Betaine

117.14600

117.07900

203-490-6

3SCV180C9W

166511

DTXSID8022666

Deliquescent scales or prisms

A16AA06|A - Alimentary tract and metabolism

2923900090

40.13000

0.5

Free-flowing, white crystals; Savoury

1.00 g/mL at 20ºC

293 °C (decomp)

H2O: 160 g/100 mL

2-8ºC

1.36X10-8 mm Hg at 25 deg C (est)

Sweet

Henry's Law constant = 6.2X10-16 atm-cu m/mol at 25 °C (est)

pKa = 2.38 (est)

121.4 Ų [M+H]+ [CCS Type: DT, Method: single field calibrated with Agilent tune mix (Agilent)]|121.6 Ų [M+H]+ [CCS Type: DT, Method: stepped-field]|135.56 Ų [M+Na]+ [CCS Type: DT, Method: stepped-field]|121.1 Ų [M+H]+ [CCS Type: DT, Method: single field calibrated with ESI Low Concentration Tuning Mix (Agilent)]|130.5 Ų [M+K]+ [CCS Type: DT, Method: single field calibrated with ESI Low Concentration Tuning Mix (Agilent)]|133.2 Ų [M+Na]+ [CCS Type: DT, Method: single field calibrated with ESI Low Concentration Tuning Mix (Agilent)]|121.1 Ų [M+H]+

Isomerizes at the mp to methyl ester of dimethylaminoacetic acid; yields trimethylamine with concd KOH|Hydroxyl radical reaction rate constant = 1.1X10-11 cu cm/molec-sec at 25 °C (est)|pH of satd soln about 8.0 /monohydrate/

NONH for all modes of transport

3

R20/21/22

S24/25

DS5900000

Xn

Stable. Hygroscopic. Incompatible with strong oxidizing agents.

P264, P280, P302+P352, P305+P351+P338, P321, P332+P313, P337+P313, P362

H315

SRP: At the time of review, criteria for land treatment or burial (sanitary landfill) disposal practices are subject to significant revision. Prior to implementing land disposal of waste residue (including waste sludge), consult with environmental regulatory agencies for guidance on acceptable disposal practices.

The Approved Drug Products with Therapeutic Equivalence Evaluations List identifies currently marketed prescription drug products, incl betaine hydrochloride, approved on the basis of safety and effectiveness by FDA under sections 505 of the Federal Food, Drug, and Cosmetic Act. /Betaine hydrochloride/|Drug products containing certain active ingredients offered over-the-counter (OTC) for certain uses. A number of active ingredients have been present in OTC drug products for various uses, as described below. However, based on evidence currently available, there are inadequate data to establish general recognition of the safety and effectiveness of these ingredients for the specified uses: betaine hydrochloride is included in digestive aid drug products. /Betaine hydrochloride/

|Warning|H315 (100%): Causes skin irritation [Warning Skin corrosion/irritation]|P264, P280, P302+P352, P305+P351+P338, P321, P332+P313, P337+P313, and P362|Aggregated GHS information provided by 273 companies from 5 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.

Betaine was detected in the effluent of processes using sugar-beet molasses as a substrate at concentrations up to 4.5 g/dm-3(1).

In an acute toxicology study in rats, death frequently occurred at doses equal to or greater than 10,000 mg/kg.

In small, open label trials of betaine therapy for homocystinuria as well as in small controlled trials of betaine in other conditions (Alzheimer disease, nonalcoholic steatohepatitis), serum enzyme elevations and clinically apparent liver injury were not reported. Indeed, in some studies, betaine has been associated with significant declines in preexisting serum enzyme elevations in a proportion of patients with nonalcoholic fatty liver disease.

The aim of this study was to assess the pharmacokinetics of orally administered betaine and its acute effect on plasma total homocysteine (tHcy) concentrations. Healthy volunteers (n = 10; 3 men, 7 women) with normal body weight (mean + or - SD, 69.5 + or - 17.0 kg), 40.8 + or - 12.4 yr old, participated in the study. The betaine doses were 1, 3, and 6 g. The doses were mixed with 150 mL of orange juice and ingested after a 12-hr overnight fast by each volunteer according to a randomized double-blind crossover design. Blood samples were drawn for 24 hr and a 24-hr urine collection was performed. Orally administered betaine had an immediate and dose-dependent effect on serum betaine concentration. Single doses of 3 and 6 g lowered plasma tHcy concentrations (P = 0.019 and P < 0.001, respectively), unlike the 1-g dose. After the highest dose, the concentrations remained low during the 24 hr of monitoring. The change in plasma tHcy concentration was linearly associated with betaine dose (P = 0.006) and serum betaine concentration (R2 = 0.17, P = 0.025). The absorption and elimination of betaine were dose dependent. The urinary excretion of betaine seemed to increase with an increasing betaine dose, although a very small proportion of ingested betaine was excreted via urine. In conclusion, a single dose of orally administered betaine had an acute and dose-dependent effect on serum betaine concentration and resulted in lowered plasma tHcy concentrations within 2 hr in healthy subjects.|The prophylactic efficiency of taurine or betaine pretreatment for the prevention of peroxidative changes induced by lipopolysaccharide treatment in the rat liver was investigated ... Lipopolysaccharide (10 mg/kg intraperitoneally) was given to rats pretreated with taurine (1.5%, w/v) or betaine (1.5%, w/v) in drinking water for 4 weeks and plasma transaminase activities as well as hepatic malondialdehyde, diene conjugate (DC), glutathione, alpha-tocopherol and ascorbic acid levels, and superoxide dismutase (SOD) and glutathione peroxidase activities were determined ... Significant increases in plasma transaminase activities and hepatic malondialdehyde and DC levels and decreases in hepatic glutathione and alpha-tocopherol levels and SOD and glutathione peroxidase activities were observed 6 h after lipopolysaccharide treatment. This treatment did not alter ascorbic acid levels in the liver compared with controls. Taurine or betaine pretreatment in lipopolysaccharide-injected rats caused significant decreases in plasma transaminase activities and hepatic malondialdehyde and DC levels, and significant increases in glutathione and alpha-tocopherol (not betaine) levels without changing ascorbic acid levels and SOD and glutathione peroxidase activities in the liver ... /According to the authors/ taurine or betaine pretreatment was effective in the prevention of lipopolysaccharide-induced hepatotoxicity and prooxidant status.|Concomitant use of betaine and folic acid may be additive with regard to the possible lowering of serum homocysteine levels.|... Remethylation of homocysteine to methionine can occur through either the folate-dependent methionine synthase pathway or the betaine-dependent betaine-homocysteine methyltransferase pathway. The relevance of betaine as a determinant of fasting total homocysteine (tHcy) is not known, nor is it known how the 2 remethylation pathways are interrelated ... The objectives of the study were to examine the relation between plasma betaine concentration and fasting plasma tHcy concentrations and to assess the effect of folic acid supplementation on betaine concentrations in healthy subjects ... A double-blind randomized trial of 6 incremental daily doses of folic acid (50-800 ug/day) or placebo was carried out in 308 Dutch men and postmenopausal women (aged 50 to 75 yr). Fasted blood concentrations of tHcy, betaine, choline, dimethylglycine, and folate were measured at baseline and after 12 wk of vitamin supplementation ... Concentrations of tHcy were inversely related to the betaine concentration (r = -0.17, P < 0.01), and the association was independent of age, sex, and serum concentrations of folate, creatinine, and cobalamin. Folic acid supplementation increased betaine concentration in a dose-dependent manner (P for trend = 0.018); the maximum increase (15%) was obtained at daily doses of 400 to 800 ug/day ... /The authors condluded/ the plasma betaine concentration is a significant determinant of fasting tHcy concentrations in healthy humans. Folic acid supplementation increases the betaine concentration, which indicates that the 2 remethylation pathways are interrelated.

Betaine is widely distributed in both plants and animals(1) as a nonproteinogenic amino acid(2).

Betaine's production and use in soldering, resin curing fluxes, organic synthesis and in the treatment of homocystinuria(1) and as a lipotrophic drug(2) may result in its release to the environment through various waste streams(SRC).

TERRESTRIAL FATE: Based on a classification scheme(1), an estimated Koc value of 3(SRC), determined from a water solubility of 611,000 mg/L at 19.3 °C(2) and a regression-derived equation(3), indicates that betaine is expected to have very high mobility in soil(SRC). The estimated pKa of betaine, an inner salt, is 2.38(4). Volatilization of betaine from moist soil surfaces is not expected to be an important fate process(SRC) because ionic compounds do not volatilize. Betaine is not expected to volatilize from dry soil surfaces(SRC) based upon an estimated vapor pressure of 1.4X10-8 mm Hg(SRC), determined from a fragment constant method(5). No information on the aerobic biodegradation of betaine was located; however, the mineralization of alkyl betaine surfactants is considerable (>60% BODT reached in 28-day screening tests(6,7)) indicating that it is likely that betaine is also readily mineralized(SRC). Betaine is expected to biodegrade under anaerobic conditions as well based on data indicating that it is removed during anaerobic sewage treatment(8).|AQUATIC FATE: Based on a classification scheme(1), an estimated Koc value of 3(SRC), determined from a water solubility of 611,000 mg/L at 19.3 °C(2) and a regression-derived equation(3), indicates that betaine is not expected to adsorb to suspended solids and sediment(SRC). An estimated pKa of 2.38(4) indicates betaine, will exist entirely as an inner salt at pH values of 5 to 9 and therefore volatilization from water surfaces will not occur as ionic compounds do not volatilize. According to a classification scheme(5), an estimated BCF of 0.3(SRC), from its water solubility(2) and a regression-derived equation(6), suggests the potential for bioconcentration in aquatic organisms is low(SRC). No information on the aerobic biodegradation of betaine was located; however, the mineralization of alkyl betaine surfactants is considerable (>60% BODT reached in 28-day screening tests(7,8)) indicating that it is likely that betaine is also readily mineralized(SRC). Betaine is expected to biodegrade under anaerobic conditions as well based on data indicating that it is removed during anaerobic sewage treatment(9).|ATMOSPHERIC FATE: According to a model of gas/particle partitioning of semivolatile organic compounds in the atmosphere(1), betaine, which has an estimated vapor pressure of 1.4X10-8 mm Hg at 25 °C(SRC), determined from a fragment constant method(2), is expected to exist solely in the particulate phase in the ambient atmosphere. Particulate-phase betaine may be removed from the air by wet or dry deposition(SRC). Betaine does not contain chromophores that absorb at wavelengths >290 nm and therefore is not expected to be susceptible to direct photolysis by sunlight(3).

Betaine is not expected to undergo hydrolysis in the environment due to the lack of functional groups that hydrolyze under environmental conditions(1). Betaine does not contain chromophores that absorb at wavelengths >290 nm and therefore is not expected to be susceptible to direct photolysis by sunlight(1).

An estimated BCF of 0.3 was calculated in fish for betaine(SRC), using a water solubility of 611,000 mg/L at 19.3 °C(1) and a regression-derived equation(2). According to a classification scheme(3), this BCF suggests the potential for bioconcentration in aquatic organisms is low(SRC), provided the compound is not metabolized by the organism(SRC).

The Koc of betaine is estimated as 3(SRC), using a water solubility of 611,000 mg/L at 19.3 °C(1) and a regression-derived equation(2). According to a classification scheme(3), this estimated Koc value suggests that betaine is expected to have very high mobility in soil. The estimated pKa of betaine, an inner salt, is 2.38(4).

An estimated pKa of 2.38(1) indicates that betaine will exist as an inner salt in the environment. Volatilization from moist soil and water surfaces is not expected because ionic compounds do not volatilize. Betaine is not expected to volatilize from dry soil surfaces(SRC) based upon an estimated vapor pressure of 1.4X10-8 mm Hg(SRC), determined from a fragment constant method(2).

The betaine concentration of over 400 foods in the U.S. was measured. Concentrations ranged from 0.3 to 1.9 mg/100 g food for 26 dairy and egg products, 0.4 to 28.8 mg/100 g food for 16 spices, 0 to 1.8 mg/100 g food for 7 samples of fats and oils, 1.8 to 23.3 mg/100 g food for 16 samples of chicken and turkey, 2.1 to 10.4 mg/100 g for 18 sausage and luncheon meats, 0.5 to 1396.1 mg/100 g for 15 samples of breakfast cereals, 0.1 to 0.8 mg/100 g for 35 fruits, 0.2 to 4.2 mg/100 g food for 10 pork product samples, 0.1 to 808.6 mg/100 g food for 62 vegetable products with beets and spinach containing significantly more betaine than other vegetables, 0.3 to 11.2 mg/100 g food for 12 nut and seed products, 6.3 to 12.8 mg/100 g food for 15 beef products, 0.1 to 8.1 mg/100 g food for 12 beverages, 2.1 to 62.1 mg/100 g food for 11 finfish and shellfish products, 0.1 to 39.6 mg/100 g food for 21 legumes and legume products, 7.6 to 33.9 mg/100 g food for 4 lamb, veal and game samples, 0.4 to 244.1 mg/100 g food for 43 baked products, 0.1 to 6.1 mg/100 g food for 20 sugars and sweets products, 0.3 to 1506.8 for 13 samples of cereal grains and pasta products, 0.5 to 98.2 mg/100 g for 50 samples of fast foods, 0.1 to 21.6 mg/100 g for 10 snacks (pretzels were 295.1 mg/100 g food)(1).

ENVIRONMENTAL: Concentrations of betaine in 5 samples of milk ranged from 0.6 to 1.9 mg/100 g milk(1).

Occupational exposure to betaine may occur through inhalation of dust and dermal contact with this compound at workplaces where betaine is produced or used(SRC). As a nonproteinogenic amino acid, betaine is produced by both plants and animals, including humans. In addition, betaine is ubiquitous in the diet of the general public through the ingestion of both plants and meats(1). Intake of betaine may be increased by the additional use of nutritional supplements containing this compound by some individuals(SRC).

Betaine is indicated for the treatment of homocystinuria to decrease elevated homocysteine blood levels. Included within the category of homocystinuria are deficiencies or defects in: 1. cystathionine beta-synthase (CBS), 2. 5,10-methylenetetrahydrofolate reductase (MTHFR), 3. cobalamin cofactor metabolism (cbl).|FDA Label|Adjunctive treatment of homocystinuria, involving deficiencies or defects in:cystathionine beta-synthase (CBS);5,10-methylene-tetrahydrofolate reductase (MTHFR);cobalamin cofactor metabolism (cbl).Cystadane should be used as supplement to other therapies such as vitamin B6 (pyridoxine), vitamin B12 (cobalamin), folate and a specific diet.

Betaine is a modified amino acid consisting of glycine with three methyl groups that serves as a methyl donor in several metabolic pathways and is used to treat the rare genetic causes of homocystinuria. Betaine has had only limited clinical use, but has not been linked to instances of serum enzyme elevations during therapy or to clinically apparent liver injury.

Genetic Disorder Agents

... /The authors/ measured blood lipids in four placebo-controlled, randomised intervention studies that examined the effect of betaine (three studies, n = 151), folic acid (two studies, n = 75), and phosphatidylcholine (one study, n = 26) on plasma homocysteine concentrations ... /They/ combined blood lipid data from the individual studies and calculated a weighted mean change in blood lipid concentrations relative to placebo. Betaine supplementation (6 g/day) for 6 wk increased blood LDL cholesterol concentrations by 0.36 mmol/L (95% confidence interval: 0.25 to 0.46), and triacylglycerol concentrations by 0.14 mmol/L (0.04 to 0.23) relative to placebo. The ratio of total to HDL cholesterol increased by 0.23 (0.14 to 0.32). Concentrations of HDL cholesterol were not affected. Doses of betaine lower than 6 g/day also raised LDL cholesterol, but these changes were not statistically significant. Further, the effect of betaine on LDL cholesterol was already evident after 2 wk of intervention. Phosphatidylcholine supplementation (providing approximately 2.6 g/day of choline) for 2 wk increased triacylglycerol concentrations by 0.14 mmol/L (0.06 to 0.21), but did not affect cholesterol concentrations. Folic acid supplementation (0.8 mg/day) had no effect on lipid concentrations.|Anhydrous betaine has been useful in the treatment of homocystinuria and betaine may be helpful in other conditions characterized by elevated plasma homocysteine levels. Betaine hydrochloride is used as a digestive aid in some. There is some suggestion in animal research that betaine may be hepatoprotective in some circumstances.|Cystadane (betaine anhydrous for oral solution) is indicated for the treatment of homocystinuria to decrease elevated homocysteine blood levels. Included within the category of homocystinuria are deficiencies or defects in: cystathionine beta-synthase (CBS), 5,10-methylenetetrahydrofolate reductase (MTHFR), and cobalamin cofactor metabolism (cbl).|VET: Betaine glucuronate is, together with 2-aminoethanol glucuronate, used as active principle in a product for symptomatic treatment of acute or chronic disorders of the liver, such as endogenous metabolic disorders, cases of exogenous intoxication or disorders related to parasite infestations. It is administered by injection in cattle, horses, sheep, goats and pigs ... . /Betaine glucuronate/|For more Therapeutic Uses (Complete) data for BETAINE (14 total), please visit the HSDB record page.

It is not known whether betaine is excreted in human milk (although its metabolic precursor, choline, occurs at high levels in human milk). Because many drugs are excreted in human milk, caution should be exercised when Cystadane is administered to a nursing woman.|Therapy with Cystadane should be directed by physicians knowledgeable in the management of patients with homocystinuria.|FDA Pregnancy Risk Category: C /RISK CANNOT BE RULED OUT. Adequate, well controlled human studies are lacking, and animal studies have shown risk to the fetus or are lacking as well. There is a chance of fetal harm if the drug is given during pregnancy; but the potential benefits may outweigh the potential risk./|Patients with homocystinuria due to cystathionine beta-synthase (CBS) deficiency may also have elevated plasma methionine concentrations. Treatment with Cystadane may further increase methionine concentrations due to the remethylation of homocysteine to methionine. Cerebral edema has been reported in patients with hypermethioninemia, including a few patients treated with Cystadane. Plasma methionine concentrations should be monitored in patients with CBS deficiency. Plasma methionine concentrations should be kept below 1,000 umol/L through dietary modification and, if necessary, a reduction of Cystadane dose.|For more Drug Warnings (Complete) data for BETAINE (11 total), please visit the HSDB record page.

Drugs used for their effects on the gastrointestinal system, as to control gastric acidity, regulate gastrointestinal motility and water flow, and improve digestion. (See all compounds classified as Gastrointestinal Agents.)|Endogenous factors or drugs that increase the transport and metabolism of LIPIDS including the synthesis of LIPOPROTEINS by the LIVER and their uptake by extrahepatic tissues. (See all compounds classified as Lipotropic Agents.)

After a single oral dose of betaine (50 mg/kg), absorption was rapid (tmax = 0.9 ± 0.3 hours and a Cmax = 0.9 ± 0.2 mM).|V/F = 1.3 l/kg|84 ml/h/kg|Betaine is absorbed from the small intestines into the enterocytes. It is released by the enterocytes into the portal circulation which carries it to the liver where there is significant first-pass extraction and first-pass metabolism of betaine. The principal metabolic reaction is the transfer of a methyl group from betaine to homocysteine via the enzyme betaine-homocysteine methyltransferase. The products of the reaction are L-methionine and dimethylglycine. Betaine hydrochloride is converted to betaine in the alkaline environment of the small intestine.|It is not known whether betaine is distributed into breast milk. However, its metabolic precursor, choline, is found in human breast milk in high concentrations .|... /The authors/ measured homocysteine, betaine, folate, vitamin B(6), and related compounds in serum/plasma from 500 healthy men and women aged 34 to 69 years before (fasting levels) and 6 hours after a standard methionine loading test. Choline, dimethylglycine, and folate were determinants of plasma betaine in a multiple regression model adjusting for age and sex. The increase in homocysteine after loading showed a strong inverse association with plasma betaine and a weaker inverse association with folate and vitamin B6. Fasting homocysteine showed a strong inverse relation to folate, a weak relation to plasma betaine, and no relation to vitamin B6. Notably, adjusted (for age and sex) dose-response curves for the postmethionine increase in homocysteine or fasting homocysteine versus betaine showed that the inverse associations were most pronounced at low serum folate, an observation that was confirmed by analyses of interaction ... Collectively, these results show that plasma betaine is a strong determinant of increase in homocysteine after methionine loading, particularly in subjects with low folate status. In 500 healthy subjects, postmethionine load increase in tHcy showed a stronger inverse relation to betaine than to folate and vitamin B6, whereas for fasting total homocysteine (tHcy) betaine was a weaker determinant than folate. For both tHcy modalities, the association with betaine was most pronounced in subjects with low folate status.|Thirty-four healthy men and women were supplied with doses of 1, 3 and 6 g betaine and then with 6 g betaine +1 mg folic acid for four consecutive 1-week periods. The mean plasma total homocysteine (tHcy) concentration decreased by 1.1 (NS), 10.0 and 14.0 % (P<0.001) after supplementation with 1, 3 and 6 g betaine respectively. A further decrease in plasma tHcy by 5 % (P<0.01) was achieved by combining 1 mg folic acid with the 6 g betaine dose. Plasma betaine increased from 31 (sd 13) to 255 (sd 136) umol/L in a dose-dependent manner (R(2) 0.97) ... /The authors/ conclude that plasma tHcy is lowered rapidly and significantly by 3 or 6 g betaine/d in healthy men and women.|... /The authors/ investigated the courses of plasma choline and betaine during normal human pregnancy and their relations to plasma total homocysteine (tHcy) ... Blood samples were obtained monthly; the initial samples were taken at gestational week (GW) 9, and the last samples were taken approximately 3 mo postpartum. The study population comprised 50 women of West African descent. Most of the subjects took folic acid irregularly ... Plasma choline (geometric x; 95% reference interval) increased continuously during pregnancy, from 6.6 (4.5, 9.7) umol/L at GW 9 to 10.8 (7.4, 15.6) umol/L at GW 36. Plasma betaine decreased in the first half of pregnancy, from 16.3 (8.6, 30.8) umol/L at GW 9 to 10.3 (6.6, 16.2) umol/L at GW 20 and remained constant thereafter ... /The authors/ confirmed a reduction in plasma tHcy, and the lowest concentration was found in the second trimester. From GW 16 onward, an inverse relation between plasma tHcy and betaine was observed. Multiple regression analysis showed that plasma betaine was a strong predictor of plasma tHcy from GW 20 onward ... The steady increase in choline throughout gestation may ensure choline availability for placental transfer with subsequent use by the growing fetus. Betaine becomes a strong predictor of tHcy during the course of pregnancy.

Betaine is absorbed from the small intestines into the enterocytes. It is released by the enterocytes into the portal circulation which carries it to the liver where there is significant first-pass extraction and first-pass metabolism of betaine. The principal metabolic reaction is the transfer of a methyl group from betaine to homocysteine via the enzyme betaine-homocysteine methyltransferase. The products of the reaction are L-methionine and dimethylglycine. Betaine hydrochloride is converted to betaine in the alkaline environment of the small intestine.|/Betaine/ is a metabolite of choline ...

14 hours

Betaine acts as a methyl group donor in the remethylation of homocysteine to methionine in patients with homocystinuria.|Betaine acts as metabolic intermediate in transmethylating processes (creatine and methionine synthesis).|Betaine acts as a methyl group donor in the remethylation of homocysteine to methionine in patients with homocystinuria. This reduces toxic concentrations of homocysteine, usually to 20 to 30% or less of pretreatment concentrations.|Betaine or trimethylglycine is a quarternary ammonium compound that was first discovered in the juice of sugar beets (Beta vulgaris). Betaine is a metabolite of choline ... and is a substrate in one of the two recycling pathways that convert homocysteine to L-methionine. The other and principal recycling reaction is catalyzed by the enzyme methionine synthase and uses methylcobalamin as a cofactor and 5-methyltetrahydrofolate as a cosubstrate.|Betaine-homocysteine methyltransferase (BHMT) is a zinc metalloenzyme which catalyzes the transfer of a methyl group from betaine to homocysteine in the formation of methionine. BHMT is found in the liver and kidneys and may also exist in brain tissue. Betaine acts to lower homocysteine levels in some with primary hyperhomocysteinemia/homocystinuria via this enzyme.

/SRP:/ Basic treatment: Establish a patent airway (oropharyngeal or nasopharyngeal airway, if needed). Suction if necessary. Watch for signs of respiratory insufficiency and assist ventilations if needed. Administer oxygen by nonrebreather mask at 10 to 15 L/min. Monitor for pulmonary edema and treat if necessary ... . Monitor for shock and treat if necessary ... . Anticipate seizures and treat if necessary ... . For eye contamination, flush eyes immediately with water. Irrigate each eye continuously with 0.9% saline (NS) during transport ... . Do not use emetics. For ingestion, rinse mouth and administer 5 ml/kg up to 200 ml of water for dilution if the patient can swallow, has a strong gag reflex, and does not drool ... . Cover skin burns with dry sterile dressings after decontamination ... . /Poisons A and B/|/SRP:/ Advanced treatment: Consider orotracheal or nasotracheal intubation for airway control in the patient who is unconscious, has severe pulmonary edema, or is in severe respiratory distress. Positive-pressure ventilation techniques with a bag valve mask device may be beneficial. Consider drug therapy for pulmonary edema ... . Consider administering a beta agonist such as albuterol for severe bronchospasm ... . Monitor cardiac rhythm and treat arrhythmias as necessary ... . Start IV administration of D5W /SRP: "To keep open", minimal flow rate/. Use 0.9% saline (NS) or lactated Ringer's if signs of hypovolemia are present. For hypotension with signs of hypovolemia, administer fluid cautiously. Watch for signs of fluid overload ... . Treat seizures with diazepam or lorazepam ... . Use proparacaine hydrochloride to assist eye irrigation ... . /Poisons A and B/

Acidin Pepsin

Oral: For solution: 1 g/level scoopful Cystadane, (Orphan Medical)|Oral: 1 gram per 1.7 mL of powder (one scoopful) (Rx) (Cystadane).|Cystadane (betaine anhydrous for oral solution)|Betaine, in the form of a white, granular, hygroscopic powder referred to as anhydrous betaine ...

Methanaminium, 1-carboxy-N,N,N-trimethyl-, inner salt: ACTIVE

Method: AOAC 970.41; Procedure: spectrophotometric method; Analyte: betaine; Matrix: orange juice; Detection Limit: not provided.|Analyte: betaine hydrochloride; matrix: chemical identification; procedure: infrared absorption spectrophotometry with comparison to standards /betaine hydrochloride/|Analyte: betaine hydrochloride; matrix: chemical identification; procedure: visual reaction (white, curdy precipitate) with silver nitrate (Chloride test) /betaine hydrochloride/|Analyte: betaine hydrochloride; matrix: chemical purity; procedure: dissolution in glacial acetic acid; addition of mercuric acetate and crystal violet indicator; titration with perchloric acid to a green endpoint /betaine hydrochloride/

HPLC determination in urine

EPA Safer Chemical Functional Use Classes -> Processing Aids and Additives|Safer Chemical Classes -> Green half-circle - The chemical is expected to be of low concern|Human drugs -> Cystadane -> EMA Drug Category|Other alimentary tract and metabolism products -> Human pharmacotherapeutic group|Human Drugs -> FDA Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book) -> Active Ingredients|Pharmaceuticals -> Animal Drugs -> Approved in Taiwan|Cosmetics -> Antistatic; Viscosity controlling

Flavoring Agents|Flavouring Agent -> FLAVOURING_AGENT;