MULTIVITAMINS + MINERALS + DEANOL + GINSENG EXTRACT

Do NOT use multivitamins with minerals if you are allergic to any ingredient in multivitamins with minerals.

Constipation, diarrhea, or upset stomach may occur. These effects are usually temporary and may disappear as your body adjusts to this medication. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

If your doctor has prescribed this drug, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

When taken by mouth, deanol can cause constipation, itching, headache, drowsiness, insomnia, excitation, vivid dreams, confusion, depression, increased blood pressure, an increase in schizophrenia symptoms, and unwanted movements of the face and mouth.

Trouble sleeping is the most common side effect of ginseng extract. Less common effects include headache, agitation, upset stomach, menstrual problems (e.g., unusual vaginal bleeding), breast pain, and dizziness. An increase or decrease in blood pressure may also occur. Siberian ginseng may also cause drowsiness, nervousness, or mood changes. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

Tell your doctor right away if any of these unlikely but serious side effects occur: fast/pounding/irregular heartbeat.

A very serious allergic reaction to this product is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Before taking this medication, tell your doctor or pharmacist your medical history, especially of: use/abuse of alcohol, liver problems, stomach/intestinal problems (e.g., ulcer, colitis).

If your brand of multivitamin also contains folic acid, be sure to tell your doctor or pharmacist if you have vitamin B12 deficiency (pernicious anemia) before taking it. Folic acid may affect certain laboratory tests for vitamin B12 deficiency without treating this anemia. Untreated vitamin B12 deficiency may result in serious nerve problems (e.g., peripheral neuropathy). Consult your doctor or pharmacist for details.

Tell your doctor if you are pregnant before using this medication.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Pregnancy and breast-feeding: Not enough is known about the use of deanol during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Clonic-tonic seizures: Deanol should not be used by people with clonic-tonic seizure disorders.

Depression: Deanol might make depression worse.

Schizophrenia: Deanol might make schizophrenia symptoms worse.

Before taking ginseng, tell your doctor or pharmacist if you are allergic to it; or to any other ingredients listed on the product label; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

People who are allergic to one type of ginseng should also avoid taking other types.

If you have any of the following health problems, consult your doctor or pharmacist before using this product: high or low blood pressure, heart problems (e.g., abnormal heart rhythm, rheumatic heart disease), bleeding/clotting problems, a certain mental/mood disorder (schizophrenia), overactive immune system disorders (e.g., lupus, rheumatoid arthritis, multiple sclerosis), conditions that are affected by estrogen (e.g., endometriosis, uterine fibroids, cancer of the breast/uterus/ovary).

Ginseng may lower blood sugar levels too much, especially in people with diabetes. Siberian ginseng may lower or raise blood sugar levels. If you have diabetes, monitor your blood sugar more carefully while using this product, and report any unusual results or symptoms to your doctor. Your doctor may need to adjust your diabetes medications.

Liquid forms of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.

This product may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This product is not recommended for use during pregnancy. Consult your doctor before using this product.

It is unknown if this product passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Before taking this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal drugs you may use, especially: other vitamin/nutritional supplements.

If your brand of multivitamin also contains iron, avoid taking this product at the same time as antacids, bisphosphonates (for example, alendronate), levodopa, thyroid medications (for example, levothyroxine), or some antibiotics (for example, tetracyclines, quinolones such as ciprofloxacin). Ask your doctor or pharmacist about how long you should wait between doses and for help finding a dosing schedule that will work with all your medications.

If your brand of multivitamin also contains folic acid, be sure to tell your doctor or pharmacist if you take certain anti-seizure drugs (e.g., hydantoins such as phenytoin).

Some drying medications are called anticholinergic drugs. Deanol might increase chemicals that can decrease the effects of these drying medications. Drying medications include atropine, scopolamine, and some medications used for allergies (antihistamines), and for depression (antidepressants).

Medications for Alzheimer’s disease (Acetylcholinesterase inhibitors) interact with deanol. Acetylcholinesterase inhibitors include donepezil (Aricept), tacrine (Cognex), rivastigmine (Exelon), and galantamine (Reminyl, Razadyne).

Various medications used for glaucoma, Alzheimer’s disease, and other conditions (Cholinergic drugs) interacts with deanol.

Some products that may interact with ginseng include: medications/products that may increase your risk of bleeding (including “blood thinners” such as warfarin and heparin, anti-platelet drugs such as clopidogrel, nonsteroidal anti-inflammatory drugs-NSAIDs such as ibuprofen, herbal products such as danshen/garlic/ginger), MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine), drugs that weaken the immune system (including corticosteroids such as prednisone, drugs to prevent organ transplant rejection such as cyclosporine), “water pills” (diuretics such as furosemide, bumetanide), other herbal products (such as fenugreek, willow bark).

Aspirin may also increase the risk of bleeding when used with ginseng. If your doctor has prescribed low doses of aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue to take the aspirin. Consult your doctor or pharmacist for more details.

Caffeine can increase the side effects of ginseng. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, certain soft drinks) and eating large amounts of chocolate.

Check the labels on all your medicines (such as cough-and-cold products, diet aids) because they may contain ingredients that could increase the side effects of ginseng. Decongestants (such as pseudoephedrine) and stimulants (such as caffeine, ephedra, ma huang) may worsen trouble sleeping, fast heartbeat, and increased blood pressure. Consult your doctor or pharmacist for more details.

If overdose is suspected, bring the victim to the nearest hospital right away.

Available brand:

• Pharmaton (Boehringer Ingelheim)