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Drug overview for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride):
Generic name: pediatric multivitamin no.175 with fluoride (multivitamins/FLOOR-ide)
Drug class: Fluorides
Therapeutic class: Electrolyte Balance-Nutritional Products
Fluoride increases resistance to dental caries and therefore is referred to as a cariostatic agent; fluoride also desensitizes dentin.
No enhanced Uses information available for this drug.
Generic name: pediatric multivitamin no.175 with fluoride (multivitamins/FLOOR-ide)
Drug class: Fluorides
Therapeutic class: Electrolyte Balance-Nutritional Products
Fluoride increases resistance to dental caries and therefore is referred to as a cariostatic agent; fluoride also desensitizes dentin.
No enhanced Uses information available for this drug.
DRUG IMAGES
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The following indications for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride) have been approved by the FDA:
Indications:
Prevention of dental caries
Vitamin deficiency
Professional Synonyms:
Caries prophylaxis
Indications:
Prevention of dental caries
Vitamin deficiency
Professional Synonyms:
Caries prophylaxis
The following dosing information is available for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride):
Fluorides are administered orally as sodium fluoride or topically directly onto teeth as sodium fluoride, acidulated phosphate fluoride, sodium monofluorophosphate, or stannous fluoride.
To minimize the risk of fluorosis and the amount of fluoride swallowed and absorbed systemically, children younger than 12 years of age should be instructed and/or supervised carefully regarding proper techniques for use of topical fluoride preparations. When using fluoride-containing dentifrices in children 3-6 years of age, only a pea-sized amount (approximately 0.25 g) of dentifrice should be applied to the toothbrush twice daily, and the child should be instructed not to swallow the toothpaste. When using fluoride-containing dentifrices in younger children (from eruption of the first tooth up to 3 years of age), only a smear (approximately 0.1 g; about the size of a grain of rice) of dentifrice should be applied to the toothbrush twice daily, and the child should be supervised to ensure that the correct amount of dentrifice is used and to minimize swallowing of the dentifrice.
The American Academy of Pediatrics (AAP) states that young children should not rinse with water after brushing their teeth with fluoridated dentifrice because their instinct is to swallow; expectorating without rinsing reduces the amount of fluoride swallowed and leaves some fluoride in saliva, where it is available for uptake into plaque. Unless a fluoride rinsing solution also is being used to provide oral fluoride supplementation, rinsing solutions should not be swallowed after administration but should be expectorated once rinsing is complete.
Patients receiving fluoride powders or concentrated rinsing solutions should be advised that the preparation must be reconstituted and/or diluted as directed prior to use. Patients receiving fluoride treatment gels or rinsing solutions for self-administration should be advised that these preparations are to be used as directed and should not be used as dentifrices or mouthwashes/gargles, respectively.
To minimize the risk of fluorosis and the amount of fluoride swallowed and absorbed systemically, children younger than 12 years of age should be instructed and/or supervised carefully regarding proper techniques for use of topical fluoride preparations. When using fluoride-containing dentifrices in children 3-6 years of age, only a pea-sized amount (approximately 0.25 g) of dentifrice should be applied to the toothbrush twice daily, and the child should be instructed not to swallow the toothpaste. When using fluoride-containing dentifrices in younger children (from eruption of the first tooth up to 3 years of age), only a smear (approximately 0.1 g; about the size of a grain of rice) of dentifrice should be applied to the toothbrush twice daily, and the child should be supervised to ensure that the correct amount of dentrifice is used and to minimize swallowing of the dentifrice.
The American Academy of Pediatrics (AAP) states that young children should not rinse with water after brushing their teeth with fluoridated dentifrice because their instinct is to swallow; expectorating without rinsing reduces the amount of fluoride swallowed and leaves some fluoride in saliva, where it is available for uptake into plaque. Unless a fluoride rinsing solution also is being used to provide oral fluoride supplementation, rinsing solutions should not be swallowed after administration but should be expectorated once rinsing is complete.
Patients receiving fluoride powders or concentrated rinsing solutions should be advised that the preparation must be reconstituted and/or diluted as directed prior to use. Patients receiving fluoride treatment gels or rinsing solutions for self-administration should be advised that these preparations are to be used as directed and should not be used as dentifrices or mouthwashes/gargles, respectively.
No enhanced Administration information available for this drug.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride):
There are 0 contraindications.
There are 2 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Erdafitinib/Serum Phosphate Level-Altering Drugs SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Medications that alter serum phosphate may interfere with interpretation of phosphate levels that are needed to determine initial erdafitinib dose.(1) CLINICAL EFFECTS: Serum phosphate levels that are elevated by concomitant medications may result in an inappropriately low dose and decreased effectiveness of erdafitinib. Serum phosphate levels that are decreased by concomitant medications may result in an inappropriately high dose and increased toxicity from erdafitinib. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturer of erdafitinib states that agents that alter serum phosphate levels should be avoided before the initial dose increase period for erdafitinib based on serum phosphate levels (days 14 to 21).(1) DISCUSSION: Concomitant administration of serum phosphate level-altering agents during the initial dose increase period of erdafitinib based on serum phosphate levels (days 14 to 21) may interfere with serum phospate levels and lead to incorrect dosing of erdafitinib.(1) Agents that may alter serum phosphate levels linked to this monograph include: aluminum carbonate, aluminum hydroxide, calcium acetate, calcium carbonate, calcium citrate, cod liver oil, ferric citrate, lanthanum, magnesium carbonate, magnesium hydroxide, potassium phosphate, sevelamer, sodium phosphate, sucroferric oxyhydroxide, tenapanor, and vitamin D.(1) |
BALVERSA |
| Fluorouracil & Fluorouracil Prodrugs/Folic Acid SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Folic acid has been shown to enhance both the therapeutic and toxic effects of fluoropyrimidines, such as 5-fluorouracil (5-FU) and fluorouracil prodrugs.(1-3) Fluorouracil prodrugs include capecitabine and tegafur. CLINICAL EFFECTS: Folic acid, when used concurrently with 5-FU or fluorouracil prodrugs, has been shown to increase side effects of 5-FU.(1-3) PREDISPOSING FACTORS: Patients who are intermediate or poor dihydropyrimidine dehydrogenase (DPYD) metabolizers have diminished or no DPYD function. Since DPYD is the rate-limiting enzyme involved in fluoropyrimidine metabolism, these patients may be more susceptible to the effects of this interaction.(3) PATIENT MANAGEMENT: Folic acid or folate analog-containing products should not be used concurrently with fluorouracil or fluorouracil prodrugs unless directed by the healthcare provider.(1-3) Fluorouracil prodrugs include capecitabine and tegafur. DISCUSSION: Due to increased toxic effects, stomatitis and diarrhea are observed more commonly, may be more severe, and may occur for a prolonged duration when compared to therapy with 5-FU alone. It is postulated that the lower standard dose of 5-FU in the US versus other regions may be due to increased folic acid supplementation within the US food supply.(2) In a cohort study in 290 patients, the use of dietary supplements with folic acid during treatment compared to nonuse increased the risk of capecitabine toxicities (HR 1.81, 95%CI: 1.15,2.85). The detection of folic acid in plasma also increased the risk of capecitabine toxicities (HR 2.09, 95%CI: 1.24,3.52 and HR 2.31, 95%CI: 1.29,4.13 at diagnosis and during treatment, respectively).(4) In a cohort study of 9 patients, patients taking folate-containing supplements and higher serum folate levels had an increased risk of grade >=2 toxicity. The risk of grade >=2 toxicity increased by 9% for every increase in serum folate level by 10 nmol/L. Patients with grade >=2 toxicity had higher serum folate levels than patients with grade <= 1 toxicity (28 nmol/L [range, 13.2-45.4] vs. 20 nmol/L [range, 12.8-45.4]; p=0.001).(5) In two case reports, patients developed capecitabine toxicity while taking supplements containing folic acid 400-500 mcg.(6) In a case report, a woman developed grade 4 diarrhea, grade 3 vomiting, and grade 3 hand-foot syndrome 8 days after the addition of capecitabine (2500 mg/m2/day) to high-dose folic acid supplementation. She developed necrotic colitis and died, despite the discontinuation of folic acid and capecitabine.(7) There are two other reports of excessive fluorouracil toxicity in patients treated with folic acid.(8) |
ADRUCIL, CAPECITABINE, FAVLYXA, FLUOROURACIL |
There are 6 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Hydantoins/Folic Acid; Pyrimethamine SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Unknown, but probably involves altered metabolism of the hydantoin. CLINICAL EFFECTS: May observe decreased effectiveness of hydantoin, resulting in loss of seizure control. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: If both drugs are administered, monitor both the hydantoin plasma levels as well as the seizure control of the patient. Adjust the dose of hydantoin accordingly. DISCUSSION: The effects of an interaction are not expected to occur in the majority of patients. Discontinuation of folic acid has caused phenytoin levels to increase in patients who experienced a decrease in phenytoin levels when folic acid was started. Monitor these patients for hydantoin toxicity. Signs and symptoms of hydantoin toxicity include ataxia, nystagmus and involuntary movements. |
CEREBYX, DILANTIN, DILANTIN-125, FOSPHENYTOIN SODIUM, PHENYTEK, PHENYTOIN, PHENYTOIN SODIUM, PHENYTOIN SODIUM EXTENDED |
| Orlistat/Fat Soluble Vitamins SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: The acetate ester forms of vitamin A and vitamin E must undergo hydrolysis for absorption from the gastrointestinal tract.(1) The enzyme responsible for this hydrolysis is inhibited by orlistat.(2) CLINICAL EFFECTS: Orlistat may reduce absorption of fat soluble vitamins, leading to a deficiency state. PREDISPOSING FACTORS: A pre-existing deficiency of fat soluble vitamins (A,D,E and K) or chronic malabsorption syndrome. PATIENT MANAGEMENT: The inhibition of fat soluble vitamin absorption by orlistat should be borne in mind during implementation of a vitamin supplementation strategy. Patients should be strongly encouraged to take a multivitamin supplement which contains fat soluble vitamins, particularly Vitamin D as it appears most susceptible to this interaction.(4,5) Multivitamin supplements should be taken at least two hours before or after the dose of orlistat, or at bedtime.(4) Patients with chronic malabsorption syndromes should not receive orlistat.(4) DISCUSSION: Adult patients taking orlistat without supplementation showed a greater reduction in vitamin A,D,E and beta-carotene levels compared to placebo during two or more consecutive visits in studies of 1-2 years duration; these patients had normal baseline values prior to orlistat therapy. Low vitamin values in orlistat patients were as follows: low Vitamin D 12%, low beta-carotene 6.1%, low Vitamin E 5.8%, low Vitamin A 2.2%.(4) A pharmacokinetic interaction study showed a 30% reduction in beta-carotene supplement absorption and a 60% decreased in vitamin E acetate absorption with concomitant orlistat.(4) In a study, orlistat produced the vitamin net concentration by approximately 43%.(1) In a study, no statistically significant decrease in vitamin A absorption was observed with concurrent orlistat.(2) In a study, mean vitamin D levels were significantly reduced compared with baseline after one month of orlistat therapy despite multivitamin supplementation.(5) |
ORLISTAT, XENICAL |
| Deferoxamine/Ascorbic Acid (Vitamin C) SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: It is believed that ascorbic acid increases the iron available for chelation from an labile intracellular iron pool. Ascorbic acid may then facilitate iron-induced oxidative tissue damage.(1) CLINICAL EFFECTS: Dietary ascorbic acid may increase the absorption of dietary iron. Supplemental ascorbic acid therapy given during chelation therapy may improve iron output;(1-9) however, excessive dosages may result in cardiac toxicity from iron-induced oxidative tissue damage.(1,2,11-13) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Ascorbic acid intake is often restricted in patients with iron overload; however, it has been used in conjunction with deferoxamine to increase iron excretion.(2) Supplemental ascorbic acid therapy should only be initiated after one month of deferoxamine therapy. Ascorbic acid therapy should only be given in patients receiving deferoxamine regularly and the dose should be given after the infusion has started. The dosage of ascorbic acid should be limited to 50 mg daily in children under 10 years of age; 100 mg daily in older children; and 200 mg daily, in divided doses, in adults.(2) Cardiac function should be monitored in patients receiving concurrent therapy. Discontinue ascorbic acid therapy in patients who develop cardiac dysfunction.(2) DISCUSSION: Supplemental ascorbic acid therapy given during chelation therapy has been shown to improve iron output,(1-9) possibly by increasing iron available for chelation from an labile intracellular iron pool.(1) However, dosages in excess of 500 mg daily have been associated with cardiac dysfunction.(1,2,11-13) |
DEFEROXAMINE MESYLATE, DESFERAL MESYLATE |
| Colesevelam/Fat Soluble Vitamins SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K.(1) CLINICAL EFFECTS: Colesevelam may reduce absorption of fat soluble vitamins, leading to a deficiency state. PREDISPOSING FACTORS: A pre-existing deficiency of fat soluble vitamins (A,D,E and K) or chronic malabsorption syndrome. PATIENT MANAGEMENT: The inhibition of fat soluble vitamin absorption by colesevelam should be borne in mind during implementation of a vitamin supplementation strategy. Oral multivitamin supplements should be taken at least four hours before the dose of colesevelam.(1) DISCUSSION: Colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K.(1) |
COLESEVELAM HCL, WELCHOL |
| Pafolacianine/Folic Acid SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Folate, folic acid, and folate-containing supplements may reduce binding of pafolacianine to folate receptors expressed on ovarian cancer cells. CLINICAL EFFECTS: Folate, folic acid, and folate-containing supplements could reduce the detection of malignant lesions with pafolacianine. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Avoid administration of folate, folic acid, or folate-containing supplements within 48 hours before administration of pafolacianine. DISCUSSION: Folate, folic acid, and folate-containing supplements may reduce binding of pafolacianine to folate receptors expressed on cancer cells, which could result in reduced detection of malignant lesions with pafolacianine. |
CYTALUX |
| Patiromer/Thiamine SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Patiromer may bind to thiamine.(1) CLINICAL EFFECTS: Concurrent use may result in decreased gastrointestinal absorption and loss of efficacy of thiamine.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of patiromer recommends administering patiromer at least 3 hours before or 3 hours after thiamine.(1) DISCUSSION: An in vitro binding study found potentially clinically significant binding of thiamine by patiromer. It is recommended to take these drugs 3 hours apart.(1) |
VELTASSA |
The following contraindication information is available for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 2 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Hypervitaminosis D |
| Leber's hereditary optic atrophy |
There are 3 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Hypercalcemia |
| Hyperphosphatemia |
| Kidney stone |
There are 6 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Atrophic gastritis |
| Dental fluorosis |
| Hypokalemia |
| Kidney disease with reduction in glomerular filtration rate (GFr) |
| No disease contraindications |
| Sarcoidosis |
The following adverse reaction information is available for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 6 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Aphthous stomatitis Bronchospastic pulmonary disease Concentration difficulty Dental fluorosis Skin rash Urticaria |
There are 15 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Abdominal distension Acute cognitive impairment Anorexia Depression Dysgeusia Erythema Excitement Flatulence Irritability Malaise Nausea Pruritus of skin Skin inflammation Skin rash Sleep disorder |
The following precautions are available for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for POLY-VI-FLOR (ARCOFOLIN) (pediatric multivitamin no.175 with fluoride)'s list of indications:
| Vitamin deficiency | |
| E56.9 | Vitamin deficiency, unspecified |
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