9 Months Folic Acid, 400 mcg 30 pcs

Pharmacodynamics
B-group vitamin (vitamin B9, vitamin B), can be synthesized by intestinal microflora. In the body it is reduced to tetrahydrofolic acid, which is a coenzyme involved in various metabolic processes. Necessary for normal maturation of megaloblasts and formation of normoblasts. It stimulates erythropoiesis, participates in the synthesis of amino acids (including glycine, methionine), nucleic acids, pyrimidines, purines and in the exchange of histidine and choline.

Pharmacokinetics

Folic acid is well and completely absorbed in the gastrointestinal tract, mainly in the upper duodenum. It is almost completely bound to plasma proteins. It is activated in the liver by the enzyme dihydrofolate reductase, converting it into tetrahydrofolic acid. The maximum concentration in blood (Cmax) is reached after 30-60 minutes.

It penetrates through the blood-brain barrier and placental barrier into breast milk. It is excreted by the kidneys mainly as metabolites; if the dose taken significantly exceeds the daily requirement for folic acid, it is excreted unchanged. Excreted with hemodialysis.

Indications

Hypovitaminosis, Malnutrition, AnemiaDeficiency of folic acid. Prevention of neural tube defects in the fetus in the first trimester of pregnancy.

Composition

1 tablet contains:

Active ingredient:
folic acid – 0.0004 g.

Excipients:
lactose monohydrate – 0,0936 g,
colloidal silica – 0,0005 g,
copovidone – 0,0050 g,
magnesium stearate – 0,0005 g.

Shell:
OpadrayII 85F22233 – 0,0030 g: polyvinyl alcohol, partially hydrolyzed – 40.00%, macrogol – 20.20%, talc – 14.80%, titanium dioxide E 171 – 19.50%, iron oxide yellow dye E 172 – 0.10%, aluminum varnish based on quinoline yellow dye E 104 – 5.40%.

How to take, the dosage

Administered orally after meals. In folic acid deficiency – 400 micrograms (1 tablet) per day.

For the prevention of neural tube defects in the fetus in the first trimester of pregnancy – 400 micrograms – 800 micrograms (1 – 2 pills).

Interaction

Decreases the effectiveness of phenytoin (requires increasing its dose). Analgesics (long-term therapy), anticonvulsants (including Phenytoin and carbamazepine). Estrogens, oral contraceptives increase the need for folic acid. Antacids, colestyramine, sulfonamines (including sulfasalazine) decrease the absorption of folic acid.

Methotrexate, pyrimethamine, triamterene, trimethoprim inhibit dihydrofolate reductase and decrease the folic acid effect (calcium folinate should be administered instead for patients using these drugs). When concomitant use with chloramphenicol, neomycin, polymyxins, tetracyclines absorption of folic acid is reduced.

Special Instructions

For the prevention of hypovitaminosis, a balanced diet is most preferable. Foods rich in folic acid – green vegetables (lettuce, spinach, tomatoes, carrots), fresh liver, legumes, beets, eggs, cheese, nuts, cereals.

Folic acid is not used to treat B12-deficient (pernicious), normocytic and aplastic anemia, as well as anemia refractory to therapy. In pernicious (B12-deficient) anemia folic acid, while improving hematological parameters, masks neurological complications. While pernicious anemia is not excluded, folic acid administration in doses greater than 100 mcg/day is not recommended (except for pregnancy and lactation).

It should be noted that patients on hemodialysis require increased amounts of folic acid.

During treatment, antacids should be used 2 h after folic acid intake, colestyramine – 4-6 h before or 1 h after folic acid intake. It should be borne in mind that antibiotics can distort (give knowingly underestimated values) the results of microbiological assessment of folic acid concentration of plasma and erythrocytes. When using high doses of folic acid, as well as therapy over a long period, a decrease in the concentration of vitamin B12 is possible.

Contraindications

Hypersensitivity to the ingredients of the drug, pernicious anemia, malignant tumors, cobalamin deficiency, childhood.

Overdose

May occur with prolonged use (more than 1-2 months) of folic acid in doses greater than 1000 mcg per day and as a result of combined use with vitamin-mineral complexes.