Dosing & Uses
Dosage Forms & Strengths
tablet
- 400mcg
- 800mcg
- 1mg
injectable solution
- 5mg/mL
Nutritional Supplementation
Recommended daily allowance (RDA)
Males: 400 mcg/day PO
Females: 400-800 mcg/day PO
Pregnant women: 600 mcg/day PO
Nursing women: 500 mcg/day PO
Upper limit: 1 mg/day PO
Neural Tube Defects Prophylaxis
Females of childbearing potential: 400 mcg/day PO
Pregnancy women: 600 mcg/day PO
Females with high risk or family history of neural tube defects: 4 mg/day PO
Folic Acid Deficiency
0.4-1 mg PO/IV/IM/SC once daily
Methanol Toxicity
50-75 mg IV q4hr for 24 hr
Methotrexate Toxicity Prophylaxis (Off-label)
1 mg PO qDay; may increase up to 5 mg/day if toxicity emerges
Dosage Forms & Strengths
tablet
- 400mcg
- 800mcg
- 1mg
injectable solution
- 5mg/mL
Nutritional Supplementation
RDA
0-6 months: 65 mcg/day PO
7-12 months: 80 mcg/day PO
1-4 years: 150 mcg/day PO
4-9 years: 200 mcg/day PO
9-14 years: 300 mcg/day PO
14-18 years: 400 mcg/day PO
Upper limit: 1-4 years, 300 mcg/day PO; 4-8 years, 400 mcg/day PO
Folic Acid Deficiency
Infants: 15 mcg/kg/day or 50 mcg/day IV/PO/IM/SC
1-10 years: 1 mg/day IV/PO/IM/SC initially, then 0.1-0.4 mg/day
Methanol Toxicity
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (1)
- pafolacianine
folic acid decreases effects of pafolacianine by receptor binding competition. Avoid or Use Alternate Drug. Avoid coadministration with folic acid or folic acid-containing supplements for 48 hr before administering pafolacianine. Use of folate, folic acid, or folate-containing supplements may reduce binding of pafolacianine to folate receptors overexpressed on ovarian cancer cells and could reduce the detection of malignant lesions with. .
Monitor Closely (5)
- glucarpidase
glucarpidase will decrease the level or effect of folic acid by increasing metabolism. Modify Therapy/Monitor Closely. Leucorvorin, reduced folates, and folate antimetabolites are substrates for glucarpidase (hydrolyzes glutamate residue from folic acid and antifolates)
- green tea
green tea, folic acid. Other (see comment). Use Caution/Monitor. Comment: Concomitant consumption of green tea with folic acid is not recommended in pregnant women, megaloblastic anemia, or when a reduction in folic acid may have clinical consequences. A folate transporter interaction has been described, leading to decreases in bioavailability of folic acid.
- omadacycline
folic acid will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- pancrelipase
pancrelipase decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. folic deficiency may occur.
- pyrimethamine
folic acid, pyrimethamine. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (44)
- aspirin
aspirin decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- aspirin rectal
aspirin rectal decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- balsalazide
balsalazide decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- bumetanide
bumetanide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- carbamazepine
carbamazepine decreases levels of folic acid by unspecified interaction mechanism. Minor/Significance Unknown.
- chloramphenicol
chloramphenicol decreases effects of folic acid by pharmacodynamic antagonism. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- chlorthalidone
chlorthalidone decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- choline magnesium trisalicylate
choline magnesium trisalicylate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- colestipol
colestipol decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- conjugated estrogens
conjugated estrogens decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
- conjugated estrogens, vaginal
conjugated estrogens, vaginal decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
- cyclopenthiazide
cyclopenthiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- diflunisal
diflunisal decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- estradiol
estradiol decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
- estrogens conjugated synthetic
estrogens conjugated synthetic decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
- estrogens esterified
estrogens esterified decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
- estropipate
estropipate decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
- ethacrynic acid
ethacrynic acid decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- ethotoin
folic acid decreases levels of ethotoin by increasing metabolism. Minor/Significance Unknown. Large doses of folic acid (>10 mg/day).
- fosphenytoin
folic acid decreases levels of fosphenytoin by increasing metabolism. Minor/Significance Unknown. Large doses of folic acid (>10 mg/day).
- furosemide
furosemide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- indapamide
indapamide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- mesalamine
mesalamine decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- mestranol
mestranol decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
- metformin
metformin decreases levels of folic acid by unspecified interaction mechanism. Minor/Significance Unknown.
- methotrexate
folic acid decreases effects of methotrexate by pharmacodynamic antagonism. Minor/Significance Unknown. Vitamin preparations containing folic acid or its derivatives may decrease responses to systemically administered methotrexate.
- methyclothiazide
methyclothiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- metolazone
metolazone decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- pentamidine
pentamidine decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- phenobarbital
folic acid decreases levels of phenobarbital by increasing metabolism. Minor/Significance Unknown.
phenobarbital decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - phenytoin
folic acid decreases levels of phenytoin by increasing metabolism. Minor/Significance Unknown. Large doses of folic acid (>10 mg/day).
- primidone
folic acid decreases levels of primidone by increasing metabolism. Minor/Significance Unknown.
primidone decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - salicylates (non-asa)
salicylates (non-asa) decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- salsalate
salsalate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- sulfamethoxazole
sulfamethoxazole decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- sulfasalazine
sulfasalazine decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- torsemide
torsemide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- triamterene
triamterene decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- willow bark
willow bark decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Bronchospasm
Erythema
Malaise
Pruritus
Rash
Slight flushing
Warnings
Contraindications
Hypersensitivity
Cautions
Undiagnosed anemias
May mask anemia at dosages >0.1 mg/day
In presence of vitamin B12 deficiency, not appropriate for monotherapy in pernicious, normocytic, or aplastic anemia
Vials must be protected from heat and light
Injection contains benzyl alcohol as preservative (benzyl alcohol is associated with gasping syndrome in neonates)
Pregnancy & Lactation
Pregnancy category: A
Lactation: Drug enters breast milk; safe for nursing
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Necessary for formation of coenzymes in metabolic systems (purine and pyrimidine synthesis required for maintenance in erythropoiesis); stimulates platelet production in folate deficiency anemia
Enhances elimination of formic acid in methanol toxicity via provision of coenzyme to folate dehydrogenase
Absorption
Absorbed in proximal part of small intestine
Onset: PO, 0.5-1 hr
Metabolism
Metabolized in liver
Elimination
Excretion: Urine
Administration
IV/IM/SC Administration
Administer by IV/IM/SC injection only when PO administration is not feasible or when malabsorption is suspected
Most individuals with malabsorption can absorb oral folic acid
For IM use, administer by deep injection
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| folic acid oral - | 400 mcg tablet |  | |
| folic acid oral - | 1 mg tablet |  | |
| folic acid oral - | 400 mcg tablet |  | |
| folic acid oral - | 400 mcg tablet |  | |
| folic acid oral - | 1 mg tablet |  | |
| folic acid oral - | 1 mg tablet |  | |
| folic acid oral - | 1 mg tablet |  | |
| folic acid oral - | 1 mg tablet |  | |
| folic acid oral - | 1 mg tablet |  | |
| folic acid oral - | 1 mg tablet |  | |
| folic acid oral - | 800 mcg tablet |  | |
| folic acid oral - | 1 mg tablet |  | |
| folic acid oral - | 400 mcg tablet |  | |
| folic acid injection - | 5 mg/mL vial |  | |
| folic acid injection - | 5 mg/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
folic acid oral
FOLIC ACID - ORAL
(FOE-lik AS-id)
USES: Folic acid is the man-made form of folate. Folate is a B-vitamin naturally found in some foods. It is needed to form healthy cells, especially red blood cells.Folic acid supplements may come in different forms (such as L-methylfolate, levomefolate, methyltetrahydrofolate). They are used to treat or prevent low folate levels. Low folate levels can lead to certain types of anemia. Conditions that can cause low folate levels include poor diet, pregnancy, alcoholism, liver disease, certain stomach/intestinal problems, kidney dialysis, among others. Women of childbearing age should receive adequate amounts of folic acid either through their diet or supplements to prevent infant spinal cord birth defects.
HOW TO USE: Take this product by mouth with or without food as directed by your doctor, usually once daily. If you are taking the over-the-counter product, follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.Dosage is based on your medical condition and response to treatment. Do not increase your dose or take this product more often than directed.Take this product regularly to get the most benefit from it. To help you remember, take it at the same time each day. Follow the diet plan recommended by your doctor or dietician. See also Notes section.If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away.
SIDE EFFECTS: Folic acid usually has very few side effects. If you have any unusual effects from taking this product, tell your doctor or pharmacist promptly.If your doctor has directed you to use this product, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this product do not have serious side effects.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking this product, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this product, tell your doctor or pharmacist your medical history, especially of: vitamin B-12 deficiency (pernicious anemia).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Folic acid is safe to take during pregnancy when used as directed. It is included in prenatal vitamin products. Certain spinal cord birth defects may be prevented by taking adequate amounts of folic acid during pregnancy. Consult your doctor for more details.Folic acid passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breastfeeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: mental/mood changes.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as complete blood count, folate blood level, vitamin B-12 blood level) should be done while you are taking this product. Keep all medical and lab appointments. Consult your doctor for more details.Folate is naturally found in leafy green vegetables, organ meats (liver, kidney), citrus fruits, and other foods. Folic acid is added to enriched grain products such as bread, pasta, and cereal. Consult your doctor or dietician for a diet plan rich in folate/folic acid.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised May 2024. Copyright(c) 2024 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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