Sweeteners, dyes, and other excipients in vitamin and mineral preparations

Multivitamins and mineral preparations are widely used for infants and children. All of these preparations contain a variety of excipients ("inert ingredients"). Excipients are generally safe; however, adverse effects have been attributed to them. Complete information about the excipients in various preparations is not readily available. The information about sweeteners, dyes, and other excipients (flavorings, preservatives, stabilizers, and fillers) for 41 chewable/liquid multivitamin and mineral preparations was obtained and tabulated. Sucrose was present in 63% (26/41) of preparations followed by lactose in 29% (12/41) of preparations. On average, a preparation contained two sweeteners. The FD&C yellow #6 (sunset yellow) was the most common dye, present in 46% (19/41) of the preparations followed by FD&C Red #40 in 29% (12/41). For 34% (14/41) of the preparations, no color or dye was identified by the manufacturers. The tables listing excipients and their adverse effects are presented and should be helpful to health care providers in selecting preparations containing individual excipients when an adverse reaction occurs or there exists a contraindication for using the excipient. The mandatory listing of all excipients is the only way to assure that physicians and consumers will be fully informed about the hidden ingredients.