FDA-filed SPL labeling · retrieved through openFDA

Betaine

Betaine is an ingredient used in oral powder products to treat homocystinuria (a rare metabolic disorder causing dangerous amino acid buildup), and in a topical product as a skin protectant.

Brand names CystadaneDr.Jucre Rebirth Activating Toner
Drug class Methylating Agent
Rx/OTC Forms 2 Routes Oral · Topical
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 4 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveApr 24, 2026
Clinical labels in scope 4
AvailabilityRx/OTC
Earliest approval/marketing year 1996
FDA-listed product records 12
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 22, 2026
Betaine at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Oral betaine products (Betaine Anhydrous, Betaine, and Cystadane) are specialized prescription treatments for homocystinuria, a rare metabolic disorder, and are taken twice daily as a dissolved powder under close medical supervision. The most important risk to watch for — especially in CBS deficiency — is dangerously high methionine levels, which can cause brain swelling, so regular blood monitoring is essential. The topical product Dr. Jucre Rebirth Activating Toner is a separate, over-the-counter skin protectant applied directly to intact skin.

📖 Betaine: Patient Information Guide

A plain-language walkthrough of Betaine — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Betaine is an ingredient found in multiple products used for distinct purposes depending on the form and brand.

  • Betaine Anhydrous For Oral Solution, Betaine Anhydrous, Betaine (oral powder), and Cystadane are all oral powder products used to treat homocystinuria — a rare inherited metabolic disorder — by lowering elevated homocysteine levels in the blood. They are approved for both pediatric and adult patients.
  • These oral products are used specifically in three types of homocystinuria: CBS (cystathionine beta-synthase) deficiency, MTHFR (5,10-methylenetetrahydrofolate reductase) deficiency, and cobalamin cofactor metabolism (cbl) defect.
  • Dr. Jucre Rebirth Activating Toner is a topical product containing betaine used as a skin protectant applied directly to the skin.
⚙️How it works

In homocystinuria, the body cannot break down homocysteine properly, causing it to build up to harmful levels. The oral betaine products work as a methyl group donor — they supply a small chemical unit that drives a reaction converting homocysteine into methionine, a different and useful amino acid. This lowers the dangerous homocysteine levels in the blood. Betaine is a natural compound in the body, derived from choline, and is also found in small amounts in beets, spinach, cereals, and seafood.

In patients with MTHFR deficiency or cobalamin cofactor defects, betaine also helps raise low levels of methionine and a related compound called SAM (S-adenosylmethionine), which are important for normal body function. Patients have been treated with these oral products for many years without evidence of the drug becoming less effective over time.

💊How it's taken

The oral betaine powder products are taken by mouth twice daily. The powder must be measured carefully with the measuring scoop that comes with the product, then dissolved completely in 4 to 6 ounces of water, juice, milk, or formula — or mixed with food — and taken right away after mixing.

  • Dosing is individualized and adjusted by your doctor based on regular blood tests measuring your homocysteine (and in some cases methionine) levels.
  • Children under 3 years old start at a lower dose that is increased gradually week by week under medical supervision.
  • Treatment should always be directed by a physician experienced in managing homocystinuria.
🤒Side effects — in detail

The most commonly reported side effects from the oral betaine products are nausea and general stomach upset. Other reported side effects include:

  • Diarrhea
  • Vomiting
  • Stomach discomfort
  • Unpleasant taste
  • Loss of appetite
  • Body or skin odor changes
  • Hair loss
  • Hives
  • Urinary incontinence (loss of bladder control)
  • Mood or personality changes, agitation, irritability, or depression

The most serious reported reaction is cerebral edema (brain swelling) in patients with CBS deficiency whose methionine levels became very high — seek medical attention immediately if you develop a severe headache, confusion, or sudden changes in thinking.

⚠️Warnings & precautions
  • Risk of brain swelling (cerebral edema) in CBS deficiency: Betaine converts homocysteine into methionine — but in patients who already have elevated methionine (common in CBS deficiency), this can push levels dangerously high. Severely high methionine has been linked to cerebral edema. This is the most serious known risk of the oral betaine products.
  • Your doctor will monitor your methionine blood levels regularly. If levels rise too high, your diet may need to change and your dose may need to be reduced.
  • Brain swelling has been reported within 2 weeks to 6 months of starting therapy in CBS-deficient patients with very high methionine levels; patients fully recovered after stopping the medication.
  • For the topical product Dr. Jucre Rebirth Activating Toner: do not use on broken or wounded skin, avoid contact with eyes, and stop use if irritation or a rash develops.
🔀What it interacts with

The FDA labels for betaine oral products do not list specific drug, food, or supplement interactions. However, always tell your doctor and pharmacist about everything you take, since dosing is guided by ongoing blood tests.

  • No specific drug-drug or drug-food interactions are listed in the oral betaine product labels.

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • CBS deficiency: If your homocystinuria is caused by CBS deficiency, you are at higher risk for methionine buildup — your doctor will monitor your blood levels closely throughout treatment.
  • Pregnancy: Limited data from case reports have not shown clear harm, but there is not enough information to be certain. Talk to your doctor if you are pregnant or planning to become pregnant.
  • Breastfeeding: It is not known whether betaine passes into breast milk or affects a nursing baby. Discuss the risks and benefits with your doctor.
  • Children: The oral betaine products are established as safe and effective in pediatric patients, including very young infants. Children under 3 years require a different starting dose adjusted gradually by a physician.
  • No contraindications: The oral betaine product labels list no absolute contraindications — meaning there is no group categorically told not to use it — but medical supervision is essential for everyone.
🚑If you take too much

There is no reported information on what happens if a person takes too much betaine oral solution. Animal studies in rats showed that very high doses were fatal, but this has not been studied in humans.

If you suspect an overdose, contact Poison Control or seek emergency medical care immediately.

📡Pharmacodynamics — effects in the body

The oral betaine products measurably lower homocysteine levels in the blood across all three types of homocystinuria — CBS deficiency, MTHFR deficiency, and cobalamin cofactor defects. An initial drop in homocysteine levels is typically seen within several days, and blood levels stabilize within about a month. In people with CBS deficiency, betaine treatment can cause significant increases in methionine levels — which requires monitoring. In patients with MTHFR deficiency or cobalamin defects, betaine also raises methionine and SAM levels, which are often low in those conditions.

🔬Pharmacokinetics — how your body processes it

Formal pharmacokinetic studies — measuring how the body absorbs, processes, and clears betaine — have not been conducted for these oral products. Blood levels of betaine have not been routinely measured in patients, and no relationship between betaine blood levels and homocysteine levels has been established. Dosing is therefore guided by monitoring homocysteine (and methionine) blood levels rather than by betaine concentrations.

📦How to store it

Store at 20° to 25°C (68° to 77°F); excursions permitted between 15° to 30°C (59° to 86°F) . Protect from moisture.

📄 Written from Betaine’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

17

Supplements & herbs that interact with Betaine

17 supplements and herbal products have documented interactions with Betaine in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 1
  • Moderate · 7
  • Minor · 9
Every supplement checked against Betaine — ranked by severity The full interaction hub: 1 major · 7 moderate · 9 minor · every one linked to its full report. Check Betaine against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Betaine — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is homocystinuria, and why do I need this medication for it?
Homocystinuria is a rare inherited condition where your body can't break down an amino acid called homocysteine properly, so it builds up in your blood to harmful levels. Over time, high homocysteine can damage blood vessels, the eyes, bones, and the nervous system. Betaine helps by chemically converting homocysteine into a safer substance called methionine, which brings your levels down. It doesn't cure the underlying condition, but it helps keep things in a safer range — which is why consistent use and regular blood monitoring matter so much.
How do I prepare and take the oral powder correctly?
You measure out your dose using the scoop that comes in the package — don't estimate it by eye. Then you stir it into 4 to 6 ounces of water, juice, milk, or formula until it's completely dissolved, or you can mix it into food. Drink or eat it right away after mixing. It's taken twice a day, and your doctor will set your specific dose based on your blood test results, so follow their guidance closely.
What side effects should I expect, and which ones should make me call my doctor?
The most common side effects are mild stomach issues — nausea, diarrhea, or general stomach upset. Some people also notice a slight body odor change or an unpleasant taste. These aren't usually dangerous. What you do want to call your doctor about right away is any severe headache, confusion, or changes in thinking, especially if you have CBS deficiency — these could be signs of a rare but serious complication involving high methionine levels and brain swelling. Also reach out if you notice significant mood changes, hair loss, hives, or loss of bladder control.
I have CBS deficiency — is there anything extra I need to watch out for?
Yes, and your doctor should already be aware of this. Betaine works by converting homocysteine into methionine, but in CBS deficiency, methionine can already be elevated. Betaine can push it even higher, and very high methionine has been linked to brain swelling in some people. Your doctor will monitor your methionine blood levels regularly. If they climb too high, you may need dietary changes or a dose adjustment. Don't skip your follow-up blood tests — they're a key part of staying safe on this medication.
Can I take this if I'm pregnant or breastfeeding?
There are very limited reports of betaine being used during pregnancy, and so far they haven't shown clear harm to the baby — but the data is thin, so this isn't a guarantee of safety. For breastfeeding, there's simply no data available on whether betaine passes into breast milk or affects a nursing baby. The best step is to have an honest conversation with your doctor about your specific situation. Untreated homocystinuria also carries risks during pregnancy, so your doctor will help weigh the benefits and unknowns together with you.
Does betaine stop working over time, and how will my doctor know if it's helping?
Based on available evidence, betaine doesn't appear to lose effectiveness over time — patients have taken it for many years without signs of it wearing off. Your doctor will track how well it's working through regular blood tests measuring your homocysteine levels. The goal is to get those levels as low as possible. An initial drop usually shows up within a few days of starting, and levels tend to stabilize within about a month. Those blood tests are the real scorecard, so keep up with them.
Is Betaine available over the counter?
Both — Betaine is sold both over the counter and by prescription, according to its FDA labeling. Lower strengths or certain forms are often available without a prescription, while higher strengths or specialized forms still require one. Ask your pharmacist which version is right for you.
When was Betaine first available?
Betaine has been available in the United States since at least 1996, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Betaine?
Betaine is supplied by 8 manufacturers listed in the FDA NDC Directory, including Recordati Rare Diseases, Cosette Pharmaceuticals, Inc., Eton Pharmaceuticals, Inc..

💬 Answers drafted from Betaine’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Betaine comes

Betaine is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Oral solution

By mouth
Brands Cystadane
How this form is used
What it may be used for
  • Betaine Anhydrous For Oral Solution is used to treat homocystinuria and lower elevated homocysteine blood levels in adults and children
  • Betaine Anhydrous is used to treat homocystinuria caused by CBS deficiency, MTHFR deficiency, or cobalamin cofactor metabolism defect
  • Cystadane is used to treat homocystinuria to decrease elevated homocysteine blood concentrations in pediatric and adult patients
  • Betaine (oral powder) is used to treat homocystinuria and reduce high homocysteine levels in pediatric and adult patients
Important instructions
  • Betaine Anhydrous For Oral Solution: measure the prescribed amount with the scoop provided, dissolve completely in 4–6 ounces of water, juice, milk, or formula, or mix with food, and take immediately
  • Cystadane: measure the prescribed amount with the scoop provided, dissolve in 4–6 ounces of water, juice, milk, or formula until fully dissolved, or mix with food, and ingest right away
  • Betaine Anhydrous: taken orally in divided doses twice daily; dose is adjusted by your doctor based on homocysteine blood level monitoring
  • Betaine (oral powder): measure with the provided scoop, dissolve in 4–6 ounces of water, juice, milk, or formula until fully dissolved, or mix with food, and take immediately
Available strengths 1 strength
9 FDA-listed product records

Topical solution

On the skin
Brands Dr.Jucre Rebirth Activating Toner
How this form is used
What it may be used for
  • Dr.Jucre Rebirth Activating Toner is used on the skin as a skin protectant
Important instructions
  • Dr.Jucre Rebirth Activating Toner: apply an appropriate amount evenly on the skin
  • Dr.Jucre Rebirth Activating Toner: for external use only — avoid contact with eyes
  • Dr.Jucre Rebirth Activating Toner: do not use on wounded or broken skin; replace the cap after each use
  • Dr.Jucre Rebirth Activating Toner: stop use and consult a doctor if signs of irritation or rash appear
Available strengths 1 strength
1 FDA-listed product record

📊 Betaine across the U.S. market

How Betaine appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

2
Dose forms
8
Manufacturers
5
Brand names
12
FDA-listed product records
1996
First marketed

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (2) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Recordati Rare Diseases25%
Cosette Pharmaceuticals, Inc.17%
Eton Pharmaceuticals, Inc.17%
AMINO GmbH8%
Lukare Medical, LLC8%
Naturecell Co., Ltd.8%
Other makers17%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Betaine is used

A general measure of how commonly Betaine is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Betaine is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

2,821
Medicaid prescriptions filled (Q1–Q4 2025)
$4.4M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Betaine prescribed? Of the 1,596 medications we measure, Betaine ranks #1,139 by Medicaid prescriptions — more than 29% of them.

Where Betaine ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Betaine product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

betaine 1000 MG Powder for Oral Solution

2,821 Medicaid prescriptions (Q1–Q4 2025) 100% of Betaine prescriptions shown $4.4M gross reimbursement (before rebates) ≈ $1,546 per prescription (gross)

Summed across the 3 of 6 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 562847

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Betaine, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 3 of 6 listed Betaine NDCs with Medicaid activity.

🔍 Compare Betaine products

A representative set of FDA-listed product records for Betaine — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Strength Route Manufacturer / Labeler Category Details
💊Oral solution
1 g/g Oral Cosette Pharmaceuticals, Inc. × 2 listings ANDA View NDC →
1 g/g Oral Eton Pharmaceuticals, Inc. × 2 listings ANDA View NDC →
1 g/g Oral Lukare Medical, LLC ANDA View NDC →
1 g/g Oral Oakrum Pharma, Llc ANDA View NDC →
1 g/g Oral Recordati Rare Diseases × 3 listings NDA View NDC →
💊Topical solution
0.001 g/100 mL Topical Naturecell Co., Ltd. UNAPPROVED DRUG OTHER View NDC →
💊Bulk drug substance
1 kg/kg AMINO GmbH BULK INGREDIENT View NDC →
35 kg/35 kg Nuray Chemicals Private Limited BULK INGREDIENT View NDC →

Showing 12 of 12 products — FDA National Drug Code Directory. See every product, package size and price: browse all 12 Betaine NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Betaine RxCUI 1512 4 dose forms · 3 strengths
  1. Dose form (SCDF) Oral Capsule RxCUI 437937 No current FDA listing
    Clinical drug / strength (SCD) hydrochloride 300 MG RxCUI 2725631
  2. Dose form (SCDF) Oral Solution RxCUI 437935 In current FDA listings
  3. Dose form (SCDF) Oral Tablet RxCUI 374870 No current FDA listing
    Clinical drug / strength (SCD) 300 MG RxCUI 199239
  4. Dose form (SCDF) Powder for Oral Solution RxCUI 1806653 In current FDA listings
    Clinical drug / strength (SCD) 1000 MG RxCUI 562847

Look up RxCUI 1512 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Cystadane Dr.Jucre Rebirth Activating Toner

🏭 Manufacturers & labelers

Recordati Rare Diseases 3 Cosette Pharmaceuticals, Inc. 2 Eton Pharmaceuticals, Inc. 2 AMINO GmbH 1 Lukare Medical, LLC 1 Naturecell Co., Ltd. 1 Nuray Chemicals Private Limited 1 Oakrum Pharma, Llc 1

RxNorm drug class

Betaine belongs to the Methylating Agent class.

Pharmacologic class Methylating Agent
Drug family (ATC) Amino acids and derivatives, Acid preparations
How it works Methylating Activity

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Apr 24, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Betaine.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Betaine after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
4
NDC products indexed
12
Distinct labelers/manufacturers represented
8
Linked representative label
Recordati Rare Diseases
Linked label effective
Apr 24, 2026
Composite sections available
19
Linked SPL Set ID
31a684d0-cd98-4e46-b43a-ccbd17c41559
Linked SPL Document ID
3a4fdd66-b72b-4aa3-94bb-bac8af98b150
Open the linked representative label on DailyMed ↗
NDC package records associated with this linked SPL 1

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 4 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Recordati Rare Diseases is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.