Foliber, tablets 28 pcs

Deficiency of folic acid causes impaired DNA synthesis in the cell preparing for chromosome replication.

The mechanism of action of Foliber is due to the participation of folic acid in the form of tetrahydrofolate in the synthesis of nucleic acids and cell division, as well as participation as a coenzyme in the synthesis of purines and pyrimidines, making it a critical factor in the formation of the central nervous system, which develops in humans on days 15-28 after fertilization.

The conversion of 5-methyltetrahydrofolate to tetrahydrofolate in the body can only occur as a result of the addition of a methyl group to homocysteine to form methionine by methioninesinthetase.

In this process, vitamin B12 is involved as a limiting cofactor, so vitamin B12 deficiency is similar in effect to folic acid deficiency activation; in addition, vitamin B12 is also involved in folic acid capture by cells, so when a cell has a primary vitamin B12 deficiency, it is also deficient in folate.

The pharmacological action of Foliber is that its use overcomes the metabolic blockade seen in mothers of children with neural tube defects. The specific nature of this metabolic blockade is in the metabolism of the essential amino acid methionine, in which folate and vitamin B12 are key elements because they are responsible for the re-methylation of homocysteine to methionine.

400 micrograms of folic acid is the minimum effective daily dose recommended by the Centers for Disease Prevention (US, UK and Australia) for healthy women as an additional daily intake to prevent neural tube defects in the fetus. The recommended daily intake of vitamin B12 is 2 micrograms.

Pharmacokinetics

Folic acid is rapidly absorbed in the jejunum, undergoing reduction and methylation to 5 methyltetrahydrofolate, which is present in the portal circulation. Maximum plasma concentrations are observed after 30-60 minutes. On the other hand, vitamin B12 can be absorbed after its interaction in the stomach with the “intrinsic factorKasla”, a glycoprotein that is secreted by the parietal cells of the stomach.

The maximum concentration in plasma is observed after 8-12 hours. As with folic acid, vitamin B12 undergoes significant intestinal-hepatic recirculation. Both components are largely bound to plasma proteins, with the excess accumulating in the liver. Each day, 4-5 µg of folate is excreted in the urine in the form of folic acid, 10-formyltetrahydrofolate and 5-methyltetrahydrofolate.

Folate is also excreted with the mother’s milk. The average half-life of vitamin B12 is about 6 days. Part of the administered dose is excreted with the urine during the first 8 hours, although most is excreted with the bile. 25% is excreted with the feces. In addition, vitamin B12 passes through the placenta and is present in the mother’s milk.

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Indications

Prevention of folic acid and vitamin B12 (cyanocobalamin) deficiency in women of childbearing age at the stages of pregnancy planning (at least 1 month before conception), and the first trimester of pregnancy to prevent the development of neural tube defects in the fetus.

Composition

Active substances:

Folic acid – 0.4 mg;

Cyanocobalamin (Vitamin B12) – 0.002 mg.

Auxiliary substances:

Sodium carboxymethyl starch (Type A),

Magnesium stearate,

Lactose monohydrate,

p> microcrystalline cellulose,

trisodium citrate,

citric acid,

maltodextrin.

How to take, the dosage

1 tablet of Foliber per day, before meals.

Interaction

Foliber should not be taken in combination with methotrexate because it acts as a folic acid antagonist by inhibiting the enzyme hydrofolate reductase.

The use of Foliber in combination with antiepileptic drugs from the group of hydantoin may decrease the effect of the latter.

Special Instructions

The drug Foliber does not affect the ability to drive and operate machinery.

Contraindications

Hypersensitivity.

With caution

This drug contains 23 mg of lactose per tablet, which should be considered in patients with impaired glucose or galactose absorption, patients with galactosemia or with lactase deficiency.

Pregnancy use

The drug is used in pregnancy when indicated.