Generic name: Vitamin A, Vitamin D, .ALPHA.-TOCOPHEROL, THIAMINE, Riboflavin, Niacin, PYRIDOXINE, and CYANOCOBALAMIN
Central Texas Community Health Centers
Dosage Form
N/A
Manufacturer
Central Texas Community Health Centers
This medication contains important usage instructions, warnings, and side effect information that you should review before use.
Liquid multivitamin supplement
Last updated: Tuesday, November 18, 2014
| Per 1 mL | % DV Infants | % DV Children under 4 years | |
|---|---|---|---|
| o Note: Enfamil Poly-Vi-Sol Liquid Multivitamin Supplement does not include folic acid | |||
| Vitamin A, IU | 750 | 50 | 30 |
| Vitamin D, IU | 400 | 100 | 100 |
| Vitamin E, IU | 5 | 100 | 50 |
| Vitamin C, mg | 35 | 100 | 88 |
| Thiamin, mg | 0.5 | 100 | 71 |
| Riboflavin, mg | 0.6 | 100 | 75 |
| Niacin, mg | 8 | 100 | 89 |
| Vitamin B6, mg | 0.4 | 100 | 57 |
| Vitamin B12, mcg | 2 | 100 | 67 |
Item #: 40265
Description: With Dropper
Unit Size: 50 mL
Cal./Unit: N/A
Prod. Yield / Unit (fl oz): N/A
Case: 12 bottles per case
Reimbursement Code: 00087-040203
Usual Daily Dose
Drops: 1.0 mL
○
1. Wagner CL, Greer FR, and the American Academy of Pediatrics Section on Breastfeeding and Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122:1142-1152.2
Testing was conducted in September 2009 by Mead Johnson Nutrition, Quality Control.Above information found at:
Enfamil Poly-Vi-Sol. On Mead-Johnson Nutrition website. Available at: https://www.meadjohnson.com/pediatrics/us-en/product-information/products/vitamins/enfamil-poly-vi-sol-drops#references. Accessed 9/7/17.
CommUnityCare Federally Qualified Health Centers
Poly-Vi-Sol
#50 ML
Date:
Name:
Dr.
Take as directed on package.
1/1/11
123456
Poly-Vi-Sol #50 ML NDC 76413-337-01
Batch: 123456
Lot: 123456
Exp: 1/1/11
MJN
Federal law prohibits the transfer of this drug to any other person than the patient for whom prescribed.
[image: MM1]Photos of the product and/or packaging supplied by the manufacturer.
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