Yes

Vitamin, Water Soluble

Dental: Treatment of megaloblastic and macrocytic anemias due to folate deficiency

Medical: Treatment of megaloblastic and macrocytic anemias due to folate deficiency; dietary supplement to prevent neural tube defects

A/C (if dose exceeds RDA recommendation)

Pernicious, aplastic, or normocytic anemias

Doses >0.1 mg/day may obscure pernicious anemia with continuing irreversible nerve damage progression. Resistance to treatment may occur with depressed hematopoiesis, alcoholism, deficiencies of other vitamins. Injection contains benzyl alcohol (1.5%) as preservative (use care in administration to neonates).

<1%: Slight flushing, general malaise, pruritus, rash, bronchospasm, allergic reaction

Decreased effect: In folate-deficient patients, folic acid therapy may increase phenytoin metabolism. Phenytoin, primidone, para-aminosalicylic acid, and sulfasalazine may decrease serum folate concentrations and cause deficiency. Oral contraceptives may also impair folate metabolism producing depletion, but the effect is unlikely to cause anemia or megaloblastic changes. Concurrent administration of chloramphenicol and folic acid may result in antagonism of the hematopoietic response to folic acid; dihydrofolate reductase inhibitors (eg, methotrexate, trimethoprim) may interfere with folic acid utilization.

Incompatible with oxidizing and reducing agents and heavy metal ions

Folic acid is necessary for formation of a number of coenzymes in many metabolic systems, particularly for purine and pyrimidine synthesis; required for nucleoprotein synthesis and maintenance in erythropoiesis; stimulates WBC and platelet production in folate deficiency anemia

Peak effect: Oral: Within 0.5-1 hour

Absorption: In the proximal part of the small intestine

Infants: 0.1 mg/day

Children <4 years: Up to 0.3 mg/day

Children >4 years and Adults: 0.4 mg/day

Pregnant and lactating women: 0.8 mg/day

RDA:

Adult male: 0.15-0.2 mg/day

Adult female: 0.15-0.18 mg/day

Therapeutic: 0.005-0.015 mg/mL

Falsely low serum concentrations may occur with the Lactobacillus casei assay method in patients on anti-infectives (eg, tetracycline)

May cause drowsiness

None reported

No information available to require special precautions

No effects or complications reported

Take as prescribed. Toxicity can occur from elevated doses. Do not self medicate. Increase intake of foods high in folic acid (eg, dried beans, nuts, bran, vegetables, fruits) as recommended by prescriber. Excessive use of alcohol increases requirement for folic acid. May turn urine more intensely yellow. Report skin rash.

Oral, but may also be administered by deep I.M., S.C., or I.V. injection; a diluted solution for oral or for parenteral administration may be prepared by diluting 1 mL of folic acid injection (5 mg/mL), with 49 mL sterile water for injection; resulting solution is 0.1 mg folic acid per 1 mL

Monitor hemoglobin

Injection, as sodium folate: 5 mg/mL (10 mL); 10 mg/mL (10 mL)

Folvite®: 5 mg/mL (10 mL)

Tablet: 0.1 mg, 0.4 mg, 0.8 mg, 1 mg

Folvite®: 1 mg

A 1 mg/mL folic acid solution may be prepared by crushing fifty 1 mg tablets. Dissolve in a small amount of distilled water, then add sufficient distilled water to make a final volume of 50 mL. Adjust the pH to 8 with sodium hydroxide. It is stable for 42 days at room temperature.

Davis RE, "Clinical Chemistry of Folic Acid," Adv Clin Chem, 1986, 25:233-94.

Lambie DG and Johnson RH, "Drugs and Folate Metabolism," Drugs, 1985, 30(2):145-55.

Olszewski AJ, Szostak WB, Bialkowska M, et al, "Reduction of Plasma Lipid and Homocysteine Levels by Pyridoxine, Folate, Cobalamin, Choline, Riboflavin, and Troxerutin in Atherosclerosis," Atherosclerosis, 1989, 75(1):1-6.