Thera-M Enhanced 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
Nutritional Supplement
Pharmacologic Class
Multivitamin/Mineral Supplement
Pregnancy Category
Not applicable (specific category depends on individual vitamin content and dosage; generally considered safe at recommended daily allowances, but specific prenatal vitamins are formulated for pregnancy)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Thera-M Enhanced Tablets are a daily supplement that provides a wide range of essential vitamins and minerals your body needs to stay healthy. They help fill nutritional gaps in your diet and support overall well-being, energy, and body functions.
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 results, 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 the liquid dose carefully using the provided measuring device. If one is not included, ask your pharmacist for a measuring device to ensure accurate dosing.
* 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 results, 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 the liquid dose carefully using the provided measuring device. If one is not included, ask your pharmacist for a measuring device to ensure accurate dosing.
* 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 the tablet with food to improve absorption and reduce stomach upset.
- Do not exceed the recommended dose unless advised by your doctor, as excessive intake of certain vitamins (especially fat-soluble ones) and minerals can be harmful.
- This supplement is not a substitute for a balanced diet. Continue to eat a variety of healthy foods.
- Store in a cool, dry place, away from direct light and out of reach of children.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
Typically 1 tablet daily with food, or as directed by a healthcare professional.
Dose Range:
1 - 1 mg
Condition-Specific Dosing:
general_nutritional_support:
1 tablet daily
Pediatric Dosing
Neonatal:
Not established (consult pediatrician for specific pediatric formulations)
Infant:
Not established (consult pediatrician for specific pediatric formulations)
Child:
Not established (consult pediatrician for specific pediatric formulations)
Adolescent:
Typically 1 tablet daily, or as directed by a healthcare professional (dosage may vary based on specific product formulation and adolescent needs)
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment for standard doses; caution with high doses of fat-soluble vitamins (A, D, E, K) and certain minerals (e.g., phosphorus, potassium) in severe impairment.
Moderate:
No specific adjustment for standard doses; caution with high doses of fat-soluble vitamins (A, D, E, K) and certain minerals (e.g., phosphorus, potassium) in severe impairment.
Severe:
Use with caution; avoid high doses of Vitamin A, Vitamin D, and phosphorus. Consult a healthcare professional.
Dialysis:
Specific vitamin/mineral supplementation may be required for dialysis patients, but general multivitamins may need adjustment. Consult a healthcare professional.
Hepatic Impairment:
Mild:
No specific adjustment for standard doses.
Moderate:
No specific adjustment for standard doses.
Severe:
Use with caution, especially with high doses of fat-soluble vitamins (A, D, E, K) due to potential for accumulation. Consult a healthcare professional.
Pharmacology
Mechanism of Action
Thera-M Enhanced Tablets provide a combination of essential vitamins and minerals that act as coenzymes, cofactors, and structural components in various metabolic pathways. They are crucial for normal cellular function, energy production, immune function, bone health, vision, and overall physiological processes. The specific mechanism depends on each individual vitamin and mineral component.
Pharmacokinetics
Absorption:
Bioavailability:
Highly variable depending on the specific vitamin/mineral, its form, presence of food, and individual patient factors. Water-soluble vitamins (B vitamins, C) are generally well-absorbed but not stored extensively. Fat-soluble vitamins (A, D, E, K) require dietary fat for absorption and are stored in the body.
Tmax:
Not precisely quantifiable for a multi-component product; varies widely by individual vitamin/mineral (e.g., minutes to hours).
FoodEffect:
Absorption of fat-soluble vitamins is enhanced by food, especially fatty meals. Some minerals (e.g., iron) may be better absorbed with Vitamin C. Some components may be better absorbed on an empty stomach (e.g., certain iron forms), but generally, multivitamins are recommended with food to minimize gastrointestinal upset.
Distribution:
Vd:
Not precisely quantifiable for a multi-component product; varies widely by individual vitamin/mineral.
ProteinBinding:
Varies by individual vitamin/mineral (e.g., Vitamin D metabolites are protein-bound, Vitamin B12 binds to intrinsic factor).
CnssPenetration:
Limited for many components; some vitamins (e.g., B vitamins) are essential for neurological function and cross the blood-brain barrier to varying degrees.
Elimination:
HalfLife:
Not precisely quantifiable for a multi-component product; varies widely by individual vitamin/mineral (e.g., hours for water-soluble, days to months for fat-soluble).
Clearance:
Not precisely quantifiable for a multi-component product; varies widely by individual vitamin/mineral.
ExcretionRoute:
Water-soluble vitamins primarily renal. Fat-soluble vitamins primarily biliary/fecal after hepatic metabolism.
Unchanged:
Varies significantly by individual vitamin/mineral.
Pharmacodynamics
OnsetOfAction:
Not applicable in the acute pharmacological sense; benefits are typically observed over weeks to months with consistent use as nutritional deficiencies are corrected or maintained.
PeakEffect:
Not applicable.
DurationOfAction:
Not applicable; effects are sustained with daily supplementation.
Safety & Warnings
Side Effects
Serious Side Effects: Seek Medical Attention Immediately
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience 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, contact your doctor for advice:
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. 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, this medication can cause severe and potentially life-threatening side effects. If you experience 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, contact your doctor for advice:
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. 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
- Diarrhea or constipation that is severe or persistent
- Headache or dizziness
- Unusual fatigue or weakness
- Yellowing of skin or eyes (jaundice)
- Changes in urination (e.g., increased frequency, dark urine)
- Muscle or joint pain
- Numbness or tingling in hands or feet
- Any signs of an allergic reaction (e.g., 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, as this may worsen your condition.
+ If you have hemolytic anemia, a condition where red blood cells are destroyed faster than they can be made.
This is not an exhaustive list of all potential interactions. Therefore, it is crucial to disclose all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you have, to your doctor and pharmacist. This will enable them to assess the safety of taking this medication with your other treatments and health conditions. Never start, stop, or adjust 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, as this may worsen your condition.
+ If you have hemolytic anemia, a condition where red blood cells are destroyed faster than they can be made.
This is not an exhaustive list of all potential interactions. Therefore, it is crucial to disclose all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you have, to your doctor and pharmacist. This will enable them to assess the safety of taking this medication with your other treatments and health conditions. Never start, stop, or adjust 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 (also known as FD&C Yellow No. 5), discuss this with your doctor, as some products may contain this ingredient.
When considering giving this medication to a child, it is crucial to consult with your doctor first, as different brands of this drug may be approved for use in children of varying ages.
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 ensure the best possible outcome for 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 (also known as FD&C Yellow No. 5), discuss this with your doctor, as some products may contain this ingredient.
When considering giving this medication to a child, it is crucial to consult with your doctor first, as different brands of this drug may be approved for use in children of varying ages.
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 ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Nausea
- Vomiting
- Diarrhea
- Stomach cramps
- Headache
- Dizziness
- Fatigue
- Irritability
- Hair loss
- Dry skin
- Joint pain
- Liver damage (from excess Vitamin A)
- Kidney stones (from excess Vitamin D or C)
- Nerve damage (from excess Vitamin B6)
- Iron poisoning (especially in children, can be fatal)
What to Do:
If you suspect an overdose, seek immediate medical attention or call a poison control center. In the US, call 1-800-222-1222. Bring the product packaging with you.
Drug Interactions
Major Interactions
- Warfarin (Coumadin) and other anticoagulants: High doses of Vitamin K can reduce the anticoagulant effect of warfarin. High doses of Vitamin E can increase the risk of bleeding.
- Tetracycline antibiotics (e.g., doxycycline, minocycline): Calcium, iron, magnesium, and zinc can chelate tetracyclines, reducing their absorption. Separate administration by at least 2-4 hours.
- Fluoroquinolone antibiotics (e.g., ciprofloxacin, levofloxacin): Calcium, iron, magnesium, and zinc can chelate fluoroquinolones, reducing their absorption. Separate administration by at least 2-4 hours.
- Levothyroxine (Synthroid): Calcium and iron can impair levothyroxine absorption. Separate administration by at least 4 hours.
Moderate Interactions
- Diuretics (e.g., thiazides, loop diuretics): May affect excretion of certain minerals (e.g., potassium, calcium, magnesium).
- Anticonvulsants (e.g., phenytoin, carbamazepine): May increase metabolism of Vitamin D and folic acid, potentially leading to deficiencies.
- Bile acid sequestrants (e.g., cholestyramine): May impair absorption of fat-soluble vitamins (A, D, E, K).
- Orlistat (Xenical): May impair absorption of fat-soluble vitamins (A, D, E, K).
- Proton pump inhibitors (PPIs) and H2 blockers: May reduce absorption of Vitamin B12 and certain minerals (e.g., calcium, magnesium) due to reduced stomach acid.
- Bisphosphonates (e.g., alendronate): Calcium and other minerals can interfere with absorption. Separate administration by at least 30 minutes to 2 hours.
Minor Interactions
- Alcohol: Can deplete B vitamins and interfere with absorption of other nutrients.
- Caffeine: May increase excretion of certain minerals.
Monitoring
Baseline Monitoring
Dietary intake assessment
Rationale: To determine if a multivitamin is necessary to supplement dietary gaps.
Timing: Prior to initiation, if nutritional deficiency is suspected.
Baseline blood tests (e.g., CBC, Vitamin D, B12, folate levels)
Rationale: If specific vitamin deficiencies are suspected or to establish a baseline for at-risk populations.
Timing: Prior to initiation, if clinically indicated.
Routine Monitoring
Symptoms of deficiency or toxicity
Frequency: Ongoing, patient self-monitoring
Target: Absence of symptoms
Action Threshold: Development of new or worsening symptoms; consult healthcare professional.
Adherence to dosing regimen
Frequency: Periodically during follow-up visits
Target: Consistent daily use as directed
Action Threshold: Inconsistent use may lead to suboptimal benefits.
Symptom Monitoring
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Headache
- Fatigue
- Skin rash
- Yellowing of skin (carotenemia from excess Vitamin A)
- Muscle weakness
- Nerve tingling/numbness (peripheral neuropathy from excess Vitamin B6)
- Bone pain
- Increased urination
- Changes in vision
Special Patient Groups
Pregnancy
Generally safe at recommended daily allowances. However, specific prenatal vitamins are formulated to meet the increased nutritional needs during pregnancy (e.g., higher folic acid, iron). Consult a healthcare professional before taking any multivitamin during pregnancy.
Trimester-Specific Risks:
First Trimester:
Adequate folic acid is crucial to prevent neural tube defects. Excessive Vitamin A (retinol) can be teratogenic.
Second Trimester:
Continued need for essential nutrients; iron needs increase.
Third Trimester:
Continued need for essential nutrients; iron and calcium needs remain high.
Lactation
Generally safe at recommended daily allowances. Nutritional needs are increased during lactation. Consult a healthcare professional before taking any multivitamin while breastfeeding.
Infant Risk:
Minimal risk to infant at recommended doses; vitamins are naturally present in breast milk. Excessive doses of certain vitamins could potentially transfer to breast milk.
Pediatric Use
Not typically recommended for infants or young children unless specifically formulated for their age group and recommended by a pediatrician. Overdose of iron is a leading cause of poisoning fatalities in young children.
Geriatric Use
Generally safe and often beneficial for older adults, who may have reduced absorption of certain nutrients (e.g., Vitamin B12) or specific dietary restrictions. However, caution is advised with high doses of certain vitamins (e.g., Vitamin A, D) due to potential for accumulation or interaction with existing conditions/medications. Consult a healthcare professional.
Clinical Information
Clinical Pearls
- Multivitamins are intended to supplement, not replace, a healthy diet.
- Advise patients to inform their healthcare provider about all supplements they are taking, especially if they are on other medications (e.g., anticoagulants, thyroid hormones).
- Educate patients on the signs and symptoms of both vitamin deficiency and toxicity.
- For patients with specific deficiencies (e.g., Vitamin D, B12), a targeted single-vitamin supplement may be more appropriate than a general multivitamin.
- Iron-containing multivitamins should be stored out of reach of children due to the risk of accidental overdose.
Alternative Therapies
- Dietary modifications to increase nutrient intake from food sources
- Individual vitamin or mineral supplements for targeted deficiencies (e.g., Vitamin D, B12, Iron, Calcium)
Cost & Coverage
Average Cost:
$10 - $30 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Often available over-the-counter (OTC) and typically not covered by prescription insurance plans, unless specifically prescribed for a medical condition and covered under a flexible spending account (FSA) or health savings account (HSA).
General Drug Facts
If your symptoms or health issues persist or worsen, it is 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 it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate 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 seeking help, be prepared to provide detailed information about the overdose, including the substance taken, the amount, and the time it occurred.