Nicadan Tablets

Multivitamins provide essential vitamins and minerals that are crucial cofactors for numerous metabolic processes, enzyme functions, and cellular activities throughout the body. They support energy production, immune function, bone health, vision, nerve function, and red blood cell formation by replenishing dietary deficiencies or increasing intake during periods of higher demand.

Urgent Side Effects: Seek Medical Attention Immediately

Although rare, some individuals may experience severe and potentially life-threatening side effects while taking this medication. If you exhibit any of the following symptoms, contact your doctor or seek medical help right away:

Signs of an allergic reaction, including:
+ 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
If your product contains iron:
+ 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. 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 unusual symptoms that bother you or persist, contact your doctor for guidance:

Common to all products:
+ Upset stomach
+ Vomiting
If your product contains iron:
+ Diarrhea or constipation
+ Change in stool color to green
+ Stomach pain

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.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have to this medication, its components, or other substances, including foods and drugs. Be sure to describe the allergic reaction you experienced.
Certain types of anemia, such as pernicious anemia, where your body lacks sufficient vitamin B12.
If you are currently taking levodopa.
If you are taking mineral oil.
* If your medication contains iron:
+ If you have an excessive amount of iron in your body.
+ If you have hemolytic anemia.

This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This is crucial because this drug may interfere with certain laboratory tests. Therefore, be sure to notify all your healthcare providers and laboratory personnel that you are taking this medication.

If you have a soy allergy, consult with your doctor before taking this medication, as some products may contain soy. Similarly, if you are allergic to tartrazine (also known as FD&C Yellow No. 5), discuss this with your doctor, as some products may contain this ingredient.

When it comes to administering this medication to children, it is important to note that different brands may be suitable for different age groups. Before giving this drug to a child, consult with their doctor to ensure you are using the correct brand and dosage.

If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. You and your doctor will need to discuss the potential benefits and risks of taking this medication to you and your baby.

• Warfarin (Coumadin) with high doses of Vitamin K: Vitamin K can reduce the anticoagulant effect of warfarin.
• Tetracyclines/Quinolones with Calcium/Magnesium/Iron/Zinc: Reduced absorption of antibiotics due to chelation.

• Levothyroxine with Calcium/Iron: Reduced absorption of thyroid hormone.
• Bisphosphonates with Calcium/Iron/Magnesium: Reduced absorption of bisphosphonates.
• Diuretics (Thiazide) with Calcium: Increased risk of hypercalcemia.
• Diuretics (Loop) with Thiamine/Potassium/Magnesium: Increased excretion of these nutrients.
• Phenytoin/Phenobarbital/Carbamazepine with Folic Acid/Vitamin D/Vitamin K: May increase metabolism of vitamins, leading to deficiency.
• Cholestyramine/Colestipol/Orlistat with Fat-soluble vitamins (A, D, E, K): Reduced absorption of fat-soluble vitamins.

• Antacids with Iron: Reduced iron absorption.
• Corticosteroids with Vitamin D/Calcium: May reduce bone density.

• Fatigue
• Weakness
• Numbness or tingling
• Skin changes (e.g., dryness, rashes)
• Hair loss
• Vision changes
• Bone pain
• Muscle cramps
• Gastrointestinal upset (nausea, vomiting, diarrhea, constipation)
• Headache
• Dizziness

Multivitamins, specifically prenatal vitamins, are highly recommended during pregnancy to ensure adequate intake of essential nutrients like folic acid (to prevent neural tube defects), iron, and calcium. However, excessive intake of certain vitamins (e.g., Vitamin A in retinol form) can be harmful.

Multivitamins are generally safe and often recommended during lactation to support maternal health and ensure adequate nutrient transfer to breast milk. Specific needs for certain vitamins (e.g., Vitamin D, B vitamins) may be higher.

Age-appropriate multivitamin formulations (drops, chewables) are available and may be recommended for children with restricted diets, poor appetite, or specific medical conditions. Dosing must be carefully managed to avoid toxicity, especially with fat-soluble vitamins and iron.

Older adults may have increased needs for certain vitamins (e.g., Vitamin D, B12 due to reduced absorption) and minerals. Multivitamin supplementation can help address these needs, but caution is advised regarding potential interactions with multiple medications.

• Advise patients that multivitamins are supplements, not substitutes for a healthy diet.
• Emphasize the importance of taking multivitamins with food to improve absorption and minimize GI upset.
• Educate patients about potential interactions, especially with warfarin (Vitamin K) and certain antibiotics (minerals).
• Remind patients that 'more is not always better' and exceeding recommended doses can lead to toxicity, particularly with fat-soluble vitamins and iron.
• For specific deficiencies, targeted single-vitamin supplements may be more appropriate than a general multivitamin.
• Counsel pregnant women on the critical importance of folic acid and the risks of excessive Vitamin A.

• Dietary modifications to increase nutrient intake from food sources.
• Targeted single-vitamin or mineral supplements for specific deficiencies (e.g., Vitamin D, B12, Iron).
• Fortified foods (e.g., cereals, milk).

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, including the amount taken and the time it happened, to ensure you receive the best possible care.