Appeton Multivitamin Lysine Syrup (Fruity Flavour)

Appeton Multivitamin Lysine Syrup (Fruity Flavour) is a liquid multivitamin dietary supplement for children from Appeton, a brand of Kotra Pharma (M) Sdn Bhd in Malaysia. It is a fruity-flavoured oral syrup supplied in a 120ml bottle, and it combines eight vitamins and vitamin-like nutrients with the essential amino acid lysine. The liquid form makes it practical for younger children who cannot yet chew or swallow tablets. The manufacturer’s directions cover children from 1 year of age as well as older children and adults.

Each 5ml of the syrup provides vitamin A 1000 IU, vitamin D3 200 IU, vitamin E 5 IU, vitamin B1 0.5mg, vitamin B2 0.5mg, vitamin B6 0.5mg, nicotinamide 6mg, pantothenic acid 2mg and lysine 80mg. Vitamin A contributes to normal vision and immune function, and vitamin D3 contributes to normal calcium absorption and the maintenance of normal bones and teeth. Vitamin E is an antioxidant nutrient, while vitamins B1, B2 and B6, nicotinamide and pantothenic acid are involved in the body’s normal energy metabolism. Unlike some children’s multivitamins, this syrup formula does not list vitamin C, vitamin B12 or folic acid.

Lysine is an essential amino acid that the body cannot make, so it must come from foods such as meat, fish, eggs, dairy and legumes. The manufacturer supplies its syrup with a Dose-Master™ measuring device for more accurate and hygienic dosing; always use the measuring device provided rather than a household spoon. This syrup supplements, but does not replace, a varied and balanced diet. Children with ongoing poor appetite, weight loss or slow growth should be assessed by a doctor.

Shake the bottle well before each use. Measure the dose for your child’s age (see Dosage) using the measuring device provided with the pack, and give it by mouth once a day. Giving the dose at the same time each day, for example with breakfast, can help you remember it.

Do not use a kitchen spoon to measure, because household spoons vary in size and can lead to giving too much or too little. Wash and dry the measuring device after each use, close the cap tightly, and keep the bottle out of children’s sight and reach, as the fruity taste may tempt children to drink extra.

Children aged 1 to 4 years: 2.5ml once daily.

Children above 4 years and adults: 5ml once daily.

The manufacturer does not give a dose for infants under 1 year old, so do not give this syrup to babies under 1 year unless a doctor advises it. Do not exceed the recommended daily dose. If a dose is missed, give the next dose at the usual time the following day; do not double the dose.

Store in a cool, dry place away from direct sunlight and heat. Keep the cap tightly closed after each use and keep the measuring device clean. Follow the storage instructions on the product label, including whether the syrup should be refrigerated after opening, and keep out of the sight and reach of children.

• Common: Mild stomach upset, nausea or loose stools, especially if the syrup is taken on an empty stomach.
• Common: Bright yellow urine, which is a harmless effect of vitamin B2 (riboflavin).
• Serious: Allergic reactions such as rash, hives, itching, swelling of the face, lips or tongue, or difficulty breathing. Stop use and seek medical help immediately.
• Serious: Signs of excess vitamin A or vitamin D if too much syrup is given or several vitamin products are combined, such as headache, vomiting, poor feeding, drowsiness, irritability, a bulging soft spot on the head in young children, excessive thirst or frequent urination. Contact a doctor promptly.

• Known allergy or hypersensitivity to any ingredient in the syrup, including its flavouring, colouring or preservatives.
• Infants under 1 year old, unless specifically advised by a doctor, as the manufacturer’s dosing starts from 1 year of age.
• Children or adults already receiving high-dose vitamin A or vitamin D, or who have been told they have high blood levels of vitamin A, vitamin D or calcium, unless a doctor approves its use.

• Other multivitamins, cod liver oil and vitamin drops: Giving this syrup together with other products containing vitamin A or vitamin D can add up to excessive intake. Check all labels and ask a pharmacist before combining products.
• Retinoid medicines: Vitamin A supplements should not be combined with oral retinoids (such as isotretinoin) without medical advice, because of the risk of vitamin A excess.
• Levodopa: Vitamin B6 can reduce the effect of levodopa when levodopa is taken without carbidopa, so adults on this medicine should check with their doctor or pharmacist first.
• Regular medicines: Children and adults on long-term medicines, such as anti-seizure medicines, should ask a doctor or pharmacist before starting any multivitamin.
• Food: No significant food interactions are known. Giving the syrup with or after a meal may reduce stomach upset.

• Shake the bottle well every time, so each dose contains an even amount of vitamins.
• Use only the measuring device that comes with the pack; a 2.5ml dose for toddlers is half of a 5ml dose.
• Give the syrup at the same time each day, such as with breakfast, to build a routine.
• Avoid giving another multivitamin, vitamin drops or cod liver oil at the same time unless a pharmacist has checked the combined vitamin A and D intake.
• Keep offering a varied diet with fruit, vegetables, protein foods and dairy, since a supplement cannot replace meals.
• See a doctor if your child keeps refusing food, loses weight or is not growing as expected.

Precautions: This syrup is intended for children from 1 year of age and adults, at the age-specific doses shown. Vitamins A and D are fat-soluble and can build up in the body, so measure doses carefully and avoid combining this syrup with other vitamin A or vitamin D sources, such as cod liver oil, vitamin drops or other multivitamins, unless a pharmacist or doctor has reviewed the total intake. Pregnant or breastfeeding women who wish to take this syrup should ask a doctor first, because high vitamin A intake should be avoided during pregnancy. If the label lists sugar or sweeteners, take this into account for children with special dietary needs and encourage regular tooth brushing.

When to See a Doctor or Pharmacist: Seek urgent medical advice if a child drinks a large amount of the syrup, even if they seem well, or shows signs of an allergic reaction. See a doctor if your child has a persistently poor appetite, is losing weight, seems unusually tired or is not growing as expected, as these signs may need medical assessment. Speak to a pharmacist before using this syrup alongside any other vitamin, mineral or herbal product or regular medicine.