VAMIN 14 Electrolite-free Solution

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Talk to a doctor about this medicine

Discuss your symptoms and possible next steps in a quick online consultation.

Doctor
5.0(36)

Andrei Popov

General medicinePain medicine7 years of experience

Dr. Andrei Popov is a family physician with specialized training in the management of chronic pain. He provides video consultations for adults in Spain and across Europe: whether you have been living with pain for months that no one has been able to properly explain, or you need to resolve a health issue without waiting weeks for an appointment.

His approach is clear: to listen, organize your case, and provide you with a practical roadmap based on evidence-based medicine and adapted to your medical history and personal needs.

Pain: how he can help

  • Chronic pain (more than 3 months
  • Migraine and recurrent or high-intensity headaches
  •  Neck, lower back, back and joint pain
  •  Post-traumatic pain after injuries or surgeries
  •  Pain of neurological origin: neuralgia, neuropathic pain, fibromyalgia

General medicine

  • Frequent respiratory infections (cold, flu, persistent cough)
  • Hypertension, diabetes and metabolic disorders
  • Review of laboratory tests and MRI/CT reports (explained in clear language)
  • Preventive medicine and health monitoring
  • Second opinions and treatment adjustments (when clinically appropriate)

What the consultation is like
 Each session lasts up to 30 minutes. We review symptoms, medical history, medications and any tests you provide, and you finish the consultation with a clear treatment plan, defined next steps, and criteria to understand when follow-up may be needed. If warning signs are detected, he will clearly advise whether you need in-person care or urgent medical attention.

Book a video appointment
€86
This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use Vamin 14 Electrolite-free

Contents of the leaflet

  1. Leaflet attached to the packaging: information for the user
  2. Vamin 14 Electrolyte-Free, solution for infusion
  3. Read the leaflet carefully before using the medicine, as it contains
    1. Table of contents of the leaflet
  4. What is Vamin 14 Electrolyte-Free and what is it used for
  5. Important information before using Vamin 14 Electrolyte-Free
    1. When not to use Vamin 14 Electrolyte-Free
    2. Warnings and precautions
    3. Vamin 14 Electrolyte-Free and other medicines
    4. Pregnancy and breastfeeding
    5. Driving and using machines
  6. How to use Vamin 14 Electrolyte-Free
    1. Using a higher dose of Vamin 14 Electrolyte-Free than recommended
  7. Possible side effects
    1. Reporting side effects
  8. How to store Vamin 14 Electrolyte-Free
  9. Contents of the pack and other information
    1. What Vamin 14 Electrolyte-Free contains
    2. What Vamin 14 Electrolyte-Free looks like and what the pack contains
    3. Marketing authorization holder and manufacturer
    4. Marketing authorization holder
    5. Manufacturer
    6. Date of last revision of the leaflet:
    7. Information intended only for healthcare professionals:
    8. Dosage and administration
    9. Overdose
    10. Preparation of the medicine for use
    11. Incompatibilities
    12. Storage conditions
    13. Disposal of unused medicine

Leaflet attached to the packaging: information for the user

Vamin 14 Electrolyte-Free, solution for infusion

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

Read the leaflet carefully before using the medicine, as it contains

important information for the patient.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor, pharmacist, or nurse.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
  • If you experience any side effects, including those not listed in this leaflet, tell your doctor, pharmacist, or nurse. See section 4.

Table of contents of the leaflet

  • 1. What is Vamin 14 Electrolyte-Free and what is it used for
  • 2. Important information before using Vamin 14 Electrolyte-Free
  • 3. How to use Vamin 14 Electrolyte-Free
  • 4. Possible side effects
  • 5. How to store Vamin 14 Electrolyte-Free
  • 6. Contents of the pack and other information

1. What is Vamin 14 Electrolyte-Free and what is it used for

Vamin 14 Electrolyte-Free is a solution of amino acids used in adult patients for intravenous infusion. It contains both amino acids produced by the body and those not produced by the body, which are found in normal food. Amino acids administered in the form of a solution have nutritional properties. To be fully utilized, the body must also receive an adequate amount of carbohydrates and fats. Vamin 14 Electrolyte-Free maintains a positive nitrogen balance (i.e., more nitrogen is taken in than excreted). This is important for maintaining proper nutrition. Indications for use: Vamin 14 Electrolyte-Free is indicated for use as a source of amino acids in parenteral nutrition in adult patients. The drug is suitable for use especially in patients with moderately increased demand for amino acids.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

2. Important information before using Vamin 14 Electrolyte-Free

When not to use Vamin 14 Electrolyte-Free

Do not use the medicine:

  • if the patient has congenital disorders of amino acid metabolism;
  • if the patient has severe liver dysfunction;
  • if the patient has uremia (a syndrome of symptoms caused by extreme impairment of kidney function), and dialysis is not possible.

Warnings and precautions

Before starting treatment with Vamin 14 Electrolyte-Free, discuss it with your doctor or nurse. Intravenous administration of amino acid solutions increases the excretion of trace elements - copper and zinc - in the urine. This is especially important in the case of long-term parenteral nutrition. The doctor should take this into account when determining the dose of copper and zinc in the patient's nutrition.

Vamin 14 Electrolyte-Free and other medicines

Tell your doctor or pharmacist about all medicines you are taking, have recently taken, or plan to take. No interaction between Vamin 14 Electrolyte-Free and other medicines has been found.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a child, consult your doctor before using this medicine. The doctor will decide whether to use this medicine in women during pregnancy or breastfeeding.

Driving and using machines

Not applicable.

3. How to use Vamin 14 Electrolyte-Free

This medicine is given only by medical personnel. Do not use the medicine yourself. In case of doubts, consult your doctor. The dosage is determined by the doctor individually for each patient, depending on body weight and health status.

If a higher dose of the medicine is used, tell your doctor or nurse immediately. If the medicine is administered at a rate greater than recommended, nausea, vomiting, and sweating, as well as thrombophlebitis (when the medicine is administered into peripheral veins), may occur. If symptoms of overdose occur, the doctor will decide on further use of the medicine. If you have any further doubts about using this medicine, consult your doctor or nurse.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects may occur:

  • allergic reaction (hypersensitivity), which manifests as a skin rash, swelling (especially of the lips, face, eyelids, tongue, and throat), shortness of breath, or fainting. You should then contact your doctor immediately.
  • nausea (rarely);
  • abnormal liver test results (increased activity of liver enzymes AspAT and AlAT);
  • thrombophlebitis, into which the medicine was administered (formation of inflammation and small blood clots, manifested by palpable hardening of the vein, redness around it, pain, and tenderness).

Reporting side effects

If you experience any side effects, including those not listed in this leaflet, tell your doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl. Side effects can also be reported to the marketing authorization holder. By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Vamin 14 Electrolyte-Free

Keep the medicine out of the sight and reach of children. Store in a temperature below 25°C. Store in the original packaging to protect from light. Do not freeze. Use the medicine immediately after opening the packaging. Unused medicine is not suitable for further use. Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the specified month. Do not use this medicine if visible solid particles are present. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the pack and other information

What Vamin 14 Electrolyte-Free contains

  • The active substances of the medicine are:

1000 ml of the solution contains: L-alanine 12.0 g, L-arginine 8.4 g, L-asparagine 2.5 g, L-cysteine (+ L-cystine) 420 mg, L-glutamic acid 4.2 g, glycine (aminooctanoic acid) 5.9 g, L-histidine 5.1 g, L-isoleucine 4.2 g, L-leucine 5.9 g, L-lysine acetate equivalent to L-lysine 6.8 g, L-methionine 4.2 g, L-phenylalanine 5.9 g, L-proline 5.1 g, L-serine 3.4 g, L-threonine 4.2 g, L-tryptophan 1.4 g, L-tyrosine 170 mg, L-valine 5.5 g

  • Other ingredients (excipients) are: acetic acid, water for injections.

Total amino acid content: 85 g/l; essential amino acid content: 38.7 g, including cysteine and tyrosine. pH: 5.6 Osmolality: 810 mOsm/kg water Nitrogen content: 13.5 g/l Electrolytes: about 90 mmol of acetate added as acetic acid and lysine acetate Energy value: 1.4 MJ/l (350 kcal/l) Antioxidants: none

What Vamin 14 Electrolyte-Free looks like and what the pack contains

The medicine is a solution for infusion. The packaging of the medicine is a glass bottle containing 500 ml or 1000 ml of the solution.

Marketing authorization holder and manufacturer

Marketing authorization holder

Fresenius Kabi AB, S-751 74 Uppsala, Sweden

Manufacturer

Fresenius Kabi Austria GmbH, Hafnerstrasse 36, A-8055 Graz, Austria For more detailed information, please contact the representative of the marketing authorization holder: Fresenius Kabi Polska Sp. z o.o., Al. Jerozolimskie 134, 02-305 Warsaw, tel.: +48 22 345 67 89

Date of last revision of the leaflet:

Information intended only for healthcare professionals:

Dosage and administration

Adult patients: the need for nitrogen necessary to maintain muscle mass depends on the patient's health status (nutritional status and degree of metabolic stress). The need is: 0.10 - 0.15 g of nitrogen/kg body weight/day (no or slight metabolic stress and normal nutritional status), 0.15 - 0.20 g of nitrogen/kg body weight/day (moderate metabolic stress with or without malnutrition), 0.20 - 0.25 g of nitrogen/kg body weight/day (severe catabolism, such as in burns, sepsis, and injuries). The dose range of 0.10 - 0.25 g of nitrogen/kg body weight/day corresponds to 7 - 18 ml of Vamin 14 Electrolyte-Free/kg body weight/day. In obese patients, the dose should be calculated based on the estimated normal body weight. Depending on the patient's needs, up to 1000 ml of Vamin 14 Electrolyte-Free can be administered per day by intravenous infusion. In patients with significantly increased demand for amino acids, a more concentrated Vamin 18 Electrolyte-Free can be used. Vamin 14 Electrolyte-Free should be administered slowly, at a rate not exceeding 1000 ml in 8 hours, which corresponds to approximately 2 ml per minute (see Overdose section).

Overdose

If Vamin 14 Electrolyte-Free is administered at a rate greater than recommended, an increased risk of nausea, vomiting, and sweating, as well as thrombophlebitis (when the medicine is administered into peripheral veins), has been observed. If symptoms of overdose occur, the infusion rate should be reduced or the infusion stopped.

Preparation of the medicine for use

The medicine should be used immediately after opening the packaging. Unused medicine is not suitable for further use.

Incompatibilities

Compatibility Other medicinal products can be added to Vamin 14 Electrolyte-Free only if their pharmaceutical compatibility has been confirmed. The introduction of additional substances should be carried out in accordance with aseptic principles. Up to 1000 ml of Vamin 14 Electrolyte-Free can be added: up to 20 ml of Addamel N, 480 mmol of NaCl, 480 mmol of KCl, 24 mmol of calcium glubionate, and 48 mmol of MgSO4. If phosphate administration is necessary, up to 60 ml of Addiphos can be added to 1000 ml of Vamin 14 Electrolyte-Free, alone or in combination with 480 mmol of NaCl, 480 mmol of KCl, and 48 mmol of MgSO4. Note that inorganic phosphate-containing solutions should not be mixed with Addamel N due to the risk of precipitate formation. Mixing in a plastic bag (not containing phthalate) - example mixture for total parenteral nutrition: Mixing should be carried out in accordance with strict aseptic principles, in a laminar flow cabinet, and in the following order:

  • 1. To Vamin 14 Electrolyte-Free can be added:
    • Addamel N;
    • Glycophos;
    • electrolytes.
  • 2. To glucose can be added:
    • Addiphos or other inorganic phosphate source.
  • 3. To Intralipid can be added:
    • Soluvit N;
    • Vitalipid N Adult.

Mixtures 1 and 2 should be transferred to a plastic bag (not containing phthalate), to which mixture 3 is then added, gently shaking the bag until a homogeneous mixture is obtained. Stability The medicine should be used immediately after opening the packaging. Unused medicine is not suitable for further use. Other medicinal products If additional medicinal products are introduced into the infusion solution, the infusion should be completed within 24 hours of preparation; this will prevent microbiological contamination. Mixing in a plastic bag (not containing phthalate) Mixtures prepared under aseptic conditions should be used within 7 days. Mixtures can be stored for up to 6 days in a refrigerator (2 - 8°C) and then administered by intravenous infusion within 24 hours. Data on stability and pharmaceutical compatibility with other medicines used for parenteral nutrition are available on request from the representative of the marketing authorization holder.

Storage conditions

Store in a temperature below 25°C. Store in the original packaging to protect from light. Do not freeze.

Disposal of unused medicine

Any unused medicine or waste material should be disposed of in accordance with local regulations.

Online doctors for Vamin 14 Electrolite-free

Discuss questions about Vamin 14 Electrolite-free, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

Doctor
5.0(36)

Andrei Popov

General medicinePain medicine7 years of experience

Dr. Andrei Popov is a family physician with specialized training in the management of chronic pain. He provides video consultations for adults in Spain and across Europe: whether you have been living with pain for months that no one has been able to properly explain, or you need to resolve a health issue without waiting weeks for an appointment.

His approach is clear: to listen, organize your case, and provide you with a practical roadmap based on evidence-based medicine and adapted to your medical history and personal needs.

Pain: how he can help

  • Chronic pain (more than 3 months
  • Migraine and recurrent or high-intensity headaches
  •  Neck, lower back, back and joint pain
  •  Post-traumatic pain after injuries or surgeries
  •  Pain of neurological origin: neuralgia, neuropathic pain, fibromyalgia

General medicine

  • Frequent respiratory infections (cold, flu, persistent cough)
  • Hypertension, diabetes and metabolic disorders
  • Review of laboratory tests and MRI/CT reports (explained in clear language)
  • Preventive medicine and health monitoring
  • Second opinions and treatment adjustments (when clinically appropriate)

What the consultation is like
 Each session lasts up to 30 minutes. We review symptoms, medical history, medications and any tests you provide, and you finish the consultation with a clear treatment plan, defined next steps, and criteria to understand when follow-up may be needed. If warning signs are detected, he will clearly advise whether you need in-person care or urgent medical attention.

Book a video appointment
€86
Doctor
5.0(12)

Yevgen Yakovenko

Family medicine12 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

Book a video appointment
€72
Doctor
5.0(3)

Lina Travkina

Family medicine13 years of experience

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

Book a video appointment
€75
Doctor
5.0(2)

Dmytro Horobets

Family medicineEndocrinology7 years of experience

Dr. Dmytro Horobets is a licensed family medicine physician in Poland, specialising in endocrinology, diabetology, obesity management, gastroenterology, pediatrics, general surgery, and pain medicine. He offers online consultations for adults and children, providing personalised medical support for a wide range of acute and chronic health concerns.

Areas of expertise:

  • Endocrinology: diabetes type 1 and type 2, prediabetes, thyroid disorders, metabolic syndrome, hormonal imbalance.
  • Obesity medicine: structured weight management plans, nutritional counselling, obesity-related health risks.
  • Gastroenterology: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), liver and biliary conditions.
  • Pediatric care: infections, respiratory symptoms, digestive issues, growth and development monitoring.
  • General surgery support: pre- and post-surgical consultations, wound care, rehabilitation.
  • Pain management: chronic and acute pain, back pain, joint pain, post-traumatic pain syndromes.
  • Cardiovascular health: hypertension, cholesterol control, risk assessment for heart disease.
  • Preventive medicine: regular check-ups, health screenings, long-term management of chronic conditions.

Dr. Horobets combines evidence-based medicine with a patient-centred approach. He carefully evaluates each patient’s medical history and symptoms, offering clear explanations and structured treatment plans adapted to individual needs.

Whether you need help managing diabetes, tackling weight-related health issues, interpreting lab results, or receiving general family medicine support, Dr. Horobets provides professional online care tailored to your specific health goals.

Book a video appointment
€71
Doctor
5.0(19)

Nuno Tavares Lopes

Family medicineGeneral medicine18 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

Book a video appointment
€70

Get Vamin 14 Electrolite-free Prescription Online

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Electronic prescription sent to your email — valid across Spain.

Frequently Asked Questions

Is a prescription required for Vamin 14 Electrolite-free?

Vamin 14 Electrolite-free does not require a prescription in Poland. You can check with a doctor online whether this medicine may be appropriate for your situation.

What is the active substance in Vamin 14 Electrolite-free?

The active ingredient in Vamin 14 Electrolite-free is amino acids. This information helps identify medicines with the same composition but different brand names.

Who manufactures Vamin 14 Electrolite-free?

Vamin 14 Electrolite-free is manufactured by Fresenius Kabi Austria GmbH. Pharmacy brands and packaging may differ depending on the distributor.

Which doctors can assess the use of Vamin 14 Electrolite-free online?

Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether Vamin 14 Electrolite-free is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.

How to buy Vamin 14 Electrolite-free in Spain?

Spain has a well-developed healthcare infrastructure across major cities such as Madrid, Barcelona, Valencia, and Seville. Pharmacies are widely available and operate under strict regulations, ensuring access to prescribed medications.

You can buy Vamin 14 Electrolite-free in Madrid, Barcelona, Seville, or Valencia at any local pharmacy with a valid prescription.

To obtain a prescription, you can use Oladoctor:

What are the alternatives to Vamin 14 Electrolite-free?

Other medicines with the same active substance (amino acids) include Aminomix 1 Novum, Aminoplasmal 15%, Aminoplasmal B. Braun 10%. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.

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