Mead Johnson BCAD 2 Iron Fortified Medical Food Powder

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• Indications:
  - BCAD 2 is to be used only in the dietary management of children and adults with MSUD or other inborn errors of branched chain amino acid metabolism under direct and continuing supervision of a doctor.
• Product characteristics:
  - Fat: Fat provides 19% of total calories in BCAD 2. The fat source is soy oil. Soy oil is a source of essential omega-6 and omega-3 fatty acids: linoleic acid, and alpha-linolenic acid.
  - Protein: Protein equivalents provide 24% of total calories in BCAD 2. The product provides the essential amino acids (except isoleucine, leucine, and valine) as well as nonessential amino acids (see Amino Acids table). Care must be taken to provide enough isoleucine, leucine, and valine from other foods to support growth and tissue maintenance. The level of protein equivalents in BCAD 2 is about 2 times higher than found in BCAD 1. The higher protein equivalent concentration in BCAD 2 helps children and adults with maple syrup urine disease meet their protein needs while consuming fewer calories from the product. This, in turn, allows BCAD 2 users to consume a greater variety of foods in order to meet their isoleucine, leucine, valine and calorie needs.
  - Carbohydrate: Carbohydrate provides 57% of total calories in BCAD 2. The carbohydrate blend is 61% corn syrup solids, 35% sucrose (table sugar), and 4% modified corn starch. The sucrose in the product helps mask the taste of the amino acids. BCAD 2 is lactose-free.
  - Vitamins and Minerals: BCAD 2 provides essential vitamins and minerals at levels that are appropriate for both children and adults.
• Ingredients:
  - Amino acids (L-glutamine, potassium aspartate, L-lysine hydrochloride, L-tyrosine, L-proline, L-alanine, L-arginine, L-phenylalanine, L-threonine, L-serine, glycine, L-histidine, L-methionine, L-tryptophan, L-cystine), corn syrup solids, sucrose, soy oil, modified corn starch, calcium phosphate, sodium citrate, magnesium phosphate, and less than 1%: potassium chloride, sodium phosphate, potassium citrate, choline chloride, L-carnitine, ascorbic acid, inositol, taurine, niacinamide, vitamin E acetate, potassium iodide, vitamin A palmitate, calcium pantothenate, biotin, vitamin K1, vitamin B12, thiamin hydrochloride, vitamin B6 hydrochloride, riboflavin, vitamin D3, folic acid, zinc sulfate, chromic chloride, sodium selenite, cupric sulfate, manganese sulfate, sodium molybdate, ferrous sulfate, ethyl vanillin.
• Instructions for preparation, storage and use:
  - Patients should consult their doctors for instructions for the correct amounts of water and powder
  - The patient;s health depends on carefully following these directions
  - Pour desired amount of water in a suitable container
  - Add powder and mix well
  - Consume immediately or cover and refrigerate prepared beverage
  - Use within 48 hours
  - Shake well before serving
  - Throw away prepared unrefrigerated beverage left in cup within 1 hour after consumption begins
  - Store unopened cans at room temperature
  - After opening can, keep tightly covered, store in a dry area and use contents within 1 month
  - Do not freeze powder or prepared formula
  - Avoid excessive heat
  - Use by date on can end
  - A packed level scoop contains approximately 17.3 g of powder
• CAUTION:
  - BCAD 2 is nutritionally incomplete
  - Care must be taken to provide enough isoleucine, leucine and valine to support growth, using other foods with these amino acid as required
  - The physician must carefully and constantly supervise the use of BCAD 2 with other foods and adjust the diet based on frequent blood tests
  - Nutritional powders are not sterile
• Warning:
  - Not for parenteral (IV) use

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