Brand Name : FOLATE
Generic Name : Folic acid
Preparation : 5 mg Tablet
Pharmacological Categories : Water Soluble Vitamin (Vitamin B9), Erythropoiesis Agent

Mechanism of Action (MOA)
FOLATE (Folic acid) is reduced to tetrahydrofolate in the body, which is a coenzyme for various metabolic processes including the synthesis of purine and pyrimidine nucleotides, and hence in the synthesis of DNA, for maintenance of erythropoiesis. FOLATE also stimulates WBC, platelet production in folate deficiency anemia.

Pharmacokinetics

  • Absorption : Rapidly absorbed from the gastrointestinal tract mainly from duodenum and jejunum
  • Onset of Action : 0.5 to 1 hour
  • Distribution : Stored in liver and actively concentrated in the cerebrospinal fluid, also distributed in breast milk
  • Metabolism : Liver and plasma
  • Excretion : Urine, faeces

Indications and Dosage

  • Folate Deficient Megaloblastic Anaemia : One tablet of FOLATE daily for 4 months; up to three tablets of FOLATE daily may be necessary in malabsorption states.
  • Chronic Haemolytic States (Thalassaemia, Sickle-cell anaemia): One tablet of FOLATE every 1 to 7 days depending on the diet or haemolysis
  • Women in the High-risk Group who wish to become Pregnant: One tablet of FOLATE daily and continue until week 12 of pregnancy
  • Methotrexate Therapy : One tablet of FOLATE once weekly
  • Antiepileptic Therapy : One tablet of FOLATE daily
  • Dialysis patients : One tablet of FOLATE every 1 to 7 days

Side Effects
RARE : Gastrointestinal disturbance, erythema, skin rash, itching, general malaise, respiratory difficulty due to bronchospasm

Contraindication
Hypersensitivity to Folic acid

Warnings / Precautions
Caution in undiagnosed megaloblastic anemias, may mask the pernicious anemia at dosage more than 0.1 mg per day. The masking of the true deficiency state can lead to serious neurological damage.

Drug Interactions

  • Oral contraceptive, antituberculous drugs, alcohol, methotrexate, pyrimethamine, traimterene, carbamazepine, chloramphenicol, trimethoprim and sulfonamide decreases folic acid level.
  • Pancrelipase decreases level of folic acid by inhibition of gastrointestinal absorption.
  • Aspirin decreases level of folic acid by inhibition of gastrointestinal absorption.
  • Folic acid decreases level of phenytoin, phenobarbital by increasing metabolism.
  • Sulfasalazine decreases level of folic acid by inhibition of gastrointestinal absorption.
  • Metformin decreases level of folic acid by unspecified interaction mechanism.
  • Frusemide, hydrochlorothiazide decreases level of folic acid by increasing renal clearance.

Presentation
FOLATE 5 mg : A box of 20 blisters, each blister of 10 tablets