Products
Folic acid is commercially available in many countries as a monopreparation in the form of tablets. It is marketed both as a drug and as a dietary supplement. It is further available in combined vitamin and mineral preparations. The name folic acid is derived from lat. , the leaf. Folic acid was first isolated from leaf spinach.
Structure and properties
Folic acid (C19H19N7O6, Mr = 441.4 g/mol) exists as a yellowish to orange crystalline powder that is practically insoluble in water. It consists of the structural elements pteridine, 4-aminobenzoic acid, and glutamic acid. Folic acid is a prodrug of the active tetrahydrofolate (tetrahydrofolic acid, THF).
Effects
Folic acid (ATC B03BB01) is a coenzyme involved in the transfer of C1 molecular building blocks in central metabolic reactions. It plays an important role in the synthesis of purines, pyrimidines, nucleic acids (DNA, RNA), and in the metabolism of amino acids. Folic acid is essential for DNA synthesis and cell regeneration. It is involved in the degradation of homocysteine to methionine. Elevated homocysteine levels are associated with various diseases.
Indications and indications
- Before and during pregnancy for primary prophylaxis of neural tube defects and for supplementation due to increased need, including during lactation.
- For the treatment of megaloblastic anemia caused by folic acid deficiency.
- As a dietary supplement, for the prevention of deficiency.
- As part of a deep-dose methotrexate therapy, see under methotrexate ready injection.
Dosage
According to the professional information. The dose is in the micro to low milligram range depending on the indication.
Contraindications
Folic acid is contraindicated in cases of hypersensitivity. In the case of pernicious anemia, folic acid must not be used alone. It must be given together with vitamin B12. For complete precautions, see the drug label.
Interactions
Drug-drug interactions are possible with antiepileptic drugs, folic acid antagonists, fluorouracil, ethanol, and chloramphenicol, among others.
Adverse effects
Folic acid is generally well tolerated. Only at high doses in the milligram range and during prolonged therapy can gastrointestinal disturbances, allergic reactions, psychiatric disorders, and increased seizures in epilepsy rarely be expected.
