|FOLIC ACID (VITAMIN B9, PTEROYLGLUTAMIC ACID)
Apo-Folic , Folacin, Novofolacid
Classifications: vitamin b9; Therapeutic: vitamin supplement
Pregnancy Category: A
0.4 mg, 0.8 mg, 1 mg tablets; 5 mg/mL injection
Vitamin B9 essential for nucleoprotein synthesis and maintenance of normal erythropoiesis. Acts against folic acid deficiency that
results in production of defective DNA that leads to megaloblast formation and arrest of bone marrow maturation.
Stimulates production of RBCs, WBCs, and platelets in patients with megaloblastic anemias.
Folate deficiency, macrocytic anemia, and megaloblastic anemias associated with malabsorption syndromes, alcoholism, primary
liver disease, inadequate dietary intake, pregnancy, infancy, and childhood.
Folic acid alone for pernicious anemia or other vitamin B12 deficiency states; normocytic, refractory, aplastic, or undiagnosed anemia; neonates.
Pregnancy (category A).
Route & Dosage
Adult: PO/IM/SC/IV ≤1 mg/d
Child: PO/IM/SC/IV ≤1 mg/d
Adult: PO/IM/SC/IV ≤0.4 mg/d
Child: PO/IM/SC/IV ≤4 y, up to 0.3 mg/d; >4 y, up to 0.1 mg/d
Infant: PO/IM/SC/IV 0.1 mg/d
PREPARE: Direct/Continuous: Given undiluted.
ADMINISTER: Direct/Continuous: Give over 3060 sec. May also add to a continuous infusion.
INCOMPATIBILITIES Solution/additive: Calcium gluconate, chlorpromazine, dextrose 40% in water, doxapram.
- Store at 15°30° C (59°86° F) in tightly closed containers protected from light, unless otherwise
Adverse Effects (≥1%)
Reportedly nontoxic. Slight flushing and feeling of warmth following IV administration
Diagnostic Test Interference
Falsely low serum folate levels may occur with Lactobacillus casei assay in patients receiving antibiotics such as tetracyclines.
Interactions Drug: Chloramphenicol
may antagonize effects of folate
therapy; phenytoin metabolism
may be increased, thus decreasing its levels.
Readily from proximal small intestine. Peak:
3060 min PO. Distribution:
Distributed to all body tissues; high concentrations in CSF; crosses placenta; distributed into breast milk. Metabolism:
In liver to active metabolites. Elimination:
Small amounts in urine in folate-deficient patients; large amounts excreted in urine with high doses.
Assessment & Drug Effects
- Obtain a careful history of dietary intake and drug and alcohol usage prior to start of therapy. Drugs reported to cause folate
deficiency include oral contraceptives, alcohol, barbiturates, methotrexate, phenytoin, primidone, and trimethoprim. Folate
deficiency may also result from renal dialysis.
- Keep physician informed of patient's response to therapy.
- Monitor patients on phenytoin for subtherapeutic plasma levels.
Patient & Family Education
- Remain under close medical supervision while taking folic acid therapy. Adjustment of maintenance dose should be made if there
is threat of relapse.