Folic Acid (Vit B9)

Therapeutic Class
Erythropoiesis agent
Indications

Treatment of megaloblastic anemia due to folic acid deficiency and in anemias of nutritional origin, pregnancy, infancy, or childhood.

Oral
Folate-deficient megaloblastic anaemia
Adult: 5 mg daily for 4 mth, up to 15 mg daily in malabsorption states. Continued dosing at 5 mg every 1-7 days may be needed in chronic haemolytic states, depending on the diet and rate of haemolysis. 
Oral
Prophylaxis of megaloblastic anaemia in pregnancy
Adult: 0.2-0.5 mg daily.
Oral
Prophylaxis of neural tube defect in pregnancy
Adult: 4 or 5 mg daily starting before pregnancy and continued through the 1st trimester.
Oral
As supplement for women of child-bearing potential
Adult: 0.4 mg daily.

Contraindications

Undiagnosed megaloblastic anaemia; pernicious, aplastic or normocytic anaemias.

Warnings / Precautions

Treatment resistance may occur in patients with depressed haematopoiesis, alcoholism, deficiencies of other vitamins. Neonates.

Not for monotherapy in pernicious anemia and other megaloblastic anemias with B12 deficiency. May obscure pernicious anemia in dosage >0.1mg/day. Decreased B12 serum levels with prolonged therapy.

Adverse Reactions

GI disturbances, hypersensitivity reactions, bronchospasm, Allergic sensitization.

 

Drug Interactions

Antiepileptics, oral contraceptives, anti-TB drugs, alcohol, aminopterin, methotrexate, pyrimethamine, trimethoprim and sulphonamides may result to decrease in serum folate concentration. Decreases serum phenytoin concentrations.

Antagonizes phenytoin effects. Increased seizures with phenytoin, primidone, and phenobarbital reported. Tetracycline may cause false low serum and red cell folate due to suppression ofLactobacillus casei.

Mechanism of Actions

Acts as cofactor for transformylation reactions in biosynthesis of purines and thymidylates of nucleic acids; acts on megaloblastic bone marrow to produce normoblastic marrow; required for nucleoprotein synthesis and maintenance of normal erythropoiesis.
Onset: Peak effect: Oral: 0.5-1 hr.
Absorption: Rapidly absorbed mainly from the duodenum and jejunum.
Distribution: Extensively bound to plasma protein. Principal site of storage is the liver. It is also concentrated in the CSF and enters the breast milk.
Metabolism: Undergoes conversion in the plasma and liver to the metabolically active 5-methyltetrahydrofolate.
Excretion: Via urine (as unchanged drug and metabolites). Removed by haemodialysis.

Assesment

Assess for alcoholism, chronic infection, and pernicious, megaloblastic, and hemolytic anemias, and for possible drug interactions.

Monitoring

Monitor for allergic/hypersensitivity reactions

Patient Counselling

Advise to seek medical attention if symptoms of allergic/hypersensitivity reaction occur.

Administration

Administration: Oral route. 

Storage: 20-25°C (68-77°F).

Pregnancy Category

A: Drug Pregnancy Category Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters

ATC Classification
B03BB01
GenericPedia Classification
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  • Available As
  • Folic Acid (Vit B9) –
  • Folic Acid (Vit B9) 0.002 mg
  • Folic Acid (Vit B9) 0.01 mg
  • Folic Acid (Vit B9) 0.02 mg
  • Folic Acid (Vit B9) 0.035 mg
  • Folic Acid (Vit B9) 0.044 mg
  • Folic Acid (Vit B9) 0.05 mg
  • Folic Acid (Vit B9) 0.078 mg
  • Folic Acid (Vit B9) 0.0833 mg
  • Folic Acid (Vit B9) 0.1 mg
  • Folic Acid (Vit B9) 0.15 mcg
  • Folic Acid (Vit B9) 0.15 mg
  • Folic Acid (Vit B9) 0.152 mg
  • Folic Acid (Vit B9) 0.16 mg
  • Folic Acid (Vit B9) 0.166 mg
  • Folic Acid (Vit B9) 0.167 mg
  • Folic Acid (Vit B9) 0.17 mg
  • Folic Acid (Vit B9) 0.2 mg
  • Folic Acid (Vit B9) 0.20 mg
  • Folic Acid (Vit B9) 0.25 mg
  • Folic Acid (Vit B9) 0.263 mg
  • Folic Acid (Vit B9) 0.3 mg
  • Folic Acid IP 0.3 mg
  • Folic Acid (Vit B9) 0.30 mg
  • Folic Acid IP 0.30 mg
  • Folic Acid (Vit B9) 0.33 mg
  • Folic Acid (Vit B9) 0.35 mg
  • Folic Acid (Vit B9) 0.375 mg
  • Folic Acid (Vit B9) 0.4 mg
  • Folic Acid (Vit B9) 0.5 mcg
  • Folic Acid IP 0.5 mg
  • Folic Acid (Vit B9) 0.5 mg
  • Folic Acid lP 0.5 mg
  • Folic Acid (Vit B9) 0.50 mg
  • Folic Acid (Vit B9) 0.501 mg
  • Folic Acid (Vit B9) 0.53 mg
  • Folic Acid (Vit B9) 0.55 mg
  • Folic Acid (Vit B9) 0.6 mg
  • Folic Acid (Vit B9) 0.7 mg
  • Folic Acid (Vit B9) 0.715 mg
  • Folic Acid (Vit B9) 0.75 mg
  • Folic Acid IP 0.75 mg
  • Folic Acid (Vit B9) 0.750 mg
  • Folic Acid (Vit B9) 0.80 mcg
  • Folic Acid (Vit B9) 1 mcg
  • Folic Acid (Vit B9) 1 mg
  • Folic Acid IP 1 mg
  • Folic Acid (Vit B9) 1. 5 mg
  • Folic Acid (Vit B9) 1.0 mg
  • Folic Acid (Vit B9) 1.1 mg
  • Folic Acid (Vit B9) 1.125 mg
  • Folic Acid (Vit B9) 1.25 mg
  • Folic Acid (Vit B9) 1.26 mg
  • Folic Acid (Vit B9) 1.5 mg
  • Folic Acid IP 1.5 mg
  • Folic Acid lP 1.5 mg
  • Folic Acid (Vit B9) 1.50 mg
  • Folic Acid (Vit B9) 1.5mg
  • Folic Acid (Vit B9) 1.8 mg
  • Folic Acid (Vit B9) 10 mcg
  • Folic Acid (Vit B9) 10 mg
  • Folic Acid (Vit B9) 100 mcg
  • Folic Acid (Vit B9) 100 mg
  • Folic Acid (Vit B9) 1000 mcg
  • Folic Acid (Vit B9) 1000 mg
  • Folic Acid (Vit B9) 12.5 mg
  • Folic Acid (Vit B9) 125 mcg
  • Folic Acid (Vit B9) 133 mcg
  • Folic Acid (Vit B9) 1334 mcg
  • Folic Acid (Vit B9) 140 mcg
  • Folic Acid (Vit B9) 15 mcg
  • Folic Acid (Vit B9) 15 mg
  • Folic Acid IP 15 mg
  • Folic Acid (Vit B9) 150 mcg
  • Folic Acid (Vit B9) 150 mg
  • Folic Acid (Vit B9) 1500 mcg
  • Folic Acid IP 1500 mcg
  • Folic Acid (Vit B9) 1500 mg
  • Folic Acid (Vit B9) 154 mcg
  • Folic Acid (Vit B9) 155 mcg
  • Folic Acid (Vit B9) 16.5 mcg
  • Folic Acid (Vit B9) 160 mcg
  • Folic Acid (Vit B9) 166 mcg
  • Folic Acid (Vit B9) 166 mg
  • Folic Acid (Vit B9) 17 mcg
  • Folic Acid IP 175 mcg
  • Folic Acid (Vit B9) 175 mcg
  • Folic Acid (Vit B9) 175 mg
  • Folic Acid (Vit B9) 178 mcg
  • Folic Acid (Vit B9) 18 mcg
  • Folic Acid (Vit B9) 184 mcg
  • Folic Acid (Vit B9) 1mg
  • Folic Acid IP 1mg
  • Folic Acid (Vit B9) 2 mcg
  • Folic Acid (Vit B9) 2 mg
  • Folic Acid (Vit B9) 2.5 mg
  • Folic Acid IP 2.5 mg
  • Folic Acid (Vit B9) 20 mg
  • Folic Acid (Vit B9) 200 iu
  • Folic Acid (Vit B9) 200 mcg
  • Folic Acid (Vit B9) 200 mg
  • Folic Acid (Vit B9) 2000 mcg
  • Folic Acid (Vit B9) 222.2 mcg
  • Folic Acid (Vit B9) 236 mcg
  • Folic Acid (Vit B9) 24 mcg
  • Folic Acid (Vit B9) 240 mcg
  • Folic Acid (Vit B9) 25 mcg
  • Folic Acid (Vit B9) 25 mg
  • Folic Acid (Vit B9) 250 mcg
  • Folic Acid (Vit B9) 250 mg
  • Folic Acid (Vit B9) 262.48 mcg
  • Folic Acid (Vit B9) 263 mcg
  • Folic Acid (Vit B9) 263 mg
  • Folic Acid (Vit B9) 272.47 mcg
  • Folic Acid (Vit B9) 272.48 mcg
  • Folic Acid (Vit B9) 275 mcg
  • Folic Acid (Vit B9) 275 mg
  • Folic Acid (Vit B9) 295 mcg
  • Folic Acid (Vit B9) 3 mg
  • Folic Acid (Vit B9) 30 mcg
  • Folic Acid (Vit B9) 30 mg
  • Folic Acid (Vit B9) 300 mcg
  • Folic Acid IP 300 mcg
  • Folic Acid (Vit B9) 300 mg
  • Folic Acid (Vit B9) 308 mcg
  • Folic Acid (Vit B9) 333.3 mcg
  • Folic Acid (Vit B9) 333.33 mcg
  • Folic Acid (Vit B9) 35 mcg
  • Folic Acid (Vit B9) 350 mcg
  • Folic Acid IP 350 mcg
  • Folic Acid (Vit B9) 350 mg
  • Folic Acid (Vit B9) 40 mcg
  • Folic Acid (Vit B9) 400 mcg
  • Folic Acid (Vit B9) 44 mcg
  • Folic Acid (Vit B9) 45 mcg
  • Folic Acid (Vit B9) 45 mg
  • Folic Acid (Vit B9) 5 mcg
  • Folic Acid IP 5 mcg
  • Folic Acid (Vit B9) 5 mg
  • Folic Acid IP 5 mg
  • Folic Acid (Vit B9) 50 mcg
  • Folic Acid (Vit B9) 50 mg
  • Folic Acid (Vit B9) 500 mcg
  • Folic Acid IP 500 mcg
  • Folic Acid (Vit B9) 500 mg
  • Folic Acid IP 500 mg
  • Folic Acid (Vit B9) 55 mcg
  • Folic Acid (Vit B9) 550 mcg
  • Folic Acid (Vit B9) 550 mg
  • Folic Acid (Vit B9) 59 mcg
  • Folic Acid (Vit B9) 600 mcg
  • Folic Acid (Vit B9) 62.5 mcg
  • Folic Acid (Vit B9) 7 mg
  • Folic Acid (Vit B9) 7.5 mg
  • Folic Acid (Vit B9) 75 mcg
  • Folic Acid (Vit B9) 75 mg
  • Folic Acid (Vit B9) 750 mcg
  • Folic Acid (Vit B9) 750 mg
  • Folic Acid IP 750 mg
  • Folic Acid (Vit B9) 77 mcg
  • Folic Acid (Vit B9) 78 mcg
  • Folic Acid (Vit B9) 79 mcg
  • Folic Acid (Vit B9) 800 mcg
  • Folic Acid (Vit B9) 9 mg
  • Folic Acid (Vit B9) 91 mcg
  • Folic Acid (Vit B9) 94.4 mcg
  • Folic Acid (Vit B9) 95.2 mcg
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