<p>Pregnancy is a time of increased nutritional demands on a woman and getting the right amounts of nutrients is of utmost importance for a successful pregnancy outcome and a healthy baby. A multivitamin and mineral supplement can help with general nutritional support preconception, and during pregnancy and breastfeeding.</p>

<p>InNatal® is an iron free formula specifically formulated to support women's preconception health, a healthy pregnancy, and healthy foetal development. It provides several key nutrients including iodine, vitamin D3, zinc, choline and the active forms of folic acid - folinic acid and 5 methyltetrahydrofolate (5 MTHF). Each daily dose provides 500 micrograms of folic acid in its active forms.</p>

• Betacarotene 3mg
• Thiamine nitrate 864 mcg (equiv. to thiamine (vitamin B1) 700mcg)
• Riboflavin sodium phosphate (active vitamin B2) 889 micrograms (equiv. to riboflavin (vitamin B2) 700micrograms)
• Nicotinamide (vitamin B3) 9mg
• Calcium pantothenate 2.73mg (equiv. to pantothenic acid (vit B5) 2.5mg)
• Pyridoxal 5 phosphate monohydrate (P5P) (active vitamin B6) 15.7mg (equiv. to pyridoxine (vitamin B6) 10mg)
• Pyridoxine hydrochlorid 18.2mg (equiv. to pyridoxine (vitamin B6) 15mg)
• Calcium folinate 191 mcg (equiv. to folinic acid (activated vit B9) 150mcg)
• Levomefolate calcium 108micrograms (equiv. to levomefolic acid (5 MTHF) (active vitamin B9) 100micrograms)
• Mecobalamin (co methylcobalamin) (active vitamin B12) 1.3micrograms
• Ascorbic acid (vitamin C) 50mg
• Colecalciferol 12.5micrograms (equiv. to vitamin D3 500IU)
• d alpha tocopheryl acetate 16.5mg (equiv. to vitamin E 22.4IU)
• Biotin 15micrograms
• Menaquinone 7 (vitamin K2) 30micrograms
• Calcium (as calcium hydrogen phosphate) 25mg
• Chromium (as chromium picolinate) 15micrograms
• Iodine (as potassium iodide) 135micrograms
• Magnesium (as magnesium phosphate pentahydrate) 15mg
• Manganese (as manganese amino acid chelate) 1mg
• Molybdenum (as molybdenum trioxide) 25micrograms
• Selenium (as selenomethionine) 17.5micrograms
• Zinc (as zinc amino acid chelate) 10mg
• Choline bitartrate 100mg
• Inositol 30mg

Adults: Take 1 capsule two times a day, or as professionally prescribed. Take with food.

This medicine contains selenium which is toxic in high doses. A daily dose of 150 micrograms for adults of selenium from dietary supplements should not be exceeded.

Advise your doctor of any medicine you take during pregnancy, particularly in your first trimester.

Contains soya bean products and sulfites.

People with high cholesterol or high blood pressure should talk to their doctors before taking vitamin B3; it may interact with their medications.

People with blood disorders should talk to their doctors before taking vitamin B3.

People with anxiety or narcolepsy should talk to their doctors before taking vitamin B6; it may interact with their medications.

Concurrent use of anti-seizure medications with vitamin B6 should be monitored.

Vitamin B6 is commonly used to reduce symptoms of morning sickness, but may interact with other anti-nausea medicines for pregnancy.

Vitamin B12 may reduce tetracycline hydrochloride (antibiotic) bioavailability; separate doses by at least two hours.

People taking blood thinners should talk to their doctors before taking vitamin K. It may interfere with the medicine.

Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.

Concurrent administration of levothyroxine and calcium may reduce drug absorption; separate doses by at least 4 hours.

Concurrent administration of quinolone antibiotics and calcium may reduce drug efficacy; take quinolones either 2 hours before or 4-6 hours after calcium.

Concurrent administration of tetracycline antibiotics and calcium may reduce drug efficacy; separate doses by at least 2 hours.

Vitamin C increases the amount of aluminium absorbed from aluminium-based antacids; separate doses by at least 2 hours.

Vitamin C supplementation should be used with caution by people with erythrocyte glucose-6-phosphate dehydrogenase deficiency, haemochromatosis, thalassaemia major or sideroblastic anaemia, due to possible exacerbation of iron toxicity from increased mobilisation of iron reserves.

People with hypercalcaemia should not take vitamin D; it will worsen symptoms.

People with diabetes should talk to their doctors before taking selenium; it may worsen symptoms.

High-dose zinc supplementation may cause gastrointestinal distress.

Zinc interacts with non-steroidal anti-inflammatory drugs; separate doses by 2 hours.

Avoid combination -

Calcium: Alendronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Alendronate

Calcium: Ceftriaxone - Cephalosporins

FDA Information for Healthcare Professionals: Ceftriaxone (21/4/2009)

Calcium: Ciprofloxacin - Quinolones

The influence of chronic administration of calcium carbonate on the bioavailability of oral ciprofloxacin.

Effects of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacin.

Interference of dairy products with the absorption of ciprofloxacin.

Effect of multiple staggered doses of calcium on the bioavailability of ciprofloxacin.

Calcium: Clodronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Clodronate

Calcium: Demeclocycline - Tetracyclines

Interactions with the absorption of tetracyclines.

Calcium: Dolutegravir

Pharmacokinetics of dolutegravir when administered with mineral supplements in healthy adult subjects.

Calcium: Doxycycline - Tetracyclines

Interactions with the absorption of tetracyclines.

Calcium: Etidronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Etidronate

Calcium: Ibandronic acid - Agents affecting calcium and bone metabolism

TGA Online Product Information: Ibandronic acid

Calcium: Minocycline - Tetracyclines

Interactions with the absorption of tetracyclines.

Absorption of minocycline hydrochloride and tetracycline hydrochloride. Effect of food, milk, and iron.

Calcium: Norfloxacin - Quinolones

Inhibition of norfloxacin absorption by antacids.

Inhibition of norfloxacin absorption by dairy products.

Pharmacokinetic interactions of norfloxacin with some metallic medicinal agents.

Calcium: Risedronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Risedronate

Calcium: Tetracycline - Tetracyclines

Interactions with the absorption of tetracyclines.

Calcium: Tiludronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Tiludronate

Skelid (tiludronate disodium) Prescribing Information.

Iodine: Amiodarone- Antiarrhythmic agents

Amiodarone. Australian Medicines Handbook 2011 (online).

Magnesium: Alendronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Alendronate

Magnesium: Ciprofloxacin - Quinolones

Reduced enteral absorption of ciprofloxacin in the presence of antacids.

Magnesium: Clodronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Clodronate

Magnesium: Demeclocycline - Tetracyclines

Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid.

Magnesium: Doxycycline - Tetracyclines

Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid.

Magnesium: Etidronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Etidronate

Magnesium: Ibandronic acid - Agents affecting calcium and bone metabolism

TGA Online Product Information: Ibandronic acid

Magnesium: Minocycline - Tetracyclines

Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid.

Magnesium: Moxifloxacin - Quinolones

Evaluation of the influence of antacids and H2 antagonists on the absorption of moxifloxacin after oral administration of a 400mg dose to healthy volunteers.

Magnesium: Norfloxacin - Quinolones

Norfloxacin interaction with antacids and minerals.

Pharmacokinetic interactions of norfloxacin with some metallic medicinal agents.

Magnesium: Penicillamine - Antirheumatoid agents

Reduction in oral penicillamine absorption by food, antacid, and ferrous sulfate.

Magnesium: Proguanil - Antimalarials

The effect of magnesium trisilicate on proguanil absorption.

Magnesium: Risedronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Risedronate

Magnesium: Tetracycline - Tetracyclines

Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid.

Magnesium: Tiludronate - Agents affecting calcium and bone metabolism

TGA Online Product Information: Tiludronate

Skelid (tiludronate disodium) Prescribing Information.

Niacin: Warfarin - Anticoagulants, antithrombotics

Critically elevated INR in a patient on warfarin after increase in extended-release niacin dose

Zinc: Demeclocycline - Tetracyclines

Interactions with the absorption of tetracyclines.

Zinc: Minocycline - Tetracyclines

Interactions with the absorption of tetracyclines.

Zinc: Norfloxacin - Quinolones

Norfloxacin interaction with antacids and minerals.

Zinc: Tetracycline - Tetracyclines

Effect of zinc sulphate on the absorption of tetracycline and doxycycline in man.

Caution -

Beta-carotene: Colchicine - Agents used in gout and hyperuraecimia

Intestinal malabsorption induced by oral colchicine. Comparison with neomycin and cathartic agents.

Beta-carotene: Orlistat - Anorectics and weight reducing agents

The effect of orlistat, an inhibitor of dietary fat absorption, on the pharmacokinetics of beta-carotene in healthy volunteers.

Calcium: Sotalol - Beta-adrenergic blocking agents

Effect of food, food constituents and fluid volume on the bioavailability of sotalol.

Calcium: Thyroxine - Thyroid hormones and antithyroid agents

Calcium carbonate and reduction of levothyroxine efficacy.

Effect of calcium carbonate on the absorption of levothyroxine.

Chromium: Thyroxinr - Thyroid hormones and antithyroid agents

New medications which decrease levothyroxine absorption.

Folate: Phenytoin - Anticonvulsants

Influence of folic acid on blood-phenytoin levels.

Phenytoin and folic acid interaction: a preliminary report.

Phenytoin and folic acid: individualized drug-drug interaction.

Folic acid improves phenytoin pharmacokinetics.

Phenytoin-folic acid interaction.

Folate: Warfarin - Anticoagulants, antithrombotics

Effects of folic acid supplementation on the pharmacokinetics and anticoagulant effect of warfarin: an open-label, prospective study of long-term administration in adults.

Iodine: Lithium - Antipsychotic agents

Iodine and lithium-induced hypothyroidism. Documentation of synergism.

Magnesium: Amikacin - Aminoglycosides

Potentiation of magnesium sulfate-induced neuromuscular weakness by gentamicin, tobramycin, and amikacin.

Magnesium: Chlorpromazine - Antipsychotic agents

Chlorpromazine: effects of antacids on its gastrointestinal absorption.

Magnesium: Gentamicin - Aminoglycosides

Potentiation of magnesium sulfate-induced neuromuscular weakness by gentamicin, tobramycin, and amikacin.

Magnesium: Nitrofurantoin - Other antibiotics and anti-infectives

Effect of magnesium trisilicate on nitrofurantoin absorption.

Magnesium: Tobramycin - Aminoglycosides

Potentiation of magnesium sulfate-induced neuromuscular weakness by gentamicin, tobramycin, and amikacin.

Selenium: Warfarin - Anticoagulants, antithrombotics

Modification of the effects of aflatoxin B1 and warfarin in young pigs given selenium.

Vitamin B6: Levodopa - Movement disorders

Pyridoxine reversal of L-dopa effects in Parkinsonism.

Failure of vitamin B6 to reverse the L-dopa effect in patients on a dopa decarboxylase inhibitor.

Vitamin B6: Phenobarbitone - Anticonvulsants

Pyridoxine and serum concentration of phenytoin and phenobarbitone.

Vitamin B6: Phenytoin - Anticonvulsants

Pyridoxine and serum concentration of phenytoin and phenobarbitone.

Vitamin C: Indinavir - Antiviral agents

Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers.

Vitamin C: Propranolol - Beta-adrenergic blocking agents

Influence of vitamin C on the absorption and first pass metabolism of propranolol.

Vitamin C: Warfarin - Anticoagulants, antithrombotics

Possible warfarin resistance due to interaction with ascorbic acid: Case report and literature review

Vitamin D (Cholecalciferol): Chemotherapeutic agents

A prospective clinical trial of cholecalciferol 2000 IU/day in colorectal cancer patients: evidence of a chemotherapy-response interaction.

Vitamin D (Cholecalciferol): Sirolimus - Immunomodifiers

Seasonal variation in blood drug concentrations and a potential relationship to vitamin D.

Vitamin E: Warfarin - Anticoagulants, antithrombotics

Risk of mortality with vitamin E supplements: the Cache County study.

The effect of vitamin E on warfarin-induced vitamin K deficiency.

Effect of vitamin E on the anticoagulant response to warfarin.

Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trials.

Zinc: Cephalexin - Cephalosporins

The Effect of Staggered Administration of Zinc Sulfate on the Pharmacokinetics of Oral Cephalexin

Zinc: Penicillamine - Antirheumatoid agents

Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents.

Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc.