Ascorbic Acid + Cod Liver Oil + Nicotinamide + Pyridoxine Hydrochloride + Riboflavin + Vitamin A + Vitamin B1 + Vitamin D3 + Vitamin E

Ascorbic Acid + Cod Liver Oil + Nicotinamide + Pyridoxine Hydrochloride + Riboflavin + Vitamin A + Vitamin B1 + Vitamin D3 + Vitamin E is a multivitamin and cod liver oil supplement medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Prevention and treatment of vitamin deficiencies when intake is inadequate or requirements are increased.
• Nutritional supplementation during periods of poor appetite, restricted diet, convalescence or increased nutritional need, when advised by a healthcare professional.
• Supportive supplementation where deficiency of vitamins A, B-complex, C, D or E is suspected or confirmed.

Adults should take this syrup only in the amount and frequency advised on the product label or prescribed by a registered doctor. It is commonly taken after food to reduce stomach upset. Do not exceed the recommended daily dose or combine with other vitamin A or vitamin D supplements unless a doctor advises it.

• Common: nausea, stomach upset, fishy aftertaste or burping, diarrhoea or constipation.
• Occasional: headache, flushing, unpleasant taste or mild skin rash.
• Serious or overdose-related: allergic reaction, persistent vomiting, severe headache, blurred vision, bone pain, unusual tiredness, excessive thirst or urination, signs of high calcium, or symptoms of vitamin A or D toxicity.

Use with caution in people with liver disease, kidney disease, high blood calcium, kidney stones, sarcoidosis or other conditions affecting vitamin D metabolism, bleeding disorders, or allergy to fish/cod liver oil. Pregnant women, breastfeeding mothers, children and people already taking other multivitamins, cod liver oil, retinoids or vitamin D should seek advice before use. Use under the guidance of a registered doctor or pharmacist.

• Other vitamin A, vitamin D, cod liver oil or multivitamin products: increased risk of toxicity.
• Retinoids such as isotretinoin or acitretin: increased risk of vitamin A toxicity; avoid unless prescribed.
• Warfarin and other anticoagulants or antiplatelet medicines: vitamin E and fish-oil components may increase bleeding risk at higher intakes.
• Orlistat, cholestyramine, colestipol and mineral oil: may reduce absorption of fat-soluble vitamins A, D and E.
• Thiazide diuretics or digoxin with vitamin D: increased concern for high calcium or heart rhythm problems in susceptible patients.
• Levodopa without carbidopa: pyridoxine may reduce levodopa effect.

• Known hypersensitivity to any ingredient, including fish or cod liver oil components.
• Existing hypervitaminosis A or hypervitaminosis D.
• Hypercalcaemia or conditions with dangerously high calcium levels, unless specifically managed by a doctor.
• Use with high-dose vitamin A or retinoid medicines unless a doctor specifically prescribes it.

During pregnancy and breastfeeding, vitamin supplementation should be taken only as advised by a registered doctor. Excess vitamin A can harm an unborn baby, and additional cod liver oil or vitamin A-containing products should not be combined without medical advice. Breastfeeding mothers should avoid exceeding recommended doses.

Store in a cool, dry place away from direct sunlight and heat. Keep the bottle tightly closed and out of the reach of children. Do not use after the expiry date, and follow the product label for any specific storage instructions after opening.