Folic acid - instructions for use, dose, side effects, contraindications

Vitamin B (vitamin B, vitamin B9) can be synthesized by the intestinal microflora. In organism folic acid is reduced to tetrahydrofolic acid, which is a coenzyme involved in various metabolic processes. It is 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, purines, pyrimidines, in the exchange of choline, histidine.

Pharmacokinetics:

Folic acid, prescribed as a drug, is well and fully absorbed into the gastrointestinal tract, mainly in the upper parts of the duodenum (even in the presence of malabsorption syndrome against the background of tropical sprue, at the same time, food folates are poorly digested in malabsorption syndrome) . Intensively binds to plasma proteins. Penetrates through the blood-brain barrier (GEB), the placenta and in | breast milk. TСmах - 30-60 minutes.

It is deposited and metabolized in the liver with the formation of tetrahydrofolic acid (in the presence of ascorbic acid under the action of dihydrofolate reductase).

It is excreted by the kidneys mainly in the form of metabolites; if the taken dose significantly exceeds the daily requirement for folic acid, then it is output in unchanged form.

It is excreted by hemodialysis.

Indications:

Treatment of megaloblastic anemia.

Hypo-and avitaminosis of folic acid, incl. with tropical and non-tropical sprue, malnutrition, pregnancy, in childhood, in patients taking antiepileptic drugs.

Contraindications:

Hypersensitivity to the components of the drug; B-scarce

anemia; children's age up to 3 years.

Carefully:Pernicious anemia and other megaloblastic anemias with cyanocobalamin deficiency; folate-dependent malignant tumors, use of dihydrofolate reductase inhibitors (eg, methotrexate).

Pregnancy and lactation:| | It is recommended to take the drug during pregnancy to prevent congenital malformations of the fetus as a lesion of the formation of the neural tube, hydrocephalus, spina bifida, anencephaly, cerebral hernia

Dosing and Administration:

Apply inside after eating.

Megapoblastic anemia: for adults and children over 3 years of age, the initial dose is up to 1 mg / day. With the use of large doses, resistance may occur, to prevent the development of fetal neural tube defects in the first trimester of pregnancy - 1 mg per day.

With a curative purpose (depending on the severity of vitamin deficiency) adults - up to mg / day for 20-30 days, children - in smaller doses, depending on

age.

Side effects:

Allergic reactions - skin rash, skin itching, bronchospasm, erythema,

hyperthermia.

Overdose:

A significant excess of the recommended doses can cause a dangerous accumulation of folacin crystals, which leads to intoxication of the body (symptoms such as nausea, vomiting, bloating, flatulence and sleep disorders last longer.) Long-term use of large doses of folic acid (more than 3 months , in a daily dose of not more than 0.2 mg, for adults and children from 4 years) can lead to a decrease in blood concentrations of vitamin B12.

Treatment: symptomatic. The drug is excreted by hemodialysis.

Interaction:

Anticonvulsant drugs (incl. phenytoin and carbamazepine), estrogens, oral contraceptives increase the need for folic acid.

Antacids (including preparations Са2 +, A13-h and Mg2 +), colestramine, sulfonamides (incl. sulfasalazine) reduce the absorption of folic acid. Methotrexate, pyrimethamine, triamterene,trimethoprim inhibit dihydrofolate reductase and reduce the effect of folic acid (instead of it, patients using these drugs should be prescribed calcium folinate).

There is no unambiguous information regarding Zn2 + preparations: some studies show that folates inhibit the absorption of Zn2 +, others disprove these data.

Special instructions:

For the prevention of hypovitaminosis B9, a balanced diet is most preferable. Foods rich in vitamin B9, green vegetables (salad, spinach), tomatoes, carrots, fresh liver, beans, beets, eggs, cheese, nuts, cereals.

(Folic acid is not used to treat B-deficiency (pernicious), normocytic and aplastic anemia. With pernicious (B-deficiency) anemia folic acid, improving hematologic indices, masks neurological manifestations. While pernicious anemia is not ruled out, administration of folic acid in doses exceeding 10.1 mg / day is not recommended (except for pregnancy and Lactation period).

(It should be borne in mind that patients on hemodialysis need increased amounts of folic acid.

During treatment, antacids should be used 2 hours after taking folic acid, colestramine - 4-6 hours before or 1 hour after taking folic acid.

(It should be borne in mind that antibiotics can distort (give knowingly underestimated indicators) the results of a microbiological evaluation of the concentration of folic acid in plasma and erythrocytes.

When using large doses of folic acid, as well as therapy for a long period, a decrease in the concentration of vitamin B12 is possible.

Effect on the ability to drive transp. cf. and fur:

Taking the drug does not affect the ability to drive and work with machinery,

Form release / dosage:Tablets of 1 mg

Packaging:

For 10 or 25 tablets in a planar cell package. 50 tablets in j jar.

Each bank or 1, 3 or 5 contour cell packs No. 10 or 1 or 2 contourcell packagings No. 25 together with instructions for use are placed in a bundle.

For hospitals: 144 banks № 50 with 20 instructions for use are placed in a cardboard box.

Storage conditions:

In a dry, dark place at a temperature of no higher than 25 ° C. Keep out of the reach of children.

Shelf life:3 years.Do not use after the expiration date.

Terms of leave from pharmacies:Without recipe

Registration number:П N010622

Date of registration:02.07.2010

The owner of the registration certificate:BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC Republic of Belarus

Manufacturer: & nbsp

BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC Republic of Belarus

Information update date: & nbsp25.09.2015

Illustrated instructions

Instructions

Folic acid (Folic acid )