Indications
B-9 is indicated for the
treatment of-
B-9 deficiency
Megaloblastic anemia
Anemias of nutritional origins, pregnancy,
infancy, or childhood.
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Pharmacology
Folic acid, as it is
biochemically inactive, is converted to tetrahydrofolic acid and
methyltetrahydrofolate by dihydrofolate reductase (DHFR). These folic acid
congeners are transported across cells by receptor-mediated endocytosis where
they are needed to maintain normal erythropoiesis, synthesize purine and
thymidylate nucleic acids, interconvert amino acids, methylate tRNA, and
generate and use formate. Using vitamin B12 as a cofactor, folic acid can
normalize high homocysteine levels by remethylation of homocysteine to
methionine via methionine synthetase.
Dosage & Administration
Adults-
Initially: 5 mg daily for 4
months.
maintenance: 5 mg every 1-7 days
depending on the underlying disease.
Children-
Up to 1 year: 500 mcg/kg daily.
Over 1 year: Same as adult dose.
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Interaction
None has been reported.
Contraindications
Folic acid is contraindicated in
patients who have shown previous intolerance to the drug.
Side Effects
B-9 is generally well tolerated.
Gastro-intestinal disturbances may occur. Hypersensitivity reactions have been
reported rarely.
Pregnancy & Lactation
No special precautions are known.
Precautions & Warnings
It should be used with caution in
patients who may have folate dependent tumours. It should never be given alone
or in conjunction with inadequate amounts of vitamin B12 for the treatment of
undiagnosed megaloblastic anaemia. Although B-9 may produce a haematopoietic
response in patients with a megaloblastic anaemia due to vitamin B12 deficiency
it should not be given alone in vitamin B12 deficiency states as it may
precipitate the onset of subacute combined degeneration of the cord. In elderly
people a cobalamin absorption test should be done before long term folate. No
harmful results found from short courses of folate.
Therapeutic Class
Drugs for Megaloblastic Anemia,
Vitamin-B preparations
Storage Conditions
Store below 30°C in a dry place,
away from light. Keep out of the reach of children.
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