Label: WESNATE DHA- ascorbic acid, cholecalciferol, .alpha.-tocopherol, d-, thiamine mononitrate, riboflavin, pyridoxine hydrochloride, folic acid, cyanocobalamin, ferrous fumarate, magnesium oxide, zinc oxide, cupric sulfate, and omega-3 fatty acids capsule, gelatin coated

Side Effects

Allergic reactions have been reported following oral administration of folic acid.

Iron can cause mild gastrointestinal side effects, particularly when taken on an empty stomach.

Folic Acid

Concurrent use of folic acid has been associated with enhanced phenytoin metabolism, lowering the level of the AED in the blood and allowing breakthrough seizures to occur.

Folinic acid may enhance the toxicity of fluorouracil.

High levels of folic acid may result in decreased serum levels of pyrimethamine.

Concurrent administration of chloramphenicol and folinic acid in folate-deficient patients may result in antagonism of the hematopoietic response to folate.

Antiepileptic drugs (including, but not limited to, phenytoin, carbamazepine, primidone, valproic acid, fosphenytoin, valproate, phenobarbital and lamotrigine) have been shown to impair folate absorption and increase the metabolism of circulating folate.

Thiamin (Vitamin B1)

Furosemide, a loop diuretic, can decrease thiamin levels.

There have been case reports that fluorouracil may increase thiamin metabolism.

Vitamin B6

Vitamin B6 should not be given to patients receiving the drug levodopa because the action of levodopa is antagonized by Vitamin B6. However, Vitamin B6 may be used concurrently in patients receiving a preparation containing both carbidopa and levodopa.

Isoniazid can produce a Vitamin B6 deficiency.

Vitamin B12

Antibiotics, cholestyramine, colchicine, colestipol, metformin, para-aminosalicylic acid, and potassium chloride may decrease the absorption of vitamin B12 , and nitrous oxide can produce a functional vitamin B12 deficiency.

Vitamin D3

Some thiazide diuretics, such as hydrochlorothiazide, as well as antacids, bile acid sequestrants (such as cholestyramine), mineral oil, orlistat, olestra, cimetidine, and anticonvulsant medications may reduce the absorption or increase the catabolism of Vitamin D.

Vitamin D supplementation should not be given with calcium to patients with hypercalcemia or conditions that may lead to hypercalcemia such as hyperparathyroidism or those who form calcium-containing kidney stones.

Iron

Iron supplements might reduce the amounts of levodopa available to the body and diminish its clinical effectiveness.

Levothyroxine ingested simultaneously with iron can result in clinically significant reductions in levothyroxine efficacy.

Proton pump inhibitors reduce the acidity of stomach contents and can reduce iron absorption.

Zinc

Zinc may decrease absorption of quinolone or tetracycline antibiotics.

Cupric oxide

Concomitant use of penicillamine and copper can cause decreased absorption of both substances.

Omega-3 Fatty Acids

Ingestion of more than 3 grams per day of omega-3 fatty acids (ALA, EPA, and DHA) may have potential antithrombotic effects, and may increase bleeding times.

Avoid administering omega-3 fatty acids to patients with inherited or acquired predisposition toward bleeding, including patients taking anticoagulants. Exercise caution with these patients to ensure that the prescribed dosage of DHA does not exceed 1 gram (1000 mg) per day.