Expiration date: 03/2025

Description pharmaceutical form:

Pill yellow with slight marbling, presence of patches of orange, chamfered and scored on one side, odourless.

Pharmacokinetics:

After oral folic acid, connecting the stomach with intrinsic factor castle (specific glycoprotein), good and completely absorbed in the digestive tract. Cmax in the blood is 30-60 min.

Almost entirely associated with plasma proteins. Deposited and metabolized in the liver with the formation of tetrahydrofolic acid (in the presence of ascorbic acid by the enzyme dihydrofolate reductase). Penetrates the GEB, placenta and in breast milk. Excreted by the kidneys in unchanged form (if accepted dose far exceeds the daily requirement), and in the form of metabolites. Displayed by hemodialysis. 5 mg accepted inside of folic acid excreted in 5 h.

Description pharmacological action:

Vitamin b In the body is converted tetragidrofolievu acid, the participating (as a coenzyme) in a variety of metabolic processes required for normal maturation of megaloblasts and normoblasts education. When folic acid deficiency develops megaloblastic type of hematopoiesis. Stimulates erythropoiesis, participates in the synthesis of amino acids (including methionine, serine, glycine), nucleic acids, purines and pyrimidines, in the metabolism of choline, histidine. During pregnancy has a protective function against the action of teratogenic and damaging the fruit factors. Promotes normal maturation and functioning of the placenta.

Indications:

• treatment and prevention of folic acid deficiency on the background of unbalanced or malnutrition
  
• treatment and prevention of anemia on a background of folic acid deficiency: macrocytic hyperchromic anemia anemia and leukopenia caused by drugs and ionizing radiation, megaloblastic anemia, post-resection anemia, sideroblastnoj anemia in the elderly anemia, associated with diseases of the small intestine, sprue and malabsorption syndrome anemia in pregnancy and breastfeeding
  
• to prevent the development of neural tube defects in the fetus (during pregnancy)
  
• prolonged treatment with antagonists of folic acid (methotrexate, combination of sulfamethoxazole and trimethoprim), anticonvulsants (phenytoin, primidon, phenobarbital).
  

Contraindications:

• hypersensitivity to the drug
  
• pernicious anemia
  
• malignant neoplasms
  
• deficiency of cobalamin.
  

Side effects:

• Allergic reactions: possible skin rashes, itching, erythema, bronchospasm.
  
• Gastrointestinal: anorexia, nausea, bloating, bitter taste in the mouth.
  

Drug interactions:

While the use of chloramphenicol, neomycin, polimiksinami, tetracyclines the absorption of folic acid decreases.

When odnovremennom the use of folic acid reduces the effects of contraceptives for oral administration, ethanol, sulfasalazine, cycloserine and glutethimide, methotrexate, phenytoin, primidon, chloramphenicol.

The administration of folic acid may reduce plasma levels of phenobarbital, phenytoin or primidon and cause an epileptic seizure.

Reducing or modifying absorption possible with simultaneous application holestiramina and folic acid, so folic acid should be taken 1 hour before or 4-6 hours after holestiramina.

Method of application and dose:

Inside.

Treatment of megaloblastic anemia due to deficiency of folic acid, 5 mg/day for 4 weeks, for prophylaxis, 2.5 mg/day.

Prevention and treatment of macrocytic anemia, malabsorbtion, inflammatory bowel diseases and unbalanced or inadequate nutrition at 15 mg/day, patients with the disease sprue — 5-15 mg/day.

Prevention of fetal neural tube defects, 2.5 mg/day for 4 weeks to the pregnancy during the first trimester of pregnancy to continue taking.

Higher maintenance doses may be administered to patients suffering from alcoholism, as well as patients with chronic infections and receiving anticonvulsant drugs.

Special instructions:

Patients on hemodialysis need increased amounts of folic acid.

Long-term use of folic acid, especially in high doses, may decrease blood concentrations of vitamin B12 (cyanocobalamin).

Prolonged use of the drug should be combined with taking vitamin B12.