Duet DHA Balanced
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
Dietary Supplement; Prenatal Vitamin and Mineral Supplement
Pharmacologic Class
Multivitamin/Mineral Supplement; Omega-3 Fatty Acid Supplement
Pregnancy Category
Not applicable (intended for use during pregnancy)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Duet DHA Balanced is a daily supplement for pregnant and breastfeeding women. It provides essential vitamins, minerals like iron and folate, and DHA (an omega-3 fatty acid). These nutrients are important for your health and for the healthy development of your baby's brain, eyes, and nervous system.
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 best 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 interfere with 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 best 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 interfere with 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 one softgel capsule daily, preferably with a meal to improve absorption and reduce stomach upset.
- Store at room temperature away from moisture and heat.
- Keep out of reach of children.
- Do not exceed the recommended dose unless directed by your healthcare provider.
- Maintain a balanced diet in addition to taking this supplement.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
One softgel capsule daily, or as directed by a healthcare professional.
Dose Range:
1 - 1 mg
Condition-Specific Dosing:
pregnancy:
One softgel capsule daily
lactation:
One softgel capsule daily
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established (intended for adults)
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment typically required for standard supplementation. Consult physician for severe impairment or specific nutrient concerns.
Moderate:
No specific adjustment typically required for standard supplementation. Consult physician for severe impairment or specific nutrient concerns.
Severe:
Consult physician. May require monitoring of specific nutrient levels (e.g., Vitamin A, D, iron) due to altered metabolism or excretion.
Dialysis:
Consult physician. Specific nutrient supplementation may be required based on individual needs and dialysis regimen.
Hepatic Impairment:
Mild:
No specific adjustment typically required for standard supplementation. Consult physician for severe impairment or specific nutrient concerns.
Moderate:
No specific adjustment typically required for standard supplementation. Consult physician for severe impairment or specific nutrient concerns.
Severe:
Consult physician. May require monitoring of specific nutrient levels (e.g., fat-soluble vitamins) due to altered absorption or metabolism.
Pharmacology
Mechanism of Action
Duet DHA Balanced provides essential vitamins, minerals, and omega-3 fatty acids (DHA) crucial for maternal health and fetal development. Folate (as L-methylfolate) is essential for neural tube development. Iron supports red blood cell formation and oxygen transport. Calcium and Vitamin D are vital for bone health. DHA is critical for fetal brain, eye, and nervous system development. The combination ensures adequate nutritional support during pregnancy and lactation, addressing increased demands and preventing deficiencies.
Pharmacokinetics
Absorption:
Bioavailability:
Highly variable depending on individual nutrient (e.g., folate >90%, iron 5-15%, DHA variable based on form and dietary fat).
Tmax:
Not specifically studied for the combination product; varies by individual nutrient (e.g., water-soluble vitamins typically within 1-4 hours, fat-soluble vitamins and DHA absorption is slower).
FoodEffect:
Generally enhanced absorption of fat-soluble vitamins and DHA when taken with food. Iron absorption can be affected by certain foods (e.g., dairy, tea, coffee) but is often enhanced by Vitamin C.
Distribution:
Vd:
Not applicable for a multi-nutrient supplement; each nutrient distributes according to its physiological role.
ProteinBinding:
Varies by nutrient (e.g., Vitamin D metabolites are protein-bound, iron binds to transferrin).
CnssPenetration:
Yes, essential nutrients and DHA cross the blood-brain barrier and placenta to support fetal development.
Elimination:
HalfLife:
Highly variable by nutrient (e.g., water-soluble vitamins hours to days, fat-soluble vitamins days to months, DHA incorporation into tissues is long-term).
Clearance:
Varies by nutrient (renal excretion for water-soluble vitamins, biliary/fecal for some fat-soluble vitamins and metabolites).
ExcretionRoute:
Renal, Biliary/Fecal
Unchanged:
Varies by nutrient; many are metabolized before excretion.
Pharmacodynamics
OnsetOfAction:
Nutritional benefits accumulate over time with consistent daily use. Immediate effects are not typically observed.
PeakEffect:
Long-term nutritional support and prevention of deficiencies.
DurationOfAction:
Daily supplementation is required to maintain adequate nutrient levels.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
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 coffee ground-like material
Stomach cramps
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although 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 unusual symptoms that bother you or persist, contact your doctor for guidance:
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 about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
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 coffee ground-like material
Stomach cramps
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although 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 unusual symptoms that bother you or persist, contact your doctor for guidance:
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 about side effects, consult 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 stomach pain or cramping
- Persistent nausea or vomiting
- Severe constipation or diarrhea
- Signs of allergic reaction (hives, difficulty breathing, swelling of face/lips/tongue/throat)
- Dark, tarry stools (may indicate excessive iron intake or other issues)
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 treatment:
Any allergies you have, including allergies to this medication, 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.
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 blood thinners (anticoagulants).
You have bleeding problems or disorders.
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other treatments and health issues. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, 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.
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 blood thinners (anticoagulants).
You have bleeding problems or disorders.
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other treatments and health issues. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.
Precautions & Cautions
It is essential to inform all 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 your healthcare providers and laboratory personnel that you are taking it. If you have 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
- Constipation
- Fatigue
- Weakness
- Headache
- Metallic taste in mouth
- In severe cases (especially iron overdose): hypotension, shock, metabolic acidosis, liver damage, coma.
What to Do:
Seek immediate medical attention or call a Poison Control Center (1-800-222-1222). Bring the product container with you.
Drug Interactions
Moderate Interactions
- Antacids (may decrease iron absorption)
- Thyroid hormones (calcium and iron may interfere with absorption; separate administration by 4 hours)
- Tetracycline/Quinolone antibiotics (calcium and iron may chelate; separate administration by 2-4 hours)
- Warfarin (Vitamin K, if present in other prenatal vitamins, can reduce anticoagulant effect; Duet DHA Balanced typically has minimal or no Vitamin K, but general caution with multivitamins is warranted)
- Anticonvulsants (some may increase folate metabolism, requiring higher folate intake)
Minor Interactions
- Dietary fiber (may slightly reduce mineral absorption)
- Caffeine/Tea (may reduce iron absorption)
Monitoring
Baseline Monitoring
Nutritional status assessment (dietary intake, pre-existing deficiencies)
Rationale: To identify specific needs or existing deficiencies before starting supplementation.
Timing: Pre-conception or early pregnancy
Hemoglobin/Hematocrit
Rationale: To assess for anemia, especially iron-deficiency anemia, which is common in pregnancy.
Timing: Early pregnancy
Routine Monitoring
General well-being and adherence
Frequency: At routine prenatal visits
Target: Not applicable
Action Threshold: Report any adverse effects or concerns to healthcare provider.
Iron status (e.g., ferritin, hemoglobin)
Frequency: As clinically indicated, typically mid-to-late pregnancy
Target: Hemoglobin >11 g/dL (1st/3rd trimester), >10.5 g/dL (2nd trimester)
Action Threshold: If levels are low, consider additional iron supplementation or investigate cause.
Symptom Monitoring
- Nausea
- Constipation
- Diarrhea
- Stomach upset
- Allergic reactions (rash, itching, swelling, severe dizziness, trouble breathing)
- Unusual fatigue or weakness (may indicate persistent deficiency)
Special Patient Groups
Pregnancy
Duet DHA Balanced is specifically formulated for use during pregnancy to provide essential vitamins, minerals, and DHA necessary for maternal health and optimal fetal growth and development, particularly for the brain and eyes. It helps prevent common nutrient deficiencies during pregnancy.
Trimester-Specific Risks:
First Trimester:
Crucial for neural tube development (folate) and organogenesis. Helps prevent early deficiencies.
Second Trimester:
Supports continued fetal growth, bone development (calcium, Vitamin D), and red blood cell production (iron).
Third Trimester:
Supports rapid fetal brain and eye development (DHA), and prepares maternal body for delivery and lactation.
Lactation
Recommended during lactation to ensure adequate nutrient transfer to breast milk and to support maternal recovery and energy levels. DHA is particularly important for infant brain and eye development via breast milk.
Infant Risk:
Low risk; provides essential nutrients to the infant via breast milk. No known adverse effects when taken at recommended doses.
Pediatric Use
Not indicated for pediatric use. Formulated for adult women during pregnancy and lactation.
Geriatric Use
Not specifically formulated for geriatric use. While some nutrients are beneficial, the formulation is tailored to the specific needs of pregnancy and lactation.
Clinical Information
Clinical Pearls
- Emphasize the importance of taking prenatal vitamins consistently, especially folate, before and during early pregnancy for neural tube development.
- Advise taking with food to minimize gastrointestinal upset, particularly from iron.
- Inform patients that iron in prenatal vitamins can cause dark stools and constipation; recommend adequate fluid and fiber intake.
- Clarify that this is a supplement, not a substitute for a healthy, balanced diet.
- Counsel on potential drug-nutrient interactions, especially with thyroid hormones, antibiotics, and antacids, advising separation of doses.
Alternative Therapies
- Individual vitamin and mineral supplements (e.g., separate folic acid, iron, DHA supplements)
- Dietary modifications to increase nutrient intake (though often insufficient to meet pregnancy demands)
Cost & Coverage
Average Cost:
$20 - $50 per 30 softgels
Generic Available:
Yes
Insurance Coverage:
Often not covered by insurance as it is an over-the-counter dietary supplement. Some FSA/HSA plans may cover it.
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 this 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 emergency medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.