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Vitamin B (vitamin B9, vitamin B), can be synthesized by intestinal microflora. In the body, it is restored to tetrahydrofolic acid, which is a coenzyme involved in various metabolic processes. Necessary for the normal maturation of megaloblasts and the formation of normoblasts. Stimulates erythropoiesis, participates in the synthesis of amino acids (including glycine, methionine), nucleic acids, pyrimidines, purines, in the exchange of histidine and choline. Pharmacokinetics
Folic acid is well and completely absorbed in the gastrointestinal tract, mainly in the upper parts of the duodenum. Almost completely bound to plasma proteins. It is activated in the liver under the influence of the enzyme dihydrofolate reductase, turning into tetrahydrofolic acid. The maximum concentration in the bloodstream (Сmax) is reached in 30 - 60 minutes. Gets through the blood-brain and placental barriers into breast milk. Excreted by the kidneys mainly in the form of metabolites; if the accepted dose significantly exceeds the daily need for folic acid, it is displayed in unchanged form. Excreted through hemodialysis.
Folic acid deficiency. Prevention of the development of neural tube defects in the fetus in the first trimester of pregnancy.
1 tablet contains:
Active ingredient: folic acid - 0.0004 g.
Excipients: lactose monohydrate - 0.0936 g, colloidal silicon dioxide - 0.0005 g, copovidone - 0.0050 g, magnesium stearate - 0.0005 g
Shell: Opadray II 85F22233 - 0.0030 g: polyvinyl alcohol, partially hydrolyzed - 40.00%, macrogol - 20.20%, talc - 14.80%, titanium dioxide E 171 - 19.50%, iron dye oxide yellow E 172 - 0.10%, aluminum lacquer based on the quinoline yellow dye E 104 - 5.40%.
Folic acid is marketed under different brands and generic names, and comes in different dosage forms:
|Brand name||Manufacturer||Country||Dosage form|
|9 months Folic acid||Valenta||Russia||pills|
|Folacin||Jadran-Galensky Laboratories ao||Croatia||pills|
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Dosage and Administration
Apply inside after eating. With a folic acid deficiency of 400 mcg (1 tab) per day. For the prevention of the development of neural tube defects in the fetus in the first trimester of pregnancy - 400 mcg - 800 mcg (1 - 2 pills).
Allergic reactions (skin rash, itching, bronchospasm, erythema, hyperthermia); on the part of the gastrointestinal tract: nausea, bloating, bitter taste in the mouth, anorexia.
With prolonged use may develop hypovitaminosis B12.
Hypersensitivity to the components that make up the drug; pernicious anemia, malignant neoplasms, cobalamin deficiency, childhood.
Reduces the effectiveness of phenytoin (requires an increase in its dose). Analgesics (long-term therapy), anticonvulsant drugs (including phenytoin and carbamazepine). Estrogens, oral contraceptives increase the need for folic acid. Antacids, colestiramine, sulfonamines (including Sulfasalazinee) reduce the absorption of folic acid. Methotrexate, pyrimethamine, triamterene, trimethoprim inhibit dihydrofolate reductase and reduce the effect of folic acid (instead of it, folinate should be prescribed to patients using these drugs). With simultaneous use with chloramphenicol, neomycin, polymyxin, tetracyclines, folic acid absorption decreases.
Pregnancy and Lactation
Folic acid is needed during preparation for pregnancy (1-3 months before the planned pregnancy) and in the first few weeks after conception (I term).
For the prevention of hypovitaminosis, most preferably a balanced diet. Foods rich in folic acid - green vegetables (lettuce, spinach, tomatoes, carrots), fresh liver, legumes, beets, eggs, cheese, nuts, cereals.
Folic acid is not used for the treatment of B12-deficient (pernicious), normocytic and aplastic anemia, as well as refractory anemia to therapy. When pernicious (B12-deficient) anemia, folic acid, improving hematological parameters, masks neurological complications. While pernicious anemia is not excluded, the administration of folic acid in doses exceeding 100 mcg / day is not recommended (except for pregnancy and lactation).
It should be borne in mind that patients on hemodialysis need increased amounts of folic acid.
During treatment, antacids should be applied 2 hours after taking folic acid, Kolestiramine - 4-6 hours before or 1 hour after taking folic acid. It should be borne in mind that antibiotics may distort (to give obviously underestimated indicators) the results of microbiological evaluation of plasma and erythrocyte folate concentrations. When using large doses of folic acid, as well as therapy for a long period, it is possible to reduce the concentration of vitamin B12.
It may occur with prolonged use (more than 1-2 months) of folic acid in doses of more than 1000 mg per day and as a result of joint use with vitamin-mineral complexes.
- Brand name: 9 months Folic acid
- Active ingredient: Folic acid
- Dosage form: pills, film coated.
- Manufacturer: Valenta
- NTD phenotypes in infants and fetuses whose mothers used multivitamins containing folic acid in early pregnancy compared to those who did not
- Folic acid fortification and supplementation
- Miscarriage and use of multi-vitamins or folic acid
- Soft drink abuse, malnutrition, and folic acid deficiency
- Caution advised before rushing to start folic acid supplements
- Population-based case control study of folic acid supplementation during pregnancy
- Comparison of national policies on periconceptional use of folic acid to prevent spina bifida and anencephaly (SBA)
- Teratology society consensus statement on use of folic acid to reduce the risk of birth defects
- Awareness of folic acid for neural tube defect prevention among Israeli women
- Acute toxicity of folic acid in pregnant women
- Folic acid and folates: the feasibility for nutritional enhancement in plant foods
- Periconceptional use of folic acid amongst women of advanced maternal age
- Preconceptional use of folic acid amongst women of advanced maternal age
- Metabolic capacity of Bacillus subtilis for the production of purine nucleosides, riboflavin, and folic acid
- Efficacy of folic acid prophylaxis for the prevention of neural tube defects
- Folic acid: Abortifacient or pseudoabortifacient?
- Folic acid and miscarriage: An unjustified link
- The effect of folic-acid derivatives on sarcoma 180
- Reversal of aminopterin-induced inhibition of sarcoma 180 by folic acid
- Studies on the mechanism of action of chemotherapeutic agents in cancer. I. A sex difference in toxicity to the folic acid analogue, 4-amino-pteroylglutamic acid
- Studies on the mechanism of action of chemotherapeutic agents in cancer. II. Requirements for the prevention of aminopterin toxicity by folic acid in mice
- Studies on the mechanism of action of chemotherapeutic agents in cancer. III. Relationship of genital growth response in mice to the folic acid analogue, 4-amino-pteroylglutamic acid
- Studies on the role of folic acid in the leukemic process
- Partial reversal of the antileukemic action of folic acid antagonists by nucleic acids