Folic acid


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Folate-deficient megaloblastic anaemia 5 mg/day for up to 4 months. May increase to 15 mg/day in malabsorption states. Maintenance: 5 mg every 1-7 days. Prophylaxis of neural tube defect in pregnancy 5 mg/day starting 4 weeks before pregnancy and continued through the 1st trimester. IM/IV/SC Folate-deficient megaloblastic anaemia Up to 1 mg/day. Maintenance: 0.4 mg/day.
Dosage Details
Oral
Prophylaxis of neural tube defect in pregnancy
Adult: 5 mg daily starting 4 weeks before pregnancy and continued through the 1st trimester.

Oral
Folate-deficient megaloblastic anaemia
Adult: 5 mg daily for up to 4 months. May increase to 15 mg daily in malabsorption states. Maintenance: 5mg every 1-7 days.
Child: >1 year Same as adult dose

Parenteral
Folate-deficient megaloblastic anaemia
Adult: Up to 1 mg daily given via IM/IV/SC inj. Maintenance: 0.4 mg daily.
Child: Same as adult dose. Maintenance: Infants: 0.1 mg daily; <4 years Up to 0.3 mg daily; >4 years 0.4 mg daily.
Administration
May be taken with or without food.
Contraindications
Untreated pernicious anaemia, untreated cobalamin deficiency or other cause of cobalamin deficiency.
Special Precautions
Patients with folate-dependent tumours.
Adverse Reactions
Cardiac disorders: Flushing.
Gastrointestinal disorders: Anorexia, nausea, abdominal distention, flatulence.
Immune system disorders: Allergic reactions.
Nervous system disorders: Malaise.
Respiratory, thoracic and mediastinal disorders: Bronchospasm.
Skin and subcutaneous tissue disorders: Erythema, pruritus, skin rash, hypersensitivity.
MonitoringParameters
Perform cobalamin absorption test for elderly prior to initiation of therapy.
Drug Interactions
May decrease concentration of phenytoin. Decreased absorption with sulfasalazine and triamterene. Chloramphenicol, methotrexate and co-trimoxazole may interfere with folate metabolism. May enhance efficacy of lithium.
Action
Description: Folic acid is essential for the production of coenzymes in many metabolic systems such as purine and pyrimidine synthesis. It is also essential in nucleoprotein synthesis, maintenance of erythropoiesis and stimulation of WBC and platelet production in folate-deficiency anaemia.
Onset: 0.5-1 hour (oral).
Pharmacokinetics:
Absorption: Rapidly absorbed from the proximal part of small intestine. Bioavailability: Approx 100% (folic acid supplement); 85% (with food); 50% (dietary folate). Time to peak plasma concentration: 1 hour (oral).
Distribution: Distributed to body tissues and stored in the liver. Actively concentrated in the CSF, and enters breast milk. Extensively bound to plasma protein.
Metabolism: Metabolised in the liver and plasma to active metabolite, 5- methyltetrahydrofolate. Undegoes enterohepatic circulation.
Excretion: Via urine.
Chemical Structure

Chemical Structure Image
Folic acid

Source: National Center for Biotechnology Information. PubChem Database. Folic acid, CID=135398658, https://pubchem.ncbi.nlm.nih.gov/compound/Folic-acid (accessed on Jan. 21, 2020)

Storage
Store between 20-25°C. Protect from light.
ATC Classification
B03BB01 - folic acid ; Belongs to the class of folic acid and derivatives. Used in the treatment of anemia.
References
Anon. Folic Acid. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 25/01/2019.

Anon. Folic Acid. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 24/01/2019.

Buckingham R (ed). Folic Acid. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/01/2019.

Folic Acid Injection, Solution (Fresenius Kabi USA, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 25/01/2019.

Joint Formulary Committee. Folic Acid. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/01/2019.

Disclaimer: This information is independently developed by MIMS based on Folic acid from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • Folic Acid DHA
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