Twin Ultra Orange Flavor

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Twin Ultra Orange Flavor uses

Twin Ultra Orange Flavor consists of Chromium, Potassium (Potassium Phosphate Dibasic), Vitamin B1 (Thiamine Hydrochloride), Vitamin B2, Vitamin B3 (Nicotinamide), Vitamin B5 (D-Pantothenic Acid), Vitamin B6 (Pyridoxine Hydrochloride), Vitamin C, Vitamin H (Biotin).

Potassium (Potassium Phosphate Dibasic):



Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) CHLORIDE EXTENDED RELEASE TABLETS USP 20 mEq K

Rx Only

DESCRIPTION

The Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq product is an immediately dispersing extended release oral dosage form of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride containing 1500 mg of microencapsulated Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride, USP equivalent to 20 mEq of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) in a tablet.

These formulations are intended to slow the release of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) so that the likelihood of a high localized concentration of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride within the gastrointestinal tract is reduced.

Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq is an electrolyte replenisher. The chemical name of the active ingredient is Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride, and the structural formula is KCl. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride, USP occurs as a white, granular powder or as colorless crystals. It is odorless and has a saline taste. Its solutions are neutral to litmus. It is freely soluble in water and insoluble in alcohol.

Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq is a tablet formulation (not enteric coated or wax matrix) containing individually microencapsulated Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride crystals which disperse upon tablet disintegration. In simulated gastric fluid at 37°C and in the absence of outside agitation, Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq begin disintegrating into microencapsulated crystals within seconds and completely disintegrates within 1 minute. The microencapsulated crystals are formulated to provide an extended release of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride.

Inactive Ingredients: Colloidal silicon dioxide, crospovidone, diethyl phthalate, ethyl-cellulose, microcrystalline cellulose.

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CLINICAL PHARMACOLOGY

The Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) ion is the principal intracellular cation of most body tissues. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) ions participate in a number of essential physiological processes including the maintenance of intracellular tonicity; the transmission of nerve impulses; the contraction of cardiac, skeletal, and smooth muscle; and the maintenance of normal renal function.

The intracellular concentration of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) is approximately 150 to 160 mEq per liter. The normal adult plasma concentration is 3.5 to 5 mEq per liter. An active ion transport system maintains this gradient across the plasma membrane.

Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) is a normal dietary constituent and under steady-state conditions the amount of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) absorbed from the gastrointestinal tract is equal to the amount excreted in the urine. The usual dietary intake of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) is 50 to 100 mEq per day.

Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion will occur whenever the rate of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) loss through renal excretion and/or loss from the gastrointestinal tract exceeds the rate of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) intake. Such depletion usually develops as a consequence of therapy with diuretics, primary or secondary hyperaldosteronism, diabetic ketoacidosis, or inadequate replacement of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) in patients on prolonged parenteral nutrition. Depletion can develop rapidly with severe diarrhea, especially if associated with vomiting. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion due to these causes is usually accompanied by a concomitant loss of chloride and is manifested by hypokalemia and metabolic alkalosis. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion may produce weakness, fatigue, disturbances or cardiac rhythm (primarily ectopic beats), prominent U-waves in the electrocardiogram, and in advanced cases, flaccid paralysis and/or impaired ability to concentrate urine.

If Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion associated with metabolic alkalosis cannot be managed by correcting the fundamental cause of the deficiency, eg, where the patient requires long-term diuretic therapy, supplemental Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) in the form of high Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) food or Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride may be able to restore normal Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) levels.

In rare circumstances (eg, patients with renal tubular acidosis) Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion may be associated with metabolic acidosis and hyperchloremia. In such patients Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) replacement should be accomplished with Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salts other than the chloride, such as Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) bicarbonate, Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) citrate, Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) acetate, or Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) gluconate.

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INDICATIONS AND USAGE

BECAUSE OF REPORTS OF INTESTINAL AND GASTRIC ULCERATION AND BLEEDING WITH CONTROLLED-RELEASE Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) CHLORIDE PREPARATIONS, THESE DRUGS SHOULD BE RESERVED FOR THOSE PATIENTS WHO CANNOT TOLERATE OR REFUSE TO TAKE LIQUID OR EFFERVESCENT Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) PREPARATIONS OR FOR PATIENTS IN WHOM THERE IS A PROBLEM OF COMPLIANCE WITH THESE PREPARATIONS.

1. For the treatment of patients with hypokalemia with or without metabolic alkalosis, in digitalis intoxication, and in patients with hypokalemic familial periodic paralysis. If hypokalemia is the result of diuretic therapy, consideration should be given to the use of a lower dose of diuretic, which may be sufficient without leading to hypokalemia.

2. For the prevention of hypokalemia in patients who would be at particular risk if hypokalemia were to develop, eg, digitalized patients or patients with significant cardiac arrhythmias.

The use of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salts in patients receiving diuretics for uncomplicated essential hypertension is often unnecessary when such patients have a normal dietary pattern and when low doses of the diuretic are used. Serum Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) should be checked periodically, however, and if hypokalemia occurs, dietary supplementation with potassium-containing foods may be adequate to control milder cases. In more severe cases, and if dose adjustment of the diuretic is ineffective or unwarranted, supplementation with Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salts may be indicated.

CONTRAINDICATIONS

Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) supplements are contraindicated in patients with hyperkalemia since a further increase in serum Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) concentration in such patients can produce cardiac arrest. Hyperkalemia may complicate any of the following conditions: chronic renal failure, systemic acidosis, such as diabetic acidosis, acute dehydration, extensive tissue breakdown as in severe burns, adrenal insufficiency, or the administration of a potassium-sparing diuretic (eg, spironolactone, triamterene, amiloride) (see OVERDOSAGE ).

Controlled-release formulations of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride have produced esophageal ulceration in certain cardiac patients with esophageal compression due to enlarged left atrium. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) supplementation, when indicated in such patients, should be given as a liquid preparation or as an aqueous (water) suspension of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride (see PRECAUTIONS: Information for Patients , and DOSAGE AND ADMINISTRATION sections).

All solid oral dosage forms of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride are contraindicated in any patient in whom there is structural, pathological (eg, diabetic gastroparesis), or pharmacologic (use of anticholinergic agents or other agents with anticholinergic properties at sufficient doses to exert anticholinergic effects) cause for arrest or delay in tablet passage through the gastrointestinal tract.

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WARNINGS

Hyperkalemia (see OVERDOSAGE )

In patients with impaired mechanisms for excreting Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)), the administration of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salts can produce hyperkalemia and cardiac arrest. This occurs most commonly in patients given Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) by the intravenous route but may also occur in patients given Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) orally. Potentially fatal hyperkalemia can develop rapidly and be asymptomatic. The use of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salts in patients with chronic renal disease, or any other condition which impairs Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) excretion, requires particularly careful monitoring of the serum Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) concentration and appropriate dosage adjustment.

Interaction with Potassium-Sparing Diuretics

Hypokalemia should not be treated by the concomitant administration of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salts and a potassium-sparing diuretic (eg, spironolactone, triamterene, or amiloride) since the simultaneous administration of these agents can produce severe hyperkalemia.

Interaction with Angiotensin-Converting Enzyme Inhibitors

Angiotensin-converting enzyme (ACE) inhibitors (eg, captopril, enalapril) will produce some Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) retention by inhibiting aldosterone production. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) supplements should be given to patients receiving ACE inhibitors only with close monitoring.

Gastrointestinal Lesions

Solid oral dosage forms of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride can produce ulcerative and/or stenotic lesions of the gastrointestinal tract. Based on spontaneous adverse reaction reports, enteric-coated preparations of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride are associated with an increased frequency of small bowel lesions (40-50 per 100,000 patient years) compared to sustained release wax matrix formulations (less than one per 100,000 patient years). Because of the lack of extensive marketing experience with microencapsulated products, a comparison between such products and wax matrix or enteric-coated products is not available. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq is a tablet formulated to provide a controlled rate of release of microencapsulated Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride and thus to minimize the possibility of a high local concentration of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) near the gastrointestinal wall.

Prospective trials have been conducted in normal human volunteers in which the upper gastrointestinal tract was evaluated by endoscopic inspection before and after 1 week of solid oral Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride therapy. The ability of this model to predict events occurring in usual clinical practice is unknown. Trials which approximated usual clinical practice did not reveal any clear differences between the wax matrix and microencapsulated dosage forms. In contrast, there was a higher incidence of gastric and duodenal lesions in subjects receiving a high dose of a wax matrix controlled-release formulation under conditions which did not resemble usual or recommended clinical practice (ie, 96 mEq per day in divided doses of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride administered to fasted patients, in the presence of an anticholinergic drug to delay gastric emptying). The upper gastrointestinal lesions observed by endoscopy were asymptomatic and were not accompanied by evidence of bleeding (Hemoccult testing). The relevance of these findings to the usual conditions (ie, non-fasting, no anticholinergic agent, smaller doses) under which controlled-release Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride products are used is uncertain; epidemiologic studies have not identified an elevated risk, compared to microencapsulated products, for upper gastrointestinal lesions in patients receiving wax matrix formulations. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq should be discontinued immediately and the possibility of ulceration, obstruction, or perforation should be considered if severe vomiting, abdominal pain, distention, or gastrointestinal bleeding occurs.

Metabolic Acidosis

Hypokalemia in patients with metabolic acidosis should be treated with an alkalinizing Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salt such as Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) bicarbonate, Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) citrate, Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) acetate, or Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) gluconate.

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PRECAUTIONS

General

The diagnosis of Twin Ultra Orange Flavor ) depletion is ordinarily made by demonstrating hypokalemia in a patient with a clinical history suggesting some cause for Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion. In interpreting the serum Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) level, the physician should bear in mind that acute alkalosis per se can produce hypokalemia in the absence of a deficit in total body Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) while acute acidosis per se can increase the serum Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) concentration into the normal range even in the presence of a reduced total body Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)). The treatment of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion, particularly in the presence of cardiac disease, renal disease, or acidosis requires careful attention to acid-base balance and appropriate monitoring of serum electrolytes, the electrocardiogram, and the clinical status of the patient.

Information for Patients

Physicians should consider reminding the patient of the following: To take each dose with meals and with a full glass of water or other liquid. To take each dose without crushing, chewing, or sucking the tablets. If those patients are having difficulty swallowing whole tablets, they may try one of the following alternate methods of administration:

  • Break the tablet in half, and take each half separately with a glass of water.
  • Prepare an aqueous (water) suspension as follows:

    1. Place the whole tablet(s) in approximately 1/2 glass of water (4 fluid ounces).

    2. Allow approximately 2 minutes for the tablet(s) to disintegrate.

    3. Stir for about half a minute after the tablet(s) has disintegrated.

    4. Swirl the suspension and consume the entire contents of the glass immediately by drinking or by the use of a straw.

    5. Add another 1 fluid ounce of water, swirl, and consume immediately.

    6. Then, add an additional 1 fluid ounce of water, swirl, and consume immediately.


Aqueous suspension of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride that is not taken immediately should be discarded. The use of other liquids for suspending Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq is not recommended.

To take this medicine following the frequency and amount prescribed by the physician. This is especially important if the patient is also taking diuretics and/or digitalis preparations.

To check with the physician at once if tarry stools or other evidence of gastrointestinal bleeding is noticed.

Laboratory Tests

When blood is drawn for analysis of plasma Twin Ultra Orange Flavor ) it is important to recognize that artifactual elevations can occur after improper venipuncture technique or as a result of in vitro hemolysis of the sample.

Drug Interactions

Potassium-sparing diuretics, angiotensin-converting enzyme inhibitors (see WARNINGS ).

Carcinogenesis, Mutagenesis, Impairment of Fertility

Carcinogenicity, mutagenicity, and fertility studies in animals have not been performed. Twin Ultra Orange Flavor ) is a normal dietary constituent.

Pregnancy Category C

Animal reproduction studies have not been conducted with Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq. It is unlikely that Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) supplementation that does not lead to hyperkalemia would have an adverse effect on the fetus or would affect reproductive capacity.

Nursing Mothers

The normal Twin Ultra Orange Flavor ) ion content of human milk is about 13 mEq per liter. Since oral Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) becomes part of the body Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) pool, so long as body Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) is not excessive, the contribution of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride supplementation should have little or no effect on the level in human milk.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

Geriatric Use

Clinical studies of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection; and it may be useful to monitor renal function.

ADVERSE REACTIONS

One of the most severe adverse effects is hyperkalemia (see CONTRAINDICATIONS , WARNINGS , and OVERDOSAGE ). There have also been reports of upper and lower gastrointestinal conditions including obstruction, bleeding, ulceration, and perforation (see CONTRAINDICATIONS and WARNINGS ). The most common adverse reactions to oral Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salts are nausea, vomiting, flatulence, abdominal pain/discomfort, and diarrhea. These symptoms are due to irritation of the gastrointestinal tract and are best managed by diluting the preparation further, taking the dose with meals or reducing the amount taken at one time.

OVERDOSAGE

The administration of oral Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) salts to persons with normal excretory mechanisms for Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) rarely causes serious hyperkalemia. However, if excretory mechanisms are impaired or if Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) is administered too rapidly intravenously, potentially fatal hyperkalemia can result (see CONTRAINDICATIONS and WARNINGS ). It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested only by an increased serum Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) concentration (6.5-8.0 mEq/L) and characteristic electrocardiographic changes (peaking of T-waves, loss of P-waves, depression of S-T segment, and prolongation of the QT-interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9-12 mEq/L).

Treatment measures for hyperkalemia include the following:

  • Patients should be closely monitored for arrhythmias and electrolyte changes.
  • Elimination of foods and medications containing Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) and of any agents with potassium-sparing properties such as potassium-sparing diuretics, ARBS, ACE inhibitors, NSAIDS, certain nutritional supplements and many others.
  • Intravenous calcium gluconate if the patient is at no risk of developing digitalis toxicity.
  • Intravenous administration of 300 to 500 mL/hr of 10% dextrose solution containing 10-20 units of crystalline insulin per 1,000 mL.
  • Correction of acidosis, if present, with intravenous sodium bicarbonate.
  • Use of exchange resins, hemodialysis, or peritoneal dialysis.

In treating hyperkalemia, it should be recalled that in patients who have been stabilized on digitalis, too rapid a lowering of the serum Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) concentration can produce digitalis toxicity.

The extended release feature means that absorption and toxic effects may be delayed for hours.

Consider standard measures to remove any unabsorbed drug.

DOSAGE AND ADMINISTRATION

The usual dietary intake of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) by the average adult is 50 to 100 mEq per day. Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion sufficient to cause hypokalemia usually requires the loss of 200 or more mEq of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) from the total body store.

Dosage must be adjusted to the individual needs of each patient. The dose for the prevention of hypokalemia is typically in the range of 20 mEq per day. Doses of 40-100 mEq per day or more are used for the treatment of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) depletion. Dosage should be divided if more than 20 mEq per day is given such that no more than 20 mEq is given in a single dose.

Each Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablet USP, 20 mEq provides 20 mEq of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride.

Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq should be taken with meals and with a glass of water or other liquid. This product should not be taken on an empty stomach because of its potential for gastric irritation (see WARNINGS ).

Patients having difficulty swallowing whole tablets may try one of the following alternate methods of administration:

  • Break the tablet in half, and take each half separately with a glass of water.
  • Prepare an aqueous (water) suspension as follows:
    • Place the whole tablet(s) in approximately 1/2 glass of water (4 fluid ounces).
    • Allow approximately 2 minutes for the tablet(s) to disintegrate.
    • Stir for about half a minute after the tablet(s) has disintegrated.
    • Swirl the suspension and consume the entire contents of the glass immediately by drinking or by the use of a straw.
    • Add another 1 fluid ounce of water, swirl, and consume immediately.
    • Then, add an additional 1 fluid ounce of water, swirl, and consume immediately.

Aqueous suspension of Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride that is not taken immediately should be discarded. The use of other liquids for suspending Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq is not recommended.

HOW SUPPLIED

Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) Chloride Extended Release Tablets USP, 20 mEq are available in bottles of 100 (NDC 62037-999-01), bottles of 500 (NDC 62037-999-05), and bottles of 1000 (NDC 62037-999-10). Potassium Chloride Extended Release Tablets USP, 20 mEq are capsule shaped, white to off-white tablets, with “ABRS-123” imprinted on one side and scored on the other side for flexibility of dosing.

Storage Conditions

Keep tightly closed. Store at controlled room temperature, 20°-25°C (68°-77°F).

Manufactured by:

Eurand, Inc.

Vandalia, OH 45377 USA

Distributed by:

Watson Pharma, Inc.

Rev. Date (01/09) 173714

Twin Ultra Orange Flavor (Potassium (Potassium Phosphate Dibasic)) chloride 20 Meq

Vitamin C:


Pharmacological action

Ascorbic acid is essential for the formation of intracellular collagen, is required to strengthen the structure of teeth, bones, and the capillary walls. Twin Ultra Orange Flavor (Vitamin C) participates in redox reactions, the metabolism of tyrosine, converting folic acid into folinic acid, metabolism of carbohydrates, the synthesis of lipids and proteins, iron metabolism, processes of cellular respiration. Reduces the need for vitamins B1, B2, A, E, folic acid, pantothenic acid, enhances the body's resistance to infections; enhances iron absorption, contributing to its sequestration in reduced form. Twin Ultra Orange Flavor (Vitamin C) has antioxidant properties.

With intravaginal application of ascorbic acid lowers the vaginal pH, inhibiting the growth of bacteria and helps to restore and maintain normal pH and vaginal flora (Lactobacillus acidophilus, Lactobacillus gasseri).

Pharmacokinetics

After oral administration ascorbic acid is completely absorbed from the gastrointestinal tract. Widely distributed in body tissues.

The concentration of ascorbic acid in blood plasma in normal amounts to approximately 10-20 mg / ml.

The concentration of ascorbic acid in white blood cells and platelets is higher than in erythrocytes and plasma. When deficient state of concentration in leucocytes is reduced later and more slowly and is regarded as the best criterion for evaluating the deficit than the concentration in plasma.

Plasma protein binding is about 25%.

Ascorbic acid is reversibly oxidized to form dehydroascorbic acid, is metabolized with the formation of ascorbate-2-sulphate which is inactive and oxalic acid which is excreted in the urine.

Ascorbic acid taken in excessive quantities is rapidly excreted unchanged in urine, it usually happens when exceeding a daily dose is 200 mg.

Why is Twin Ultra Orange Flavor prescribed?

For systemic use of Twin Ultra Orange Flavor (Vitamin C) Kimia Farma: prevention and treatment of hypo- and avitaminosis of Twin Ultra Orange Flavor (Vitamin C); providing increased need for Twin Ultra Orange Flavor (Vitamin C) during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.

For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.

Dosage and administration

This medication administered orally, IM, IV, intravaginally.

For the prevention of deficiency conditions Twin Ultra Orange Flavor dose is 25-75 mg / day, for the treatment - 250 mg / day or more in divided doses.

For intravaginal used ascorbic acid drugs in appropriate dosage forms.

Twin Ultra Orange Flavor (Vitamin C) side effects, adverse reactions

CNS: headache, fatigue, insomnia.

Digestive system: stomach cramps, nausea and vomiting.

Allergic reaction: describes a few cases of skin reactions and manifestations of the respiratory system.

Urinary system: when used in high doses - hyperoxaluria and the formation of kidney stones of calcium oxalate.

Local reactions: with intravaginal application - a burning or itching in the vagina, increased mucous discharge, redness, swelling of the vulva. Other: sensation of heat.

Twin Ultra Orange Flavor contraindications

Increased sensitivity to ascorbic acid.

Using during pregnancy and breastfeeding

The minimum daily requirement of ascorbic acid in the II and III trimester of pregnancy is about 60 mg.

Ascorbic acid crosses the placental barrier. It should be borne in mind that the fetus can adapt to high doses of ascorbic acid, which takes a pregnant woman, and then a newborn baby may develop the ascorbic disease as the reaction of cancel. Therefore, during pregnancy should not to take ascorbic acid in high doses, except in cases where the expected benefit outweighs the potential risk.

The minimum daily requirement during lactation is 80 mg. Ascorbic acid is excreted in breast milk. A mother's diet that contains adequate amounts of ascorbic acid, is sufficient to prevent deficiency in an infant. It is unknown whether dangerous to the child's mother use of ascorbic acid in high doses. Theoretically it is possible. Therefore, it is recommended not to exceed the maximum daily nursing mother needs to ascorbic acid, except when the expected benefit outweighs the potential risk.

Special instructions

Twin Ultra Orange Flavor (Vitamin C) is used with caution in patients with hyperoxaluria, renal impairment, a history of instructions on urolithiasis. Because ascorbic acid increases iron absorption, its use in high doses can be dangerous in patients with hemochromatosis, thalassemia, polycythemia, leukemia, and sideroblastic anemia.

Patients with high content body iron should apply ascorbic acid in minimal doses.

Twin Ultra Orange Flavor (Vitamin C) is used with caution in patients with deficiency of glucose-6-phosphate dehydrogenase.

The use of ascorbic acid in high doses can cause exacerbation of sickle cell anemia.

Data on the diabetogenic action of ascorbic acid are contradictory. However, prolonged use of ascorbic acid should periodically monitor your blood glucose levels.

It is believed that the use of ascorbic acid in patients with rapidly proliferating and widely disseminated tumors may worsen during the process. It should therefore be used with caution in ascorbic acid in patients with advanced cancer.

Absorption of ascorbic acid decreased while use of fresh fruit or vegetable juices, alkaline drinking.

Twin Ultra Orange Flavor drug interactions

In an application with barbiturates, primidone increases the excretion of ascorbic acid in the urine.

With the simultaneous use of oral contraceptives reduces the concentration of ascorbic acid in blood plasma.

In an application of Twin Ultra Orange Flavor (Vitamin C) with iron preparations ascorbic acid, due to its regenerative properties, transforms ferric iron in the bivalent, which improves its absorption.

Ascorbic acid in high doses can decrease urine pH that while the application reduces the tubular reabsorption of amphetamine and tricyclic antidepressants.

With the simultaneous use of aspirin reduces the absorption of ascorbic acid by about a third.

Twin Ultra Orange Flavor (Vitamin C) in an application with warfarin may decrease effects of warfarin.

With the simultaneous application of ascorbic acid increases the excretion of iron in patients receiving deferoxamine. In the application of ascorbic acid at a dose of 500 mg / day possibly left ventricular dysfunction.

In an application with tetracycline is increased excretion of ascorbic acid in the urine.

There is a described case of reducing the concentration of fluphenazine in plasma in patients treated with ascorbic acid 500 mg 2 times / day.

May increase the concentration of ethinyl estradiol in the blood plasma in its simultaneous application in the oral contraceptives.

Twin Ultra Orange Flavor in case of emergency / overdose

Symptoms: long-term use of large doses (more than 1 g) - headache, increased CNS excitability, insomnia, nausea, vomiting, diarrhea, gastritis giperatsidnyh, ultseratsiya gastrointestinal mucosa, inhibition of the function insular apparatus of the pancreas (hyperglycemia, glycosuria), hyperoxaluria, nephrolithiasis (calcium oxalate), damage to the glomerular apparatus of the kidneys, moderate thamuria (when receiving a dose of 600 mg / day).

Decrease capillary permeability (possibly deteriorating trophic tissues, increased blood pressure, hypercoagulability, the development of microangiopathy).

When IV administration in high doses - the threat of termination of pregnancy (due to estrogenemia), hemolysis of red blood cells.

Twin Ultra Orange Flavor pharmaceutical active ingredients containing related brand and generic drugs:

Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


Twin Ultra Orange Flavor available forms, composition, doses:

Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.


Twin Ultra Orange Flavor destination | category:

Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


Twin Ultra Orange Flavor Anatomical Therapeutic Chemical codes:

A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


Twin Ultra Orange Flavor pharmaceutical companies:

Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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References

  1. "Potassium". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).
  2. "Chromium". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).
  3. "Chromium". http://www.drugbank.ca/drugs/DB1113... (accessed August 28, 2018).

Frequently asked Questions

Can i drive or operate heavy machine after consuming Twin Ultra Orange Flavor?

Depending on the reaction of the Twin Ultra Orange Flavor after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Twin Ultra Orange Flavor not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

Is Twin Ultra Orange Flavor addictive or habit forming?

Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.

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Review

sdrugs.com conducted a study on Twin Ultra Orange Flavor, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Twin Ultra Orange Flavor consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

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The information was verified by Dr. Rachana Salvi, MD Pharmacology

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