Family Doctor 2008

Is anemia what’s holding you back? Ask your healthcare provider about Repliva 21/7® —a prescription iron supplement that is clinically proven to restore iron levels in women References: 1. 4. 5. 2. 3. Hemochromatosis and hemosiderosis are contraindications to iron therapy. Folic acid in doses above 1.0 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurological manifestations remain progressive. WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately. Adverse reactions with iron therapy may include constipation, diarrhea, nausea, vomiting, dark stools, and abdominal pain. Adverse reactions with iron therapy are usually transient. Allergic sensitization has been reported following both oral and parenteral administration of folic acid. Rx Only DESCRIPTION Repliva 21/7® Tablets for oral administration to provide 28-day iron supplement therapy. Each red film-coated tablet contains: Iron (elemental iron) Sumalate®* iron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 mg Ferrous fumarate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 mg Succinic acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 mg Vitamin C Ascorbic acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 mg Ester-C ®† supplement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 mg Folic acid, USP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 mg Vitamin B12 (cyanocobalamin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 mcg Inactive Ingredients: aluminum hydrate, citric acid, croscarmellose sodium, FD&C Red No. 40 aluminum lake, FD&C Yellow No. 6 aluminum lake, hypromellose, lactose monohydrate, lecithin, magnesium stearate, malic acid, microcrystalline cellulose, polydextrose, polyethylene glycol, polyvinyl alcohol, povidone, silicon dioxide, sodium benzoate, sodium citrate, sorbic acid, starch, talc, titanium dioxide, triacetin. Each purple film-coated tablet contains 150 mg of succinic acid and the following inactive ingredients: croscarmellose sodium, D&C Red No. 27 aluminum lake, FD&C Blue No. 1 aluminum lake, hydrated alumina, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, silicon dioxide, stearic acid, talc, titanium dioxide. CLINICAL PHARMACOLOGY: Iron is an essential component in the formation of hemoglobin. Adequate amounts of iron are necessary for effective erythropoiesis. Iron also serves as a cofactor of several essential enzymes, including cytochromes that are involved in electron transport. Folic acid is required for nucleoprotein synthesis and the maintenance of normal erythropoiesis. Folic acid is converted in the liver and plasma to its metabolically active form, tetrahydrofolic acid, by dihydrofolate reductase. Vitamin B12 is required for the maintenance of normal erythropoiesis, nucleoprotein and myelin synthesis, cell reproduction and normal growth. Intrinsic factor, a glycoprotein secreted by the gastric mucosa, is required for active absorption of Vitamin B12 from the gastrointestinal tract. INDICATIONS AND USAGE: For the treatment of all anemias responsive to oral iron therapy, such as hypochromic anemia associated with pregnancy, chronic or acute blood loss, dietary restriction, metabolic disease and post-surgical convalescence. CONTRAINDICATIONS: This product is contraindicated in patients with a known hypersensitivity to any of the ingredients. Hemochromatosis and hemosiderosis are contraindications to iron therapy. WARNINGS: Folic acid alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where Vitamin B12 is deficient. WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately. PRECAUTIONS General: Do not exceed recommended dose. The type of anemia and the underlying cause or causes should be determined before starting therapy with Repliva 21/7® Tablets. Since the anemia may be a result of a systemic disturbance, such as recurrent blood loss, the underlying cause or causes should be corrected, if possible. Folic Acid: Folic acid in doses above 1.0 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurological manifestations remain progressive. Pernicious anemia should be excluded before using this product since folic acid may mask the symptoms of pernicious anemia. Pediatric Use: Safety and effectiveness in pediatric patients have not been established. Geriatric Use: Clinical studies on this product have not been performed in sufficient numbers of subjects aged 65 and over to determine whether elderly subjects respond differently from younger subjects. 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. ADVERSE REACTIONS: Adverse reactions with iron therapy may include constipation, diarrhea, nausea, vomiting, dark stools and abdominal pain. Adverse reactions with iron therapy are usually transient. Allergic sensitization has been reported following both oral and parenteral administration of folic acid. OVERDOSAGE: The clinical course of acute iron overdosage can be variable. Initial symptoms may include abdominal pain, nausea, vomiting, diarrhea, tarry stools, melena, hematemesis, hypotension, tachycardia, metabolic acidosis, hyperglycemia, dehydration, drowsiness, pallor, cyanosis, lassitude, seizures, shock and coma. DOSAGE AND ADMINISTRATION: Usual adult dose is 1 tablet daily, or as directed by a physician. The Repliva 21/7® TheraPak supplies a 28-day course of iron therapy that consists of 21 red active tablets and 7 purple absorption period tablets. Take 1 red tablet daily for 21 days, followed by 1 purple tablet daily for 7 days. After 28 tablets have been taken, a new course may be started if prescribed. HOW SUPPLIED: Repliva 21/7® Tablets are available in a TheraPak blister dispenser (NDC 64011-207-34) containing 28 oval shaped tablets (21 red tablets and 7 purple tablets). The red film-coated tablets are debossed “Ther-Rx” on one side and “201” with a partial bisect on the other side. The purple film-coated tablets are debossed “Ther-Rx” on one side and “206” with a partial bisect on the other side. Store at 25°C (77°F); excursions permitted to 15° - 30°C (59° - 86°F). [See USP Controlled Room Temperature.] Avoid excessive heat 40°C (104°F). Avoid freezing. *Sumalate® is a registered trademark of Albion International, Inc., Clearfield, Utah and the product is protected under U.S. Patent Nos. 5,516,925 and 6,716,814, licensed exclusively to KV Pharmaceutical Co. for iron products. Other U.S. patents pending. † Ester-C ® is a licensed trademark of The Ester C Company. Mktd. by Ther-Rx Corp., St. Louis, MO 63044 U.S. Patent Nos.: 5,516,925; 6,716,814. Other U.S. patents pending. P5497-1 07/08

Table of Contents Feed for the Digital Edition of Family Doctor 2008

Family Doctor 2008 Foreward Introduction Contents What Do You Want From Health Care? Confident Communication Need a New Doctor? Understanding Your Health Insurance OTC Safety as Simple as 1-2-3 The Fight Against Resistance Drug Interactions Prevention is Better than Cure Hitting a Home Run 'The Herbalist Will See You Now' Healthy Eating to Boost Your Heart and Health Exercise: The Elixir of Life Back from the Brink Taking Control Up All Night Vitamins and Minerals 101 Allergies: Combating the Causes Protect Yourself From Colds and the Flu Diabetes: Assessing Your Risk Dealing with Diabetes The Cholesterol Count Getting a Grip on Hypertension Facts About CKD Banish the Burn Easing the Pain Stop the Pounding Urinary Tract Infections: Common and Preventable Skin Essentials The ABCs of COPD Impotence: Tackling the Old Taboo Taking Responsibility for Your Health Prostate Cancer Screening: Is it For You? Protecting Your Prostate Heart Disease and Women: Know the Risks Birth Control to Suit You Maneuvering Through Menopause Help for PMS Infertility: Problems Having a Baby Preventive Health: What Women Need to Know Pregnancy: Taking Care of You and Your Baby Eating for Two Postpartum Mood Disorders The Basics of Breast Milk Newborn Screening Tests: Possible Lifesavers Common Newborn Conditions Childhood Vaccines: Why They're Necessary Food Allergies: The Facts Facing Your Acne Raising Grades Staying On Your Feet Age Gracefully: Take Care of Your Bones Battling Osteoarthritis Tackling Anxiety Beating the Blues

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