Folivit

Each tablet contains 5 mg of Folic acid.

Pharmacology: Pharmacodynamics: Folic acid is the precursor of tetrahydrofolic acid, which is involved as a cofactor for transformylation reactions in the biosynthesis of purines and thymidylates of nucleic acids are required for nucleoprotein synthesis. Impairment of thymidylate synthesis in patients with Folic acid deficiency is thought to account for the defective deoxyribonucleic acid (DNA) synthesis that leads to megaloblast formation and megaloblastic and macrocytic anemias. Folic acid acts on megaloblastic bone marrow to produce a normoblastic marrow; maintenance in erythropoiesis; stimulates WBC and platelet production in folate deficiency anemia. So, Folic acid is used for the treatment of megaloblastic anemias due to a deficiency of Folic acid as seen in anemias of nutritional origin, pregnancy or childhood.
Pharmacokinetics: Absorption/Distribution: Folic acid is absorbed rapidly from the small intestine, mainly from the duodenum and jejunum. Folic acid appears in the plasma approximately 5 to 30 minutes after an oral dose; peak levels are generally reached within 1 hour. Normal serum levels of total folate have been reported to be 5 to 15 ng/mL; normal cerebrospinal fluid levels are approximately 16 to 21 ng/mL. Normal erythrocyte folate levels have been reported to range from 175 to 316 ng/mL. In general, folate serum levels below 5 ng/mL indicate folate deficiency, and levels below 2 ng/mL usually result in megaloblastic anemia.
Metabolism/Excretion: Folic acid is metabolized in the liver to 7,8-dihydrofolic acid and eventually to 5,6,7,8-tetrahydrofolic acid with the aid of reduced diphosphopyridine nucleotide (DPNH) and folate reductases. An oral dose of 5 mg in one study and a dose of 40 mcg/kg of body weight in another study resulted in approximately 50% of the dose appearing in the urine. After a single oral dose of 15 mg, up to 90% of the dose was recovered in the urine. A majority of the metabolic products appeared in the urine after 6 hours; excretion was generally complete within 24 hours. Small amounts of orally administered Folic acid have also been recovered in the feces. Folic acid is also excreted in the milk of lactating mothers.

Folic acid is used in the treatment of the folate deficiency state: nutritional, megaloblastic anemias.

For the treatment of folate-deficient megaloblastic anemia it is recommended given orally in dose of 5 mg daily; up to 15 mg daily may be necessary in malabsorption states.

Overdosage and Treatment: Oral Folic acid is generally regarded as not toxic for normal humans but it may cause neurological injury when given to patients with undiagnosed pernicious anemia. Daily oral supplements of 5-10 mg Folic acid appear to be well-tolerated and without toxicity in normal nonpregnant subjects. Even with doses as high as 15 mg per day, there have been no substantiated reports of side effects.

Hypersensitivity to Folic acid or any component of the formulation or previous intolerance to the drug.

Folic acid should never be given alone with pernicious, aplastic, or normocytic anemias when anemia is present with vitamin B₁₂ deficiency or with inadequate amounts of vitamin B₁₂ for the treatment of undiagnosed megaloblastic anemia.

Pregnancy Risk factor: A.
Folic acid is usually indicated in the treatment of megaloblastic anemias of pregnancy. Folic acid requirements are increased during pregnancy; a deficiency may result in fetal harm. Studies in pregnant women have not shown that Folic acid increases the risk of abnormalities if administered during pregnancy. During lactation, Folic acid requirement is markedly increased. Folic acid is excreted in the milk of lactating mothers. No adverse effects have been observed in breast-fed infants whose mothers were receiving Folic acid.

CNS: Other side effects reported in patients receiving 15 mg daily include altered sleep patterns, difficulty in concentrating, irritability, overactivity, excitement, mental depression, and impaired judgement.
GI side effects, including anorexia, nausea, abdominal distention, flatulence, and a bitter or bad taste, have been reported in patients receiving 15 mg of Folic acid daily for 1 month.
Hypersensitivity: Allergic sensitization has been reported following oral administration of Folic acid. Rare instances of allergic responses to Folic acid preparation have included skin rash, itching, general malaise, and respiratory difficulty.

Drug causing folate deficiency: Folate deficiency may result from increased loss of folate, as in renal dialysis or interference with metabolism (eg, Folic acid antagonists such as methotrexate); the administration of anticonvulsants, such as phenytoin, primidone, and barbiturates; alcohol consumption and, especially, alcoholic cirrhosis; and the administration of pyrimethamine and nitrofurantoin. The levels/effects of Folic acid may be decreased by green tea.
There is evidence that the anticonvulsant action of phenytoin is antagonized by Folic acid. A patient whose epilepsy is completely controlled by phenytoin may require increased doses to prevent convulsions if Folic acid is given.

Store below 30°C.

Vitamins & Minerals (Pre & Post Natal) / Antianemics

B03BB01 - folic acid ; Belongs to the class of folic acid and derivatives. Used in the treatment of anemia.

NDD