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Cod Liver Oil (EPA 26mg+DHA 24mg + Vitamin A 670IU + Vitamin D3 67IU + Vitamin E 0.3IU) Soft Gelatin Capsule
Cod Liver Oil (EPA 26mg+DHA 24mg + Vitamin A 670IU + Vitamin D3 67IU + Vitamin E 0.3IU) Soft Gelatin Capsule
b) Description:
The Vitamin A and D content of Cod Liver Oil ensures that normal dietary requirements
are met and that Vitamin A and D deficiency states are corrected.
The essential fatty acids, Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid
(DHA), found in Cod Liver Oil, undergo beta oxidation, EPA is a precursor of the ‘3’ series
of prostaglandins and in a cascade reaction can lead to the production of thrombozane
A3 and prostacyclin PG13.
Precise data on the rate of turnover of EPA and DHA in lipids of nervous tissue have not
been determined.
f) Side-effects:
Vitamin excess can be harmful but a very large overdose of this product would be
needed to produce ill effects.
As most undesirable effects are based on post-marketing spontaneous reporting, precise
frequency estimation is not possible.
- Gastrointestinal disorders, particularly at high doses, e.g. eructation,
fishy after-taste, nausea, vomiting, abdominal pain, constipation, diarrhoea
- Moderate increases in hepatic transaminases have been reported in
patients with hypertriglyceridaemia
- Skin reactions, e.g. acne, eczema and rash Reporting of suspected adverse
reactions
h) Precautions:
Do not take other supplements of Vitamin A and D whilst taking this product. Benefits
from Cod Liver Oil supplementation in malabsorption syndromes are unlikely.
Omega-3 fatty acids may have antithrombotic activity at high doses and in patients
susceptible to bleeding. Therefore, they should be given with caution to patients with
haemorrhagic disorders or to those receiving anticoagulants or other drugs affecting
coagulation.
There is some evidence to suggest that fish oil supplements may adversely affect
patients with aspirin-sensitive asthma.
Caution is required in hepatic impairment, particularly if receiving high doses. It is
advisable that patients with hepatic impairment do not receive high doses.
i) Drug Interactions:
Thiazide diuretics with vitamin D may raise calcium levels.
Oestrogen contraceptive pills can raise plasma levels of vitamin A.
In view of a potential effect on bleeding time and platelet aggregation (See Section 4.4),
great care should be exercised in patients on concomitant anti-coagulation therapy or
receiving other drugs which may affect coagulation factors, e.g aspirin, warfarin,
cephalosporin.
j) Over dose:
Vitamin A toxicity generally presents as irritability, vomiting, loss of appetite and skin
changes.
Vitamin D toxicity leads to disturbing of calcium metabolism and calcification of soft
tissues including the lungs and kidneys.
The benefit of gastric decontamination is uncertain. Consider activated charcoal
(charcoal dose: 50 g for adults; 1 g/kg for children) only if the patient presents within 1
hour of ingestion of 1.5 mg/kg (5000 iu/kg) or more vitamin A. Other symptomatic and
supportive measures should be provided when indicated. Hepatic, renal, cardiac and fluid
electrolyte status should be carefully monitored.
5. TECHNICAL DATA
a) Composition/Formula
II. Excipients
b) Manufacturing Instructions:
1) Place the following materials into a Rapid Mixer Granulator (RMG) after passing through
#16 mesh screen (if necessary).
Sodium Starch Glycolate, Lactose, Micro crystalline Cellulose (Avicel PH101).
2) Add Povidone solution to step-1 and mix for 5 to 7 minutes until a granulating mass is
obtained.
3) Discharge the wet mass through to a FBD bowl at slow speed with both Agitator and
Chopper ON.
4) Dry the wet granules in fluid bed dryer at 700 C-750 C temperature. Keep the moisture
content up to 1%.
5) Pass the dried granules through #20 mesh screen and place the granules into double
cone blender.
6) Add Clomiphene Citrate to the step 4 and mix for 20 minutes.
7) Then add Magnesium Stearate and mix it for 1 minute.
8) Send some blend to QC for analysis.
9) Transfer the blend into a suitable tare container line with polybag with proper labeling and
lid.
6. Pharmacological Data:
Pharmacokinetics
The essential fatty acids, Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid
(DHA), found in Cod Liver Oil, undergo beta oxidation, EPA is a precursor of the ‘3’ series
of prostaglandins and in a cascade reaction can lead to the production of thrombozane
A3 and prostacyclin PG13.
Precise data on the rate of turnover of EPA and DHA in lipids of nervous tissue have not
been determined.
7. Clinical Data:
There are no clinincal data of relevance which are additional to those already included in
other sections of the SPC
b) Estimated price – per dose; per day treatment, cost for the recommended
course of treatment: To be submitted at the time of inclusion.
Signature: Signature: