Foli Kidz100 ml

Folic acid (vitamin B9) is indicated for the following:

Established/FDA-approved uses

• Treatment of megaloblastic and macrocytic anemias caused by folate deficiency (e.g. due to poor diet, malabsorption, pregnancy, alcoholism, or hemolytic anemia).
• Treatment and prevention of folate-deficiency states.

Guideline-supported use

• Periconceptional supplementation (before conception and during early pregnancy) to reduce the risk of fetal neural tube defects (e.g. spina bifida, anencephaly). Standard recommended dose for average-risk women is 400–800 mcg daily; women with a prior neural tube defect-affected pregnancy or other high-risk factors may be advised much higher doses (e.g. 4–5 mg daily) under medical supervision.

Adjunct use

• Adjunct therapy with low-dose methotrexate in non-oncologic conditions (e.g. rheumatoid arthritis, psoriasis) to reduce methotrexate-related gastrointestinal and hepatic toxicity, without significantly reducing methotrexate's therapeutic effect.

Folic acid is not indicated as sole therapy for pernicious anemia or other vitamin B12-deficiency anemias (see Contraindications).

Each tablet typically contains Folic acid USP 1 mg or 5 mg; lower-strength preparations (e.g. 400 mcg / 0.4 mg) are also available as over-the-counter prenatal/dietary supplements. Formulations may vary by manufacturer; refer to the specific product label for exact strength and excipients.

Folic acid is the synthetic, oxidized form of vitamin B9, a water-soluble B-complex vitamin that the body cannot synthesize and must obtain from diet or supplementation. It is essential for DNA synthesis, cell division, and the formation of red blood cells. In the body, Folic acid is converted to its active metabolite, tetrahydrofolate, which participates in one-carbon transfer reactions required for nucleotide synthesis and amino acid metabolism. Folic acid is available as an oral tablet and is used both as a dietary supplement and as a therapeutic agent for folate-deficiency conditions.

Folic acid belongs to the vitamin B-complex group; specifically, it is classified as a hematinic agent / water-soluble vitamin (vitamin B9) used in the management of folate-deficiency anemias and as a nutritional supplement.

Folic acid itself is pharmacologically inactive and must be reduced in the body to tetrahydrofolate (via dihydrofolate reductase), the metabolically active form. Tetrahydrofolate and its derivatives act as coenzymes in single-carbon transfer reactions essential for:

• Purine and pyrimidine (thymidylate) synthesis, required for DNA and RNA replication.
• Conversion of homocysteine to methionine.
• Amino acid interconversions (e.g. glycine-serine).

Folate deficiency impairs DNA synthesis in rapidly dividing cells, most notably erythroid precursors in bone marrow, leading to megaloblastic anemia. Adequate folate status around conception is also critical for neural tube closure in the developing embryo, which is why periconceptional supplementation with Folic acid reduces neural tube defect risk.

Absorption: readily absorbed from the proximal small intestine (jejunum). Distribution: stored mainly in the liver; also present in plasma and cerebrospinal fluid. Metabolism: reduced to tetrahydrofolate in the liver and intestinal mucosa. Excretion: excess amounts are excreted largely unchanged in urine.

Folic acid is taken orally, with or without food, once daily unless otherwise directed by a physician. Consistent daily timing helps maintain steady folate levels.

Folic acid has the following well-established clinically significant interactions:

• Phenytoin: Folic acid may lower serum phenytoin concentrations, potentially reducing seizure control; patients on phenytoin who start Folic acid should have phenytoin levels monitored.
• Methotrexate: Folic acid can antagonize the therapeutic effect of methotrexate when used for oncologic indications; however, in low-dose non-oncologic methotrexate regimens (e.g. rheumatoid arthritis), Folic acid is intentionally co-administered under medical supervision to reduce methotrexate toxicity without significant loss of efficacy. Do not adjust either drug without physician guidance.
• Sulfasalazine: may reduce intestinal absorption of folate; patients on long-term sulfasalazine may need folate supplementation.
• Antiepileptic drugs generally (e.g. phenobarbital, primidone): similar mechanism to phenytoin; monitor for altered seizure control.

Folic acid is generally very well tolerated at recommended doses. Reported side effects are uncommon and include:

• Mild gastrointestinal upset (nausea, bloating, loss of appetite) — rare.
• Altered or bitter taste — rare.
• Allergic reactions (skin rash, itching, or, very rarely, more severe hypersensitivity reactions) — rare, more often reported with high or parenteral doses.
• Sleep disturbance or irritability has been reported anecdotally at high doses, though not well established.

Seek medical attention if signs of an allergic reaction (rash, swelling, difficulty breathing) occur.

Folic acid is well established as beneficial and is routinely recommended during pregnancy. Adequate periconceptional and first-trimester intake of Folic acid (typically 400–800 mcg daily, or higher in high-risk women as advised by a physician) significantly reduces the risk of fetal neural tube defects and is considered standard-of-care prenatal supplementation. Folic acid is also considered safe during breastfeeding at recommended nutritional doses and is commonly included in postnatal/lactation supplements to support maternal folate stores and milk folate content. Women who are pregnant, breastfeeding, or planning pregnancy should still consult a physician to confirm the appropriate dose for their individual risk factors.

Before starting Folic acid, patients should be evaluated for underlying vitamin B12 deficiency, since Folic acid can mask the hematologic signs of B12 deficiency while neurological damage progresses (see Contraindications). Folic acid should be used with caution, and only under medical supervision, in patients on phenytoin or other antiepileptic drugs, due to the potential for reduced seizure control (see Interactions). Patients undergoing hemodialysis or with malabsorption syndromes may have increased folate requirements. High-dose Folic acid supplementation without medical guidance is not recommended, as it can complicate the diagnosis of B12 deficiency and is not proven to provide additional benefit beyond recommended doses in most patients.

Folic acid has low toxicity as it is water-soluble and excess amounts are excreted in the urine; significant toxicity from oral overdose is rare. However, if a substantially excessive dose has been taken, or if any unusual symptoms occur, seek immediate medical attention or contact a poison control center/emergency services. Do not attempt to manage a suspected overdose with home remedies; bring the product packaging when seeking medical care.

Store at room temperature (below 30°C), away from light and moisture. Keep out of reach of children.

Pregnant Women

Folic acid is recommended and considered beneficial during pregnancy for prevention of neural tube defects (see Pregnancy and Lactation).

Breastfeeding Women

Folic acid is considered safe at recommended nutritional doses during breastfeeding (see Pregnancy and Lactation).

Elderly

No specific dose adjustment is required for elderly patients; however, folate deficiency should not be treated with Folic acid alone until vitamin B12 deficiency has been ruled out, as B12 deficiency is more common in this age group.

Renal Impairment

Patients on hemodialysis may have increased folate requirements due to dialysis losses; dosing should be individualized by a physician.

Hepatic Impairment

No well-established dose adjustment is required; use as directed by a physician.

Duration depends on the indication: folate-deficiency anemia is typically treated until hematologic values normalize and the underlying cause is corrected (often several weeks to a few months); periconceptional supplementation with Folic acid is continued from at least one month before conception through the first trimester of pregnancy; adjunct use with methotrexate is continued for as long as methotrexate therapy continues, as directed by the prescribing physician.

Vitamin B-complex agent; water-soluble vitamin (vitamin B9); hematinic.

Folic acid is converted in the body to tetrahydrofolate, an essential coenzyme for one-carbon transfer reactions required for purine and pyrimidine (DNA/RNA) synthesis and amino acid metabolism, thereby supporting normal cell division and red blood cell maturation.

A

Folic acid is used in children for the treatment and prevention of folate-deficiency anemia, with dosing individualized by age and severity of deficiency (see Dosage and Administration for pediatric dosing). Safety and efficacy of high-dose Folic acid regimens (as used in certain adult indications, e.g. high-risk periconceptional supplementation) have not been established in children; pediatric use should be guided by a physician based on diagnosed deficiency or specific clinical need.