This combination product contains a mineral (iron) along with 3 vitamins (vitamin C, vitamin B12, and folic acid). It is used to treat or prevent a lack of these nutrients which may occur in certain health conditions (such as anemia, pregnancy, poor diet, surgery recovery). Iron is an important mineral that the body needs to produce red blood cells. Vitamin C improves the absorption of iron from the stomach. Vitamin B12 is important for normal blood, cells, and nerves. Folic acid is needed to form healthy cells, especially red blood cells.

Women of childbearing age should maintain adequate amounts of folic acid either through diet or supplements to prevent spinal cord birth defects.

If you are taking the over-the-counter product, read all directions on the product package before taking this medication. Take this medication by mouth, usually once daily or as directed by your doctor.

This medication is best taken on an empty stomach 1 hour before or 2 hours after meals. If stomach upset occurs, you may take this medication with food. Avoid taking antacids, dairy products, tea, or coffee within 2 hours before or after this medication because they will decrease its effectiveness.

Take with a full glass of water (8 ounces or 240 milliliters) unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this medication.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. To prevent staining the teeth, you may mix the dose in a glass of water or juice, and drink it through a straw. If your liquid form is to be given by dropper, the dose may be placed well back on the tongue and followed with water or juice. If your liquid form is a suspension, shake the bottle well before each dose.

If you are taking extended-release capsules, swallow the capsules whole. Do not crush or chew the capsules. Doing so can release all of the drug at once, increasing the risk of side effects.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.

Constipation, diarrhea, or upset stomach may occur. These effects are usually temporary and may disappear as your body adjusts to this medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Iron may cause your stools to turn black, which is not harmful.

If your doctor has prescribed this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking this medication, tell your doctor or pharmacist if you are allergic to any of its ingredients; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before taking this medication, tell your doctor or pharmacist your medical history, especially of:

• certain metabolic disorders (such as hemochromatosis, hemosiderosis)
• use/abuse of alcohol
• stomach/intestinal problems (such as ulcers, colitis)
• vitamin B12 deficiency (pernicious anemia)

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breastfeeding.

See also How To Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug are:

• certain anti-seizure drugs (such as phenytoin)

This product can decrease the absorption of other drugs such as bisphosphonates (for example, alendronate), levodopa, penicillamine, quinolone antibiotics (for example, ciprofloxacin, levofloxacin), thyroid medications (for example, levothyroxine), and tetracycline antibiotics (for example, doxycycline, minocycline). Separate your doses of these medications as far as possible from your doses of this product. Ask your doctor or pharmacist about how long you should wait between doses and for help finding a dosing schedule that will work with all your medications.

This medication may interfere with certain lab tests (such as tests for blood in the stools), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: stomach pain, nausea, vomiting, diarrhea.

If your doctor has prescribed this medication for you, do not share it with others.

Lab and/or medical tests (such as complete blood count, vitamin B12 levels) may be done while you are taking this product. Keep all medical and lab appointments. Consult your doctor for more details.

There are many iron supplement products available, both with and without a prescription. Some brands also contain ingredients (such as succinic acid, docusate) that might help your body absorb more iron or decrease side effects. Consult your doctor or pharmacist if you have questions about available iron supplements or their ingredients.

This medication is not a substitute for a proper diet. It is important to maintain a well-balanced diet. Foods rich in iron include beans, nuts, asparagus, oatmeal, red meat, dried peaches, and pork liver. B vitamins (including folic acid) are naturally found in leafy greens and other vegetables, meat, fish, poultry, and enriched breads/cereals.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.