Questions and answers

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What are CitraNatal® prenatal vitamins?

CitraNatal® prenatal vitamins are the ONLY branded prescription prenatal multivitamin/multimineral supplements that incorporate the unique attributes of calcium citrate with the vital nutrients you and your baby need. CitraNatal® vitamins are specially formulated for women who require nutritional support prior to conception, throughout pregnancy and during the postnatal period.

What is carbonyl iron and why is it used in CitraNatal® vitamins?

Carbonyl iron is a pure form of elemental iron that is widely used as a food additive. It has remarkably low toxicity and much larger doses are tolerated when compared to other irons such as ferrous sulfate. Carbonyl does not have many of the side effects associated with other iron products—particularly ferrous sulfate—such as gastrointestinal irritation, nausea, and either constipation or diarrhea.

What is a dual iron compound?

CitraNatal® Assure contains two different types of iron products—20 mg of carbonyl iron and 7 mg of ferrous gluconate. CitraNatal® 90 DHA contains 90 mg of carbonyl iron as an option for doctors with patients who require extra iron.

What should I tell a pharmacist who wants to substitute another vitamin for my CitraNatal® vitamin prescription?

Although many prenatal vitamins are similar, CitraNatal® vitamins are uniquely different in their formulation. CitraNatal® vitamins are the only branded prescription prenatal vitamins that incorporate the unique attributes of calcium citrate. They are also among the few prenatal vitamins on the market that contain the stool softener docusate sodium. Additionally, CitraNatal® vitamins contain a pure, all-vegetable source DHA. As a result, there are no potential harmful side-effects such as mercury or PCBs.

Why do CitraNatal® vitamins contain docusate sodium?

Docusate sodium is a stool softener and can help alleviate constipation, a common problem often associated with pregnancy.

Are CitraNatal® vitamins recommended after my baby arrives?

Ask your physician whether you should continue to take a prenatal vitamin after your baby arrives. Nutritional demands on the new mother are why most physicians continue to prescribe prenatal vitamins through the lactating period. CitraNatal® prenatal vitamins can help a new mother meet her nutritional needs while breast-feeding.

Can CitraNatal® vitamins be taken with food or milk?

Food and milk products can inhibit the amount of iron absorption if taken concurrently. It is suggested that any prenatal vitamin be taken at least 1 hour after meals. Please check with your physician for his or her preference.

Are CitraNatal® vitamins chewable?

No, because iron-containing products will cause temporary staining of teeth. The tablets are scored, however, for easy swallowing.

Are there any artifical colors or dyes in CitraNatal® Rx?

CitraNatal® vitamins contain no artificial dyes, colors or added sweeteners.

WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. KEEP THIS PRODUCT OUT OF THE REACH OF CHILDREN. In case of accidental overdose, call a doctor or poison control center immediately.

If you are pregnant, may become pregnant, or recently gave birth, CitraNatal® ® prescription multivitamins are designed to improve your nutritional health. Be sure to talk with your physician or healthcare practitioner prior to starting any prescription prenatal vitamin regimen.

Important Safety Information

All CitraNatal® products contain Folic acid, which has been shown to reduce the risk of neural tube defects. Some patients taking Folic acid have reported allergic reactions. Talk to your doctor before taking CitraNatal® if you have a known sensitivity to any of its ingredients.

CitraNatal® products are not for everyone. If you have certain types of anemia (pernicious anemia or other megaloblastic anemias) and you are vitamin B12 deficient, Folic acid alone is not enough to treat your condition. Doses of more than 0.1 mg Folic acid per day can hide the symptoms of these anemias, making them difficult to diagnose. Consult with your doctor to find the treatment that is right for you.

Certain CitraNatal® products contain an all-natural, plant-based form of DHA, an omega-3 fatty acid that is found in the brain and eye. You should exercise caution to ensure that your prescribed dosage does not exceed 1 gram (1000 mg) per day. Taking more than 3 grams of omega-3 fatty acids per day has been shown to have antithrombotic effects, including an increased bleeding time and reduced clotting ratio (INR). Inform your doctor and avoid taking omega-3 fatty acids if you are currently taking anticoagulants (blood thinners) or if you have an inherited or acquired tendency to bleed.

CitraNatal® products include iron. Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under six. Always keep CitraNatal® products and other medications out of reach of children, and in case of accidental overdose, call a doctor or poison control center immediately.

To report negative side effects, contact Mission Pharmacal Company at 1-800-298-1087 or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.


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