Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional before making any decisions about your health or treatment.
Folic Acid® (Folic Acid / Vitamin B9)
Summary
Folic acid, also known as folate or vitamin B9, is a crucial water-soluble vitamin that plays a vital role in numerous bodily functions. It is essential for the synthesis of DNA and RNA, the building blocks of genetic material, and is critical for cell growth, division, and repair. Its importance is particularly highlighted during periods of rapid cell division and growth, such as during pregnancy and infancy. Folic acid is fundamental for the production of healthy red blood cells, preventing a type of anemia called megaloblastic anemia. Beyond its role in blood formation, it contributes to overall neurological health and is a key factor in preventing serious birth defects, specifically neural tube defects, when taken by women of childbearing age before and during early pregnancy.
Manufacturer
Folic acid is a generic active ingredient produced by multiple pharmaceutical companies. Key manufacturers in the Egyptian market include MEPACO, Pharopharma, Amoun, EIPICO, El Nile, and Memphis, among others.
Category & Active Ingredient
- Category: Vitamin (B-Complex Group)
- Active Ingredient: Folic Acid (Vitamin B9)
Available Forms & Strengths in Egypt
Folic acid is available in Egypt from several pharmaceutical companies in various strengths. The following is a list of some of the available brands and their manufacturers:
- Folic Acid (Mepaco): 500 mcg tablets, produced by MEPACO-MEDIFOOD.
- Folic Acid (Pharopharma): 0.8 mg (800 mcg) tablets, produced by Pharopharma.
- Folic Acid (Amoun): 5 mg tablets, produced by Amoun.
- Folic Acid (EIPICO): 5 mg tablets, produced by EIPICO.
- Folic Acid (El Nile): 5 mg tablets, produced by El Nile Co. for Pharmaceuticals and Chemical Industries.
- Folic Acid (Memphis): 5 mg tablets, produced by Memphis Co. for Pharm. & Chemical Ind.
- Folic Acid (Puritans Pride): 400 mcg and 800 mcg tablets, imported by Arab Importers Trading (AIT).
It is important to note that the higher strength tablets (e.g., 5 mg) are typically used for therapeutic purposes, such as treating established deficiency, while the lower strengths (e.g., 400-800 mcg) are commonly used for supplementation and prevention, especially in the context of pregnancy.
Properties and Mechanism of Action
Folic acid is the synthetic form of folate (Vitamin B9). Its primary role is in the synthesis of DNA and RNA, which are fundamental for cell division and growth. It acts as a coenzyme in various metabolic reactions, particularly in the transfer of one-carbon units. This function is crucial for the synthesis of purines and pyrimidines (the building blocks of DNA) and for the methylation cycle, which is involved in gene expression and neurotransmitter synthesis.
Upon ingestion, folic acid is rapidly absorbed and converted into its biologically active form, tetrahydrofolate (THF). The body stores folic acid mainly in the liver and actively concentrates it in the cerebrospinal fluid, highlighting its importance for neurological function. One of its most well-known functions is its role in hematopoiesis (blood cell formation), where it is essential for the maturation of red blood cells, thus preventing megaloblastic anemia.
Indications
Folic acid is indicated for a variety of conditions, primarily those related to its deficiency or increased physiological demand. Its most critical roles include:
- Prevention and Treatment of Folate Deficiency States: Used to prevent and treat folate deficiency, which can lead to megaloblastic anemia.
- Pregnancy and Lactation: Crucial for women of childbearing age to prevent neural tube defects (NTDs) in the developing fetus, such as spina bifida.
- Dietary Supplementation: Used to ensure adequate intake and support overall health and red blood cell formation.
- Other Conditions: May be indicated in conditions with increased folate requirements like hemolytic anemia, chronic alcoholism, and for patients on dialysis.
Dosage and Administration
The dosage of folic acid varies significantly depending on the indication, age, and individual needs. Always follow medical advice for appropriate dosing.
- General Supplementation (Prevention): For adults, typically 400 micrograms (0.4 mg) daily. For women planning pregnancy, 400 to 800 micrograms daily is recommended.
- Treatment of Folate Deficiency (Megaloblastic Anemia): Higher doses are prescribed, often ranging from 1 to 5 mg daily.
- Specific Populations: Dosage for children, pregnant, or lactating women should be determined by a healthcare professional.
Side Effects
Folic acid is generally well-tolerated. However, very large doses may cause:
- Gastrointestinal Upset: Mild symptoms like nausea, abdominal distension, or flatulence.
- Allergic Reactions: Rarely, hypersensitivity reactions like skin rash or itching can occur.
- Central Nervous System Effects: Very high doses (e.g., 15 mg/day) have been anecdotally linked to altered sleep patterns or irritability.
Contraindications
The primary contraindication is a known hypersensitivity to folic acid. Key precautions include:
- Undiagnosed Megaloblastic Anemia: Folic acid should not be used alone in this case, as it can mask a Vitamin B12 deficiency, allowing irreversible neurological damage to progress. Vitamin B12 deficiency must be ruled out or treated concurrently.
- Pernicious Anemia: Requires concurrent Vitamin B12 therapy.
- Certain Malignancies: Should be used with caution in patients with certain folate-dependent tumors, under medical supervision.
Drug Interactions
Folic acid can interact with several medications:
- Anticonvulsants (e.g., phenytoin): These drugs can lower folate levels, and high doses of folic acid may reduce the anticonvulsant's effectiveness.
- Methotrexate: Folic acid can interfere with the efficacy of this drug, which is a folate antagonist.
- Sulfasalazine: Can inhibit the absorption of folic acid.
- Pyrimethamine: Concurrent use can reduce the efficacy of this antimalarial drug.
Precautions & Warnings
The most critical warning is regarding its use in megaloblastic anemia. It is imperative to confirm that the anemia is not due to Vitamin B12 deficiency before initiating high-dose folic acid therapy alone. Supplementation during pregnancy is a key preventive measure for birth defects and is strongly recommended.
Frequently Asked Questions (FAQ)
What is the difference between folate and folic acid?
Folate is the natural form of Vitamin B9 in foods. Folic acid is the synthetic (man-made) form used in supplements, which is generally more bioavailable.
Why is folic acid so important during pregnancy?
It is crucial for the development of the neural tube (the baby's brain and spinal cord). Adequate intake significantly reduces the risk of serious birth defects like spina bifida.
Can I get enough folic acid from my diet alone?
It can be challenging. Folic acid in supplements is more readily absorbed, which is why supplementation is often recommended, especially for women planning a pregnancy.
What are the symptoms of folic acid deficiency?
Symptoms include fatigue, weakness, pale skin, shortness of breath, irritability, and a sore tongue. Consult a doctor if you suspect a deficiency.
References
- Mayo Clinic: For comprehensive patient-focused information on uses, dosage, and safety. Folic Acid (Oral Route) - Overview
- National Institutes of Health (NIH): For detailed scientific and health professional data on folate. Folate - Health Professional Fact Sheet
- Drug Information Pamphlet: Key information is also sourced from the internal leaflet provided with the medication, which contains specific instructions from the manufacturer.
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