Daily-Vite: Package Insert and Label Information

DAILY-VITE- vitamin a acetate, ascorbic acid, cholecalciferol, thiamine hydrochloride, riboflavin, niacin, pyridoxine hydrochloride, folic acid and cyanocobalamin tablet
Central Texas Community Health Centers

TAMPER RESISTANT — DO NOT USE IF IMPRINTED SAFETY SEAL UNDER CAP IS BROKEN OR MISSING

DIRECTIONS

Adults only: One tablet daily, preferably with a meal, as a dietary supplement or as directed by your doctor.

Supplement Facts
Serving Size 1 Tablet
Amount per tablet % Daily Value
Vitamin A (as acetate) 5000 IU 100%
Vitamin C (as ascorbic acid) 60 mg 100%
Vitamin D-3 (as cholecalciferol) 400 IU 100%
Vitamin B-1 (as thiamine HCl) 1.5 mg 100%
Vitamin B-2 (riboflavin) 1.7 mg 100%
Niacin (as Vitamin B-3) 20 mg 100%
Vitamin B-6 (as pyridoxine HCl) 2 mg 100%
Folic Acid 0.4 mg 100%
Vitamin B-12 (as cyanocobalamin) 6 mcg 100%

Other Ingredients: Dicalcium phosphate, stearic acid, microcrystalline cellulose, starch, hypromellose, talc, gelatin, croscarmellose sodium, sucrose, FD&C red #40 lake, mineral oil, polyethylene glycol, titanium dioxide, sodium ascorbate, triglycerides, triacetin, FD&C yellow #6 lake, silica, mixed tocopherols and BHT.

To preserve quality and freshness, keep bottle tightly closed.

Store between 15° — 30°C (59° — 86°F).

KEEP OUT OF REACH OF CHILDREN.

Questions or comments?
1-800-645-2158
www.rugbylaboratories.com

Distributed by:
Rugby Laboratories
31778 Enterprise Drive
Livonia, MI 48150

Re-order No. 370496
Rev. 03/16 R-29
11087-03-16

LOT # / EXP. DATE:

PRINCIPAL DISPLAY PANEL — 100 Tablet Bottle Label

Austin/Travis Co. Health & Human Services Dept. 1000 Toyath St Austin, TX 78702 512-972-6206

Daily-Vite tabs #100

Date:

Name: Dr.

Take as directed on package.

04/2019

171489

Daily-Vite tabs #100 NDC 76413-341-01

Batch:
08301705
Lot:
171489
Exp:
04/2019

RUGBY

Federal law prohibits the transfer of this drug to any other person than the patient for whom prescribed.

PRINCIPAL DISPLAY PANEL -- 100 Tablet Bottle Label
(click image for full-size original)
DAILY-VITE
vitamin a acetate, ascorbic acid, cholecalciferol, thiamine hydrochloride, riboflavin, niacin, pyridoxine hydrochloride, folic acid, and cyanocobalamin tablet
Product Information
Product Type Item Code (Source) NDC:76413-341
Route of Administration ORAL DEA Schedule
Active Ingredient/Active Moiety
Ingredient Name Basis of Strength Strength
VITAMIN A ACETATE (VITAMIN A) VITAMIN A 5000 [iU]
ASCORBIC ACID (ASCORBIC ACID) ASCORBIC ACID 60 mg
CHOLECALCIFEROL (CHOLECALCIFEROL) CHOLECALCIFEROL 400 [iU]
THIAMINE HYDROCHLORIDE (THIAMINE ION) THIAMINE HYDROCHLORIDE 1.5 mg
RIBOFLAVIN (RIBOFLAVIN) RIBOFLAVIN 1.7 mg
NIACIN (NIACIN) NIACIN 20 mg
PYRIDOXINE HYDROCHLORIDE (PYRIDOXINE) PYRIDOXINE HYDROCHLORIDE 2 mg
Folic acid (Folic acid) Folic acid 0.4 mg
CYANOCOBALAMIN (CYANOCOBALAMIN) CYANOCOBALAMIN 6 ug
Inactive Ingredients
Ingredient Name Strength
ANHYDROUS DIBASIC CALCIUM PHOSPHATE
stearic acid
microcrystalline cellulose
HYPROMELLOSE, UNSPECIFIED
talc
GELATIN, UNSPECIFIED
croscarmellose sodium
sucrose
FD&C RED NO. 40
ALUMINUM OXIDE
mineral oil
POLYETHYLENE GLYCOL, UNSPECIFIED
titanium dioxide
sodium ascorbate
triacetin
FD&C YELLOW NO. 6
SILICON DIOXIDE
TOCOPHEROL
BUTYLATED HYDROXYTOLUENE
Product Characteristics
Color RED Score no score
Shape ROUND Size 5mm
Flavor Imprint Code
Contains
Packaging
# Item Code Package Description Multilevel Packaging
1 NDC:76413-341-01 100 TABLET in 1 BOTTLE, PLASTIC None
Marketing Information
Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
DIETARY SUPPLEMENT 03/01/2016
Labeler — Central Texas Community Health Centers (079674019)
Establishment
Name Address ID/FEI Operations
Central Texas Community Health Centers 079674019 REPACK, RELABEL
Establishment
Name Address ID/FEI Operations
Rugby 383359612 MANUFACTURE

Revised: 09/2017 Central Texas Community Health Centers

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