Choosing the Right OTC Multivitamin

Yvette C. Terrie, BSPharm, RPh
Published Online: Thursday, August 16, 2012
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Patients seeking to supplement a healthy diet have a multitude of age- and gender-specific choices.

Consumers who are interested in using a multivitamin or multimineral supplement can easily become overwhelmed by the broad array of options. Pharmacists are in a pivotal position to assist such patients in selecting a supplement that suits their individual nutritional needs, as well as to counsel patients on potential risks for drug–micronutrient interactions. (See table below.)

In addition, pharmacists can help customers choose from among the everexpanding range of multivitamin and multimineral supplements that manufacturers have formulated to meet the needs of various patient populations.

These specialized formulations include gender- and age-specific multivitamin supplements as well as formulations that address nutritional needs during the teen years, the reproductive years, menopause, and for those over the age of 50 years. Some multivitamin supplements are also formulated to support cardiovascular health, vision, and memory. Other formulations are marketed for those who engage in sports, those on weight loss plans, and those who want to increase their energy level.

Multivitamin and multimineral supplements come in a variety of dosage forms, including tablets and chewable, liquid, and gummy forms. Most people can meet their nutritional needs through dietary means alone, but many patients choose to use a multivitamin/multimineral supplement to ensure optimal health. Patients with severe nutritional deficiencies should always be referred to their primary health care provider for further evaluation.



Some of the newest multivitamin/ multimineral formulations available include fruit-flavored One A Day Women’s VitaCraves Gummies and One A Day Men’s VitaCraves Gummies (Bayer Healthcare).1 Each of these is formulated to meet the gender-specific needs of patients who are younger than 50 years. One A Day Women’s 50+ Healthy Advantage and One A Day Men’s 50+ Healthy Advantage are also available and have been reformulated with increased quantities of 7 antioxidants to support cell health.

Other new multivitamin products include Centrum Specialist Prenatal and Centrum Specialist Vision (Pfizer Consumer Healthcare). Nature Made (Pharmavite) also offers a new daily multivitamin supplement called Skin Beauty and Wellness Pack, containing antioxidants to support skin health. In addition, Bayer Healthcare has introduced a new formulation of its Flintstones Complete Chewables multivitamin for children.

Before recommending any multivitamin/multimineral supplement, pharmacists should assess the patient’s medical history and medication profile for possible drug–micronutrient interactions or contraindications.For example, calcium, magnesium, and zinc may decrease the absorption of certain antibiotics, such as tetracyclines and fluoroquinolones.2,3 In addition, metformin and anti-ulcer agents may decrease absorption of vitamin B12 and folic acid, whereas individuals taking antidepressants may have reduced levels of vitamins B6 , B12 , and D.2,3 Patients should be made aware that nutritional supplements are intended to prevent nutritional deficiencies and maintain nutritional stores, and are not intended for self-treatment of vitamin deficiencies.3 Patients exhibiting nutritional deficiencies should be encouraged to seek medical care from their primary health care provider. Pharmacists should also ascertain whether the patient is currently taking any other nutritional supplements to avoid therapeutic duplications, as well as to decrease the incidence of potential toxicities.

Patients should also be reminded to take these supplements as directed and to consume a nutritious diet consisting of a wide variety of foods to ensure balanced and optimal nutrition.


                                                                                   
Table 2: Examples of Nonprescription Multivitamin Supplements
Bausch & Lomb
Ocuvite Eye Vitamin Adult 50+ Formula
Ocuvite Lutein Eye Vitamin and Mineral Supplement
Ocuvite Lutein & Zeaxanthin Eye Vitamin and Mineral Supplements
PreserVision Eye Vitamin AREDS Formula Soft Gels/Tablets
PreserVision Eye Vitamin AREDS 2 Formula Soft Gels
PreserVision Eye Vitamin Lutein Formula Soft Gels
Centrum
Adults Under 50 Tablets
Kids
Men Under 50 Tablets
Silver Adults 50+ Tablets
Silver Men 50+ Tablets
Silver Women 50+ Tablets
Specialist Energy
Specialist Heart
Specialist Prenatal
Specialist Vision
Women Under 50 Tablets
Nature’s Bounty
ABC Plus
Eye-Vites
Multi-Day
Prenatal
Prescriptive Formulas Optimal Vitamin Packs Men’s
Prescriptive Formulas Optimal Vitamin Packs Women’s
Ultra Man
Your Life Multi Adult Gummies
Your Life Multi Men’s 45+
Your Life Multi Women’s 45+
Nature Made
Multi Adult Gummies
Multi Complete
Multi For Her (tablet/liquid softgel)
Multi For Her 50+ (tablet/liquid softgel)
Multi For Him (tablet/liquid softgel)
Multi For Him 50+
Multi Prenatal
Multi Prenatal DHA
Postnatal Multi + DHA
Nature’s Way
Alive! Adult Multi-Vitamin Gummy
Alive! Energy 50+
Alive! Men’s 50+ Multivitamin-Multimineral
Alive! Multi-Vitamin (No Iron Added)
Alive! Once Daily Men’s
Alive! Once Daily Women’s
Alive! Women’s 50+ Multivitamin-Multimineral
Completia Diabetic Multivitamin
Completia Prenatal Multivitamin
One A Day
Cholesterol Plus
Teen Advantage for Her
Teen Advantage for Him
Menopause Formula
Men’s 50+ Healthy Advantage
Men’s Health Formula
Women’s 50+ Healthy Advantage
Women’s Active Metabolism
Women’s Active Mind & Body
Women’s Plus Healthy Skin Support
Women’s Prenatal
VitaCraves Gummies
VitaCraves Gummies Plus Immunity Support
Vitafusion
DailyVision Lutein + Multivitamin Gummies
Men’s Gummy Vitamins
MultiVites Gummy Vitamins
Platinum 50+ Gummy Vitamins
PreNatal Gummy Vitamins
Women’s Gummy Vitamins

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Virginia.

References
1. One A Day Vitamins [Product Information] Bayer Consumer website. www.oneaday.com Accessed June 27,2012.
2. Beers, Mark. Nutritional Disorders. Merck Manual 18th Edition. pp 8-10. Huckleberry, Yvonne and Rollins, Carol. Essential and Conditionally Essential Nutrients. In Krinsky D, Berardi R, Ferreri S, et al, eds. Handbook of Nonprescription Drugs 17th ed. Washington, DC: American Pharmacists Association; 2012.

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