Supplement "folic acid", be sure to pay attention to these 9 points!

*For medical professionals only

Clinical decision-making can be simpler

Folic acid is a water-soluble B vitamin that is necessary for the growth and reproduction of human cells, can be used to treat anemia caused by folate deficiency, and is also a nutrient supplement for pregnant women.

However, folic acid supplementation is also very learned, and it is necessary to pay attention to the following points:

01 Precautions

1． Intravenous injection is more likely to cause adverse reactions, so it should not be used; intramuscular injection, it should not be injected with vitamin B1, vitamin B2, vitamin C in the same tube.

2． Oral administration of large doses of folic acid can affect the absorption of trace elements of zinc.

3． The diagnosis is confirmed before the drug is taken. If experimental, oral administration of physiological amounts (0.5 mg a day) should be used.

4． Trophic megaloblastic anemia is often associated with iron deficiency and should be supplemented with iron, protein and other B vitamins.

5． Patients with pernicious anemia and suspected vitamin B12 deficiency do not use folic acid alone, because this will increase the burden of vitamin B12 and neurological symptoms.

6． Maintenance therapy is generally not required unless it is a patient with malabsorption.

7． It is forbidden to use this product when its properties change.

8． Keep out of reach of children.

9． If other medicines are being used, consult a physician or pharmacist before using this product.[1][2][3]

02 Contraindications[1-4]

Megaloblastic anemia caused by vitamin B12 deficiency cannot be treated with folic acid alone.

It is contraindicated in people who are allergic to this product and its metabolites.

Folic acid is contraindicated in patients who are intolerant to this product.

03 Other precautions

Folic acid monotherapy should not be used for the treatment of pernicious anemia and other megaloblastic anemia due to vitamin B12 deficiency.

There is a potential risk of folic acid administration in patients with undiagnosed anemia, and in addition to pregnancy and lactation, the therapeutic dose of folic acid taken per day should not exceed 0.4 mg until pernicious anemia is ruled out.

The dose of folic acid in a multivitamin preparation should not exceed the amount specified in the recommended daily dietary supply (RDA), and folic acid should be taken alone if the therapeutic amount is to be reached.

Patients with pernicious anemia who take more than 0.4 mg of folic acid per day and receive inappropriate vitamin B12 treatment may cause hematologic indicators to return to normal, but vitamin B12 is still deficient, so neurological complications continue to progress.

Blind taking folic acid can lead to serious neurological damage until a correct diagnosis is made. Adequate amounts of vitamin B12 can prevent, stop, or improve neurological changes caused by pernicious anemia [4].

bibliography:

[2] Drug information: folic acid tablets, Chinese medicine quasi-word H20044917;2013/04/26.

[3] Drug information: folic acid for injection, National Pharmaceutical Standard H20050739.

[4] Product Information: FOLIC ACID tablet, Amneal Pharmaceuticals LLC, December 28, 2020.

Source: Clinical Decision Assistant

Editor-in-charge: Xu Liyan

Proofreader: Zang Hengjia

Plate making: Xue Jiao