamins)
What to Do:
Immediately contact a poison control center (1-800-222-1222) or seek emergency medical attention. Treatment may involve supportive care, gastric decontamination, and specific antidotes depending on the components and severity of overdose.
Drug Interactions
Moderate Interactions
- Levothyroxine (Iron and Calcium can impair absorption; separate administration by at least 4 hours).
- Tetracycline/Quinolone antibiotics (Iron and Calcium can chelate, reducing antibiotic absorption; separate administration by at least 2-4 hours).
- Antacids (Can affect absorption of iron and other minerals).
- Bisphosphonates (Calcium can impair absorption; separate administration).
- Warfarin (Vitamin K, though usually low in prenatals, can theoretically reduce anticoagulant effect. High doses of Vitamin E or DHA might increase bleeding risk, but unlikely with typical prenatal doses).
- Diuretics (Thiazide diuretics can increase calcium reabsorption; loop diuretics can increase calcium excretion).
Minor Interactions
- Certain foods (e.g., phytates in whole grains, oxalates in spinach can reduce mineral absorption; caffeine can affect calcium absorption).
Monitoring
Baseline Monitoring
General nutritional status
Rationale: To assess baseline deficiencies and guide overall dietary recommendations.
Timing: Pre-conception or early pregnancy
Hemoglobin/Hematocrit
Rationale: To assess for anemia, especially iron-deficiency anemia, which is common in pregnancy.
Timing: Baseline and periodically during pregnancy
Routine Monitoring
Patient well-being and adherence
Frequency: At routine prenatal visits
Target: N/A
Action Threshold: Report any adverse effects or concerns.
Dietary intake assessment
Frequency: Periodically during pregnancy
Target: Adequate intake of diverse food groups
Action Threshold: Counseling if dietary gaps are identified.
Symptom Monitoring
- Nausea
- Constipation (common with iron supplementation)
- Stomach upset
- Allergic reactions (rare)
- Unusual fatigue or weakness (may indicate inadequate supplementation or other issues)
Special Patient Groups
Pregnancy
Duet DHA is specifically formulated and recommended for use during pregnancy to provide essential nutrients for maternal health and fetal development. It helps meet the increased nutritional demands of pregnancy.
Trimester-Specific Risks:
First Trimester:
Crucial for neural tube development (folic acid) and organogenesis. Generally safe and recommended.
Second Trimester:
Supports rapid fetal growth and development. Generally safe and recommended.
Third Trimester:
Supports continued fetal growth, brain development (DHA), and prepares maternal body for delivery. Generally safe and recommended.
Lactation
Recommended during lactation to support maternal nutritional needs and provide essential nutrients (e.g., DHA) to the infant via breast milk.
Infant Risk:
L1 (Compatible with breastfeeding). Generally considered safe and beneficial for the infant.
Pediatric Use
Not intended for direct pediatric use, but the nutrients are vital for fetal and infant development when taken by the mother.
Geriatric Use
Not specifically formulated for geriatric use, though general multivitamin/mineral supplementation may be appropriate for this population based on individual needs.
Clinical Information
Clinical Pearls
- Emphasize the importance of consistent daily intake throughout pregnancy and lactation.
- Advise patients that iron in prenatal vitamins can cause constipation and dark stools; recommend increasing fiber and water intake.
- Counsel on proper storage to maintain potency and prevent accidental ingestion by children.
- Remind patients that a prenatal vitamin is a supplement, not a substitute for a healthy, balanced diet.
- Discuss potential interactions with other medications, especially thyroid hormones and certain antibiotics, and advise spacing doses.
Alternative Therapies
- Individual vitamin and mineral supplements (e.g., separate folic acid, iron, calcium, DHA supplements) if a combined product is not tolerated or specific deficiencies require higher doses.
- Dietary modifications to increase intake of nutrient-rich foods.
Cost & Coverage
Average Cost:
Varies widely, typically $20-$60 per 30 tablets/capsules
Generic Available:
Yes
Insurance Coverage:
Often covered by insurance plans as a prescription (if prescribed) or through FSA/HSA. Over-the-counter versions may not be covered.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.