Drug Index

Folic acid

Mechanism :

An exogenous source of folate is required for nucleoprotein synthesis and the maintenance of normal erythropoiesis. Folic acid, whether given by mouth or parenterally, stimulates the production of red blood cells, white blood cells, and platelets in persons suffering from certain megaloblastic anemias.

Indication :

  • Folate deficiency
  • Hemolytic anemia
  • Juvenile idiopathic arthritis
  • Methotrexate induced nausea
  • Megaloblastic anemia
  • Methanol Deficiency

Contraindications :

Prior to therapy with folate, in megaloblastic anaemia, vitamin B12 deficiency must be excluded, as neuropathy may be precipitated.

Dosing :

Folic Acid Deficiency:
Infants: 15 mcg/kg/day OR 50 mcg/day either orally/IV/IM/SC.
1-10 years: 1 mg/day either orally/IV/IM/SC initially followed by 0.1-0.4 mg/day.
Methanol Toxicity:
1 mg/kg IV every 4 hours for 1 day.
Megaloblastic anemia due to folate deficiency:
1 mg oral, <1 year: 500 mcg/kg oral, 1-18 years: 5 mg daily once orally for 4 months.
Hemolytic Anemias:
Oral <12 years: 2.5 mg and 12-18 years: 10 mg once daily.
To limit methotrexate associated side effects: Oral 2-18 years: 1 mg once daily.
Recommended Daily Allowance:
0-6 months:
65 mcg/day once orally.
7-12 months:
80 mcg/day once orally.
1-4 years:
150 mcg/day once orally; Max: 300 mcg/day once orally.
4-9 years:
200 mcg/day once orally; Max: 400 mcg/day once orally.
9-14 years:
300 mcg/day once orally.
14-18 years:
400 mcg/day once orally.

Adverse Effect :

Allergic sensitization, flushing, irritability, difficulty sleeping, malaise may occur rarely.

Interaction :

Sulfasalazine: May decrease phenytoin serum concentration, decrease absorption with sulfasalazine.

Folic Acid Antagonists: Prevent formation of active metabolite so ineffective for treating overdose of these drugs.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDDialysed. Dose as in normal renal function
HDDialysed. Dose as in normal renal function
HDF/High fluxDialysed. Dose as in normal renal function
CAV/VVHDDialysed. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are needed.
01/19/2024 02:22:57 Folic acid
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