Tab-A-vite Tablets
WARNING: If your product has iron in it: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: It is used to help growth and good health.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Vitamin/Mineral Supplement
Pharmacologic Class
Multivitamin
Pregnancy Category
Not applicable for dietary supplements; individual vitamins vary (e.g., B vitamins, C, D are generally Category A or C at recommended doses; high dose Vitamin A is Category X). Consult healthcare provider for specific product.
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Multivitamins are supplements that contain a combination of essential vitamins and minerals your body needs to function properly. They are used to fill nutritional gaps in your diet and ensure you get enough of these important nutrients, especially if your diet is not balanced or if you have increased needs.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions and read all the information provided. Take your medication as directed, and follow these guidelines:
You can take this medication with or without food. If it upsets your stomach, try taking it with food.
For best absorption, take this medication at bedtime. If you have questions about the timing, consult your doctor or pharmacist.
Extended-Release Products: Swallow the tablets whole; do not chew, break, or crush them.
Liquid Medication: Measure your dose carefully using the provided measuring device. If one is not included, ask your pharmacist for a device to measure your medication accurately.
* Chewable Tablets: Chew the tablets thoroughly before swallowing.
Storing and Disposing of Your Medication
Keep your medication in a safe place, out of the reach of children and pets. Store it at room temperature in a dry location, away from heat and light. Avoid storing it in a bathroom.
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 get the most benefit from your medication, follow your doctor's instructions and read all the information provided. Take your medication as directed, and follow these guidelines:
You can take this medication with or without food. If it upsets your stomach, try taking it with food.
For best absorption, take this medication at bedtime. If you have questions about the timing, consult your doctor or pharmacist.
Extended-Release Products: Swallow the tablets whole; do not chew, break, or crush them.
Liquid Medication: Measure your dose carefully using the provided measuring device. If one is not included, ask your pharmacist for a device to measure your medication accurately.
* Chewable Tablets: Chew the tablets thoroughly before swallowing.
Storing and Disposing of Your Medication
Keep your medication in a safe place, out of the reach of children and pets. Store it at room temperature in a dry location, away from heat and light. Avoid storing it in a bathroom.
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.
Lifestyle & Tips
- Take with food to improve absorption and reduce stomach upset.
- Do not exceed the recommended dose, as excessive intake of certain vitamins (especially fat-soluble ones like A, D, E, K) can be harmful.
- Maintain a balanced diet rich in fruits, vegetables, and whole grains, as supplements are not a substitute for healthy eating.
- Store in a cool, dry place, away from direct light and moisture, and out of reach of children.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
One tablet orally once daily, preferably with a meal, or as directed by a healthcare professional.
Dose Range:
1 - 1 mg
Condition-Specific Dosing:
deficiency:
Higher doses of specific vitamins may be indicated for diagnosed deficiencies, under medical supervision.
Pediatric Dosing
Neonatal:
Not established for general multivitamin tablets; specific liquid formulations or drops are used for infants.
Infant:
Not established for general multivitamin tablets; specific liquid formulations or drops are used for infants.
Child:
Product-specific; generally based on age and dietary needs. Consult product label or pediatrician.
Adolescent:
Typically adult dosing, or product-specific for adolescents.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment typically needed for standard multivitamin doses.
Moderate:
No specific adjustment typically needed for standard multivitamin doses, but caution with fat-soluble vitamins (A, D, E, K) due to potential accumulation. Monitor levels if high doses are used.
Severe:
Caution advised, especially with fat-soluble vitamins (A, D, E, K) and minerals like phosphorus or potassium if present. Consult nephrologist. Avoid high doses of Vitamin A.
Dialysis:
Specific renal-formulated multivitamins are often recommended to avoid accumulation of certain vitamins/minerals and to supplement those lost during dialysis.
Hepatic Impairment:
Mild:
No specific adjustment typically needed for standard multivitamin doses.
Moderate:
Caution with fat-soluble vitamins (A, D, E, K) due to impaired absorption or metabolism. Monitor levels if high doses are used.
Severe:
Caution advised, especially with fat-soluble vitamins (A, D, E, K) due to impaired absorption, metabolism, and storage. Avoid high doses of Vitamin A. Consult hepatologist.
Pharmacology
Mechanism of Action
Multivitamins provide essential vitamins and minerals that are crucial cofactors for numerous metabolic processes, enzyme functions, cellular growth, and tissue repair. They help prevent and treat vitamin and mineral deficiencies that may arise from inadequate dietary intake, malabsorption, increased requirements (e.g., pregnancy, lactation, certain diseases), or drug-induced depletion.
Pharmacokinetics
Absorption:
Bioavailability:
Varies widely by specific vitamin/mineral, formulation (e.g., chelated minerals, ester forms of vitamins), and presence of food. Generally, water-soluble vitamins (B, C) are readily absorbed, while fat-soluble vitamins (A, D, E, K) require dietary fat for optimal absorption.
Tmax:
Highly variable, generally 1-4 hours for most water-soluble vitamins. Fat-soluble vitamins may have delayed and prolonged absorption.
FoodEffect:
Generally recommended to take with food to enhance absorption of fat-soluble vitamins and minimize gastrointestinal upset.
Distribution:
Vd:
Varies widely; water-soluble vitamins distribute into total body water, while fat-soluble vitamins are stored in adipose tissue and liver.
ProteinBinding:
Varies; some vitamins (e.g., Vitamin D, Vitamin A) are highly protein-bound, while others (e.g., Vitamin C, B vitamins) are minimally bound.
CnssPenetration:
Limited for some, but essential for others (e.g., B vitamins are crucial for neurological function and cross the blood-brain barrier).
Elimination:
HalfLife:
Highly variable; minutes to hours for water-soluble vitamins (e.g., Vitamin C, B vitamins), days to months for fat-soluble vitamins (e.g., Vitamin D, Vitamin A).
Clearance:
Varies widely; renal for water-soluble, biliary/fecal for fat-soluble.
ExcretionRoute:
Water-soluble vitamins primarily renal; fat-soluble vitamins primarily biliary/fecal.
Unchanged:
High for water-soluble vitamins; low for fat-soluble vitamins.
Pharmacodynamics
OnsetOfAction:
Not acutely defined for chronic supplementation; benefits accrue over days to weeks as deficiencies are corrected.
PeakEffect:
Not acutely defined; reflects sustained optimal levels.
DurationOfAction:
Continuous with daily dosing; body stores of fat-soluble vitamins can last for extended periods.
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
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 or 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 not mentioned here. 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.
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
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 or 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 not mentioned here. 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 nausea or vomiting
- Diarrhea or severe constipation
- Unusual fatigue or weakness
- Headache
- Muscle or joint pain
- Hair loss
- Dry, cracked skin
- Yellowing of skin or eyes (jaundice)
- Changes in urination (e.g., increased frequency, dark urine)
- Any signs of allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)
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.
Certain types of anemia, such as pernicious anemia, where the body lacks sufficient vitamin B12.
If you are taking levodopa, as it may interact with this medication.
If you are taking mineral oil, as it may affect the absorption of this medication.
* If your product contains iron:
+ If you have an excessive amount of iron in your body, which could lead to adverse effects.
+ If you have hemolytic anemia, a condition where red blood cells are destroyed faster than they can be made.
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 existing health conditions and medications. 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.
Certain types of anemia, such as pernicious anemia, where the body lacks sufficient vitamin B12.
If you are taking levodopa, as it may interact with this medication.
If you are taking mineral oil, as it may affect the absorption of this medication.
* If your product contains iron:
+ If you have an excessive amount of iron in your body, which could lead to adverse effects.
+ If you have hemolytic anemia, a condition where red blood cells are destroyed faster than they can be made.
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 existing health conditions and medications. Never start, stop, or change the dose 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 lab personnel that you are taking it.
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 (FD&C Yellow No. 5), discuss this with your doctor, as some products may contain this ingredient.
When administering this medication to children, note that different brands may be suitable for different age groups. Therefore, it is crucial to consult with your doctor before giving this medication to a child 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.
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 (FD&C Yellow No. 5), discuss this with your doctor, as some products may contain this ingredient.
When administering this medication to children, note that different brands may be suitable for different age groups. Therefore, it is crucial to consult with your doctor before giving this medication to a child 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.
Overdose Information
Overdose Symptoms:
- Nausea
- Vomiting
- Diarrhea
- Stomach cramps
- Headache
- Dizziness
- Fatigue
- Irritability
- Blurred vision
- Hair loss
- Dry skin
- Bone pain
- Hypercalcemia (from excess Vitamin D, leading to confusion, frequent urination, kidney stones)
- Liver damage (from excess Vitamin A or iron)
What to Do:
Discontinue use immediately. Seek emergency medical attention or call a Poison Control Center (1-800-222-1222). Treatment is supportive and may involve gastric decontamination if ingestion was recent.
Drug Interactions
Major Interactions
- Warfarin (Coumadin) + Vitamin K: Vitamin K can reduce the anticoagulant effect of warfarin.
- Tetracyclines (e.g., doxycycline, minocycline) / Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) + Iron/Calcium/Magnesium/Zinc: These minerals can chelate with antibiotics, reducing their absorption and efficacy. Separate administration by at least 2-4 hours.
- Levothyroxine + Calcium/Iron: Calcium and iron can impair levothyroxine absorption. Separate administration by at least 4 hours.
Moderate Interactions
- Anticonvulsants (e.g., phenytoin, phenobarbital) + Folic Acid/Vitamin D: Anticonvulsants can increase the metabolism of folic acid and Vitamin D, potentially leading to deficiencies.
- Diuretics (e.g., thiazides, loop diuretics) + Calcium/Potassium/Magnesium: Can affect excretion of these minerals, leading to either depletion or accumulation.
- Bile Acid Sequestrants (e.g., cholestyramine) + Fat-soluble Vitamins (A, D, E, K): Can impair absorption of fat-soluble vitamins.
- Orlistat + Fat-soluble Vitamins (A, D, E, K): Can impair absorption of fat-soluble vitamins. Take multivitamin at least 2 hours before or after orlistat.
- Proton Pump Inhibitors (PPIs) / H2 Blockers + Vitamin B12/Calcium/Iron: Can reduce absorption of these nutrients due to decreased gastric acid.
Minor Interactions
- Alcohol + B Vitamins: Chronic alcohol consumption can deplete B vitamins.
- Caffeine + Calcium: High caffeine intake may slightly increase calcium excretion.
Monitoring
Baseline Monitoring
Dietary intake assessment
Rationale: To identify potential dietary gaps and determine the need for supplementation.
Timing: Prior to initiation
Symptoms of vitamin/mineral deficiency
Rationale: To establish baseline health status and guide specific supplementation if needed.
Timing: Prior to initiation
Routine Monitoring
General well-being and symptom resolution
Frequency: Ongoing
Target: Improved energy, reduced fatigue, improved skin/hair/nails (if related to deficiency)
Action Threshold: Persistent or worsening symptoms may indicate inadequate dosing, malabsorption, or an underlying medical condition.
Specific vitamin/mineral levels (e.g., Vitamin D, B12, Iron)
Frequency: Only if deficiency is suspected or diagnosed, or if high doses are being used.
Target: Within normal reference ranges for age and sex.
Action Threshold: Levels outside target range may require dose adjustment or investigation into underlying causes.
Symptom Monitoring
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Stomach upset
- Headache
- Unusual fatigue
- Changes in urine color (e.g., bright yellow from riboflavin)
- Symptoms of hypervitaminosis (e.g., bone pain, dry skin, hair loss for Vitamin A toxicity; hypercalcemia for Vitamin D toxicity)
Special Patient Groups
Pregnancy
Essential for fetal development and maternal health. Specific prenatal vitamins are recommended, which contain higher levels of folic acid and iron, and appropriate levels of other vitamins. High doses of Vitamin A (retinol) should be avoided due to teratogenic risk.
Trimester-Specific Risks:
First Trimester:
Crucial for neural tube development (folic acid). Avoid excessive Vitamin A.
Second Trimester:
Continued support for fetal growth and maternal health.
Third Trimester:
Support for fetal growth and preparation for delivery.
Lactation
Important for maternal health and to ensure adequate nutrient content in breast milk. Continue prenatal or specific postnatal vitamins as advised by a healthcare provider.
Infant Risk:
Low risk at recommended doses; high doses of certain vitamins (e.g., Vitamin A) could potentially be harmful to the infant.
Pediatric Use
Specific pediatric formulations (drops, chewables) are available with age-appropriate dosing. Avoid adult formulations for young children due to potential for overdose, especially with iron and fat-soluble vitamins.
Geriatric Use
May benefit from specific formulations designed for seniors, which often contain higher Vitamin D, B12, and calcium, and lower iron (unless deficiency is present). Absorption of some nutrients may decrease with age.
Clinical Information
Clinical Pearls
- Multivitamins are intended to supplement, not replace, a healthy diet.
- Advise patients to check the specific vitamin and mineral content of their multivitamin, as formulations vary widely.
- Counsel patients on potential interactions with medications, especially warfarin, certain antibiotics, and thyroid hormones.
- Emphasize the importance of not exceeding the recommended dose, particularly for fat-soluble vitamins (A, D, E, K) and minerals like iron, which can accumulate and cause toxicity.
- Patients with specific medical conditions (e.g., kidney disease, liver disease, hemochromatosis) or those taking multiple medications should consult their healthcare provider before starting a multivitamin.
Alternative Therapies
- Dietary modifications to increase nutrient intake
- Individual vitamin or mineral supplements for specific deficiencies (e.g., Vitamin D, B12, Iron, Calcium)
- Fortified foods
Cost & Coverage
Average Cost:
$5 - $30 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Generally Over-The-Counter (OTC) and not covered by most insurance plans unless prescribed for a specific medical condition (e.g., prenatal vitamins, specific deficiencies).
General Drug Facts
If your symptoms or health condition do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance. To ensure safe and effective treatment, never share your prescribed medication with others, and do not take medication that has been prescribed for someone else. Some medications may have additional patient information leaflets; consult with your pharmacist to determine if this applies to your prescription. If you have any questions or concerns about your medication, it is crucial to discuss them with 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 reporting the overdose, be prepared to provide detailed information, including the name of the medication taken, the amount consumed, and the time it occurred.