Folic acid. Folic acid - instructions for use Folic acid 50 tablets 1 mg

Pharmacodynamics

Vitamin B (vitamin B c, vitamin B 9) can be synthesized and is necessary for the normal maturation of megaloblasts and the formation of normoblasts. Participates in the synthesis of amino acids (including glycine, methionine), nucleic acids, purines, pyrimidines, in the metabolism of choline, histidine.

Pharmacokinetics

Folic acid is well and completely absorbed from the gastrointestinal tract, mainly in the upper parts of the duodenum (even in the presence of malabsorption syndrome due to tropical sprue).

Intensively binds to plasma proteins. Penetrates through the blood-brain barrier, the placenta, and also into breast milk. Tmax - 30-60 min. Deposited and metabolized in the liver to form tetrahydrofolic acid (in the presence of ascorbic acid under the action of dihydrofolate reductase).

It is excreted by the kidneys mainly in the form of metabolites. If the dose taken significantly exceeds the daily requirement for folic acid, it is excreted unchanged.

Eliminated by hemodialysis.

Indications for the drug Folic acid

folate deficiency anemia;

hypo- and avitaminosis of folic acid (including with tropical sprue, celiac disease, malnutrition).

Contraindications

hypersensitivity to the components of the drug;

B 12 - deficiency anemia;

sucrase deficiency;

isomaltase deficiency;

fructose intolerance;

glucose-galactose malabsorption;

children's age (up to 3 years).

Carefully: folate deficiency anemia with cyanocobalamin deficiency.

Use during pregnancy and breastfeeding

Considering that folic acid deficiency is especially dangerous in the first weeks of pregnancy, it is recommended to take this vitamin in preparation for pregnancy, as well as during the entire period of gestation, 1 mg daily.

The dose and degree of risk cannot be determined independently; this should only be done by the attending physician.

Side effects

Allergic reactions - skin rash, itching, bronchospasm, erythema, hyperthermia.

Interaction

Anticonvulsants (including phenytoin and carbamazepine), estrogens, and oral contraceptives increase the need for folic acid.

Antacids (including calcium, aluminum and magnesium preparations), cholestyramine, sulfonamides (including sulfasalazine) reduce the absorption of folic acid.

Methotrexate, pyrimethamine, triamterene, trimethoprim inhibit dihydrofolate reductase and reduce the effect of folic acid (patients using these drugs should be prescribed calcium folinate instead).

Regarding zinc preparations, there is no clear information: some studies show that folates inhibit the absorption of zinc, while others refute this data.

Directions for use and doses

Inside.

Folate deficiency anemia: for adults and children of any age, the initial dose is 1 mg/day. When large doses are used, resistance may occur.

Maintenance treatment: for newborns - 0.1 mg/day; for children under 4 years old - 0.3 mg/day; for children over 4 years of age and adults - 0.4 mg/day; during pregnancy and lactation - from 0.1 to 0.8 mg/day.

For hypo- and vitamin deficiency of folic acid (depending on the severity of vitamin deficiency): adults - up to 5 mg/day; for children - in smaller doses depending on age. The course of treatment is 20-30 days.

With concomitant alcoholism, hemolytic anemia, chronic infectious diseases, after gastrectomy, malabsorption syndrome, with liver failure, liver cirrhosis, stress, the dose of the drug should be increased to 5 mg/day.

Overdose

Doses of folic acid up to 4-5 mg are well tolerated. Higher doses may cause disturbances in the central nervous system and gastrointestinal tract.

special instructions

To prevent folic acid hypovitaminosis, a balanced diet is most preferable. Foods rich in folic acid: green vegetables (lettuce, spinach), tomatoes, carrots, fresh liver, legumes, beets, eggs, cheese, nuts, cereals.

Folic acid is not used to treat B12-deficient, normocytic and aplastic anemia. In B 12-deficiency anemia, folic acid, improving hematological parameters, masks neurological complications. Until B12-deficiency anemia has been ruled out, administration of folic acid in doses exceeding 0.1 mg/day is not recommended (with the exception of pregnancy and lactation).

It should be kept in mind that hemodialysis patients require increased amounts of folic acid.

During treatment, antacids should be used 2 hours after taking folic acid, cholestyramine - 4-6 hours before or 1 hour after taking folic acid. It should be borne in mind that antibiotics can distort (provide deliberately underestimated indicators) the results of microbiological assessment of the concentration of folic acid in plasma and erythrocytes. When using large doses of folic acid, as well as during therapy for a long period, a decrease in the concentration of vitamin B 12 (cyanocobalamin) is possible.

A woman needs folic acid in a certain amount. It is involved in protein metabolism, which means its deficiency will affect the condition of the entire body. This vitamin has the greatest effect on hematopoiesis and the neuroendocrine system. Folic acid is especially necessary for women after 40, since hormonal levels change at this age. Vitamin deficiency can increase symptoms such as frequent flushing, emotional outbursts and decreased performance.

Folic acid (vitamin B9) enters the body with food and is partially produced by normal intestinal microflora.

Derivatives of folic acid are called folates. Folates are especially needed by rapidly dividing cells, which is why they are so necessary for children growing up and pregnant women to ensure proper growth and development of the fetus. The nervous system of the fetus can be especially affected by folate deficiency, so pregnant women are prescribed to take them in high dosages.

After 40 years, folic acid becomes even more important for a woman. This happens because the physiological process of hormonal changes in the body begins. Particularly important is the fact that the secretion of estrogens, which supported the activity of not only the reproductive organs, but also the rest of the body, decreases. The benefits of vitamin B9 are associated with its estrogen-like effect.

How does folate deficiency manifest?

Folates do not accumulate in the body, so they need to be replenished every day. More than half of women suffer from their deficiency. Most often this is due to:

• deficiency of vitamin B9 in the diet, since during heat treatment of foods it is almost completely destroyed;
• high need for folic acid during certain periods of life (during growth, pregnancy, menopause);
• impaired absorption of folate in the intestine in various diseases of the digestive system.

The first symptoms of deficiency are decreased appetite, lethargy, weakness, and inability to perform daily duties. Mood is also disturbed; the extreme manifestation of this symptom is depression. Irritable weakness, tearfulness, insomnia at night and drowsiness during the day appear.

Long-term deficiency of vitamin B9 leads to the development of megaloblastic anemia. The condition is associated with impaired maturation of red blood cells - erythrocytes. Immature giant red blood cells are called megaloblasts and do not cope with their transfer function to the organs and tissues of the body.

The disease manifests itself in the form of loss of appetite, nausea, vomiting, diarrhea, and shortness of breath. Stomatitis often develops in the mouth - aphthous ulcers appear, gums bleed, hair falls out, nails become dull and brittle, memory and the ability to absorb new knowledge and skills are impaired.

All about vitamin B9 - in one video

What is the danger of hypovitaminosis B9 for women?

In children and adolescents, vitamin deficiency manifests itself in stunted growth and sexual development. In the second half of a woman’s life, it can manifest itself in the form of early menopause. Sometimes menopause begins on time (after 40 years), but occurs with a number of unpleasant symptoms, then they talk about menopausal syndrome, which can develop against the background of folate deficiency.

The most dangerous is hypovitaminosis B9 during pregnancy. It is needed for the development of fetal nerve cells, which not only divide very quickly, but also acquire a certain specialization - differentiate.

The deficiency is manifested by signs of impaired brain development in the fetus, which can be seen on ultrasound: swelling of the brain, an increase in the size of the head (hydrocephalus), underdevelopment or complete absence of the brain (microcephaly or anencephaly), the appearance of a crack in the spine when the fetal spinal cord and it leaves the nerves uncovered (spina bifida), etc.

Sometimes the changes are not visible, but after birth the child lags behind in neuropsychic development. Against the background of vitamin B9 deficiency, other anomalies (heart defects, etc.) may form in the fetus.

Disturbances in the structure and function of the placenta are also possible. This can result in miscarriage and malnutrition of the fetus, resulting in damage to the brain.

What is the danger of an excess of antianemic vitamin?

If vitamins enter the body with food, an overdose is almost impossible. It is dangerous to take medications and dietary supplements containing folate for a long time.

Excess folate will cause vitamin B12 deficiency. This manifests itself in the development of anemia and peripheral nerve diseases. Symptoms of folic acid overdose:

• nausea, vomiting, diarrhea, abdominal pain, unpleasant metallic taste in the mouth;
• the appearance of increased anxiety, nervous excitability;
• insomnia;
• various types of skin rashes;
• acute paroxysmal pain in the heart.

With an excess of folic acid, the risk of rapid progression of tumor processes also increases, since all rapidly dividing cells need folic acid. If there is no tumor, folates prevent its development, but already in a precancer state they stimulate tumor growth.

Folic acid for women after 40 years

Between the ages of 40 and 45, the menopause begins. This condition is also called perimenopause and is divided into 3 periods: premenopause (from the onset of menopause to the last menstruation), menopause (last menstruation) and postmenopause (after menopause).

Menopause is accompanied by emotional disorders, instability of blood pressure (BP), frequent hot flashes, etc. Metabolism is disrupted, which manifests itself in postmenopause in the form of osteoporosis, atherosclerosis and associated pathology.

Why do women need folic acid after 45:

• due to estrogen-like properties - it has an effect similar to the female sex hormones estrogens; this property allows, if not eliminate, then significantly smooth out such symptoms of premenopause as hot flashes, sweating, changes in blood pressure, palpitations, etc.;
• increases mental and physical performance, improves mood, eliminates depression; this happens because B9 is involved in the exchange of neurotransmitters (substances through which nerve impulses are transmitted) such as the stress hormone adrenaline and the happiness hormone serotonin;
• suppresses skin aging, reduces dry mucous membranes.

Why do women over 50 need folic acid?

• B9 has anti-atherosclerotic properties - normalizes cholesterol metabolism, prevents the deposition of atherosclerotic plaques and related circulatory diseases;
• prevents osteoporosis;
• stimulates the synthesis of blood cells;
• stimulates the functioning of the immune system, thereby suppressing infections and oncological processes.

Vitamin B9 for women's health

The benefits of folate for a woman are invaluable: children and adolescents grow, their cells divide rapidly. With a deficiency of folic acid, a girl lags behind in physical, mental and sexual development.

The influence of B9 on a woman of fertile age is enormous. Under its influence, the neuroendocrine system functions correctly, the condition of which determines the health and appearance of a woman. During pregnancy, it is needed to bear the fetus.

When the physiological process of aging begins, folates reduce the symptoms of menopause. After 50 years, folic acid for women is a protection against the consequences of metabolic disorders such as osteoporosis, atherosclerosis, type 2 diabetes, etc.

Folic acid is produced in 1 mg tablets. For treatment, doctors prescribe large dosages of medication (up to 5 mg per day). For prevention, 200 mcg per day (a fifth of a tablet) is sufficient. You need to take the vitamin once a day.

Folic acid and beauty

Vitamin B9 preserves the beauty and youth of a woman. Skin epithelial cells are constantly renewed, the skin rejuvenates. Reproduction of epithelial cells occurs by division with the participation of folic acid.

B9 is also involved in protein metabolism, as a result of which collagen and elastin proteins are formed in fibrocytes (connective tissue cells located in the deep layers of the skin), giving the skin a firm, fresh appearance and elasticity.

How much folic acid does a woman need?

Women's daily requirement for folic acid:

• 11 – 14 years – 150 mcg;
• 15 years and over forty years – 200 mcg;
• pregnant women – 400 mcg;
• nursing mothers – 300 mcg.

Interaction of folic acid with vitamins and minerals

Taking folic acid goes well with most vitamins and minerals. But before you start taking vitamins, you should consult your doctor and find out their compatibility. Compatibility of B9 with other vitamins and minerals:

• B12 (cyanocobalamin) – combines perfectly, complementing the action (but with long-term use folic acid deficiency develops cyanocobalamin and, as a result, severe pernicious anemia);
• B6 (pyridoxine) – combines well and helps prevent atherosclerosis; long-term B6 deficiency leads to B9 deficiency;
• B3 (nicotine, PP) – compatible;
• C (ascorbic acid) – combines well; B9 is better absorbed with ascorbic acid;
• E (tocopherol) – neutral combination;
• A (retinol) – neutral combination;
• D (calciferol) – neutral combination.

Folic acid is not compatible with:

• B2 (riboflavin) - with this combination, B9 quickly decomposes;
• zinc - an insoluble precipitate is formed that is not absorbed into the blood.

What foods contain B9?

The peculiarity of folates contained in products is that it is impossible to overdose. Therefore, during menopause, you need to have the following products in your diet:

• garden greens, especially parsley (115 mcg/100 g), dill and leeks, asparagus (260 mcg/100 g);
• vegetables - cabbage (30 mcg/100 g), carrots, pumpkin, beets, tomatoes (45 mcg/100 g);
• legumes – beans, lentils, beans (160 mcg/100 g);
• cereals – wheat (50 mcg/100g), rye, buckwheat, corn;
• nuts – most in peanuts (240 mcg/100 g);
• seeds - sunflower, pumpkin, sesame;
• fruits – most in citrus fruits (30 mcg/100 g);
• berries – raspberries, currants, strawberries, watermelons (30 mcg/100 g);
• animal liver (up to 240 mcg/100 g);
• fish liver;
• eggs.

Vitamin B9 is essential for a woman's body. Women especially need this vitamin during pregnancy and menopause. It protects women from the unpleasant symptoms of menopause and from the consequences of metabolic disorders characteristic of this period.