Acute diarrhea can damage the lining of the intestine. Folic acid can help repair this damage.

In one preliminary trial, supplementing with very large amounts of folic acid (5 mg three times per day for several days) shortened the duration of acute infectious diarrhea by 42%.34 However, a double-blind trial failed to show any positive effect with the same level of folic acid.35 Therefore, evidence that high levels of folic acid supplementation will help people with infectious diarrhea remains weak.
35. Ashraf H, Rahman MM, Fuchs GJ, Mahalanabis D. Folic acid in the treatment of acute watery diarrhoea in children: a double-blind, randomized, controlled trial. Acta Pdiatr 1998;87:11135.

Vitamin B9 - folic acid - is required for

Folic acid is required for DNA synthesis and cell growth and is important for red blood cell formation, energy production as well as the forming of amino acids. Folic acid is essential for creating heme, the iron containing substance in hemoglobin, crucial for oxygen transport. It is important for healthy cell division and replication, since its involvement as coenzyme for RNA and DNA synthesis. It is also required for protein metabolism and in treating folic acid anemia. Folic acid also assists in digestion, and the nervous system, and works at improving mental as well as emotional health. This nutrient may be effective in treating depression and anxiety. Shortage of folic acid may be indicated with diarrhea, heartburn and constipation. Folic acid is very important in the development of the nervous system of a developing fetus.

Deficiency of vitamin B9
A deficiency of folic acid on an unborn baby may increase the risk of the baby being born with spina bifida and other serious defects of the nervous system. When deficient of folic acid, you might suffer from fatigue, acne, a sore tongue, cracking at the corners of your mouth (same as deficiency of vitamin B2, vitamin B6 as well as iron). Long term deficiency may result in anemia and later in osteoporosis, as well as cancer of the bowel and cervix.

Dosage
The dosage underneath is the Recommended Dietary Allowance (RDA), but be aware that this dosage is the minimum that you require per day, to ward off serious deficiency of this particular nutrient. In the therapeutic use of this nutrient, the dosage is usually increased considerably, but the toxicity level must be kept in mind. 400 micrograms per day.

Toxicity and symptoms of high intake

Anybody on medication for epilepsy should be careful with large amounts of folic acid, since it can change the functioning of such drugs. Too much folic acid may mask a Vitamin B12 deficiency. Regular high intake of folic acid may cause digestive upset, energy loss and insomnia.

Best used with

Folic acid is more effective when taken with the B group vitamins especially vitamin B12 and vitamin B6. Vitamin C is also good to have around folic acid.

When more may be required

Pregnant women are sometimes advised to take a small supplement of folic acid to help prevent spina bifida and other congenial nervous disorders, and may also assist to reduce the risk of toxemia in pregnancy, premature labor and hemorrhaging. It is also thought to enhance the production of milk after delivery. Sufferers of psoriasis may consider taking extra folic acid, people under stress or anyone consuming alcohol. Women on birth control pills or busy with hormone replacement therapy may benefit from folic acid, as well as children if they are on goats milk instead of cows milk.

Enemy of vitamin B9 - folic acid

Light, heat and storage for extended periods can destroy this vitamin.

Other interesting points

Localized deficiencies of folic acid may exist for smokers, as low levels have been detected in the lungs of smokers.

Food sources of vitamin B9

Fresh green vegetables, such as spinach and broccoli contain folic acid. It is also found in fruit, starchy vegetables, beans, whole grains and liver.

olic Acid
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Dosage Form: tablets Folic Acid TABLETS, USP

Folic Acid Description

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Folic Acid, N-[p-[[(2-amino-4-hydroxy-6-pteridinyl) methyl]-amino] benzoyl]-L-glutamic acid, is a B complex vitamin containing a pteridine moiety linked by a methylene bridge to para-aminobenzoic acid, which is joined by a peptide linkage to glutamic acid. Conjugates of Folic Acid are present in a wide variety of foods, particularly liver, kidneys, yeast, and leafy green vegetables. Commercially available Folic Acid is prepared synthetically. Folic Acid occurs as a yellow or yellowish-orange crystalline powder and is very slightly soluble in water and insoluble in alcohol. Folic Acid is readily soluble in dilute solutions of alkali hydroxides and carbonates, and solutions of the drug may be prepared with the aid of sodium hydroxide or sodium carbonate, thereby forming the soluble sodium salt of Folic Acid (sodium folate). Aqueous solutions of Folic Acid are heat sensitive and rapidly decompose in the presence of light and/or riboflavin; solutions should be stored in a cool place protected from light. The structural formula of Folic Acid is as follows:

C19H19N7O6 441.40

M.W.

Each tablet, for oral administration, contains 1 mg Folic Acid. Folic Acid Tablets USP 1 mg contain the following inactive ingredients: lactose monohydrate, microcrystalline cellulose, sodium starch glycolate and stearic acid.

Folic Acid - Clinical Pharmacology

Folic Acid acts on megaloblastic bone marrow to produce a normoblastic marrow. In man, an exogenous source of folate is required for nucleoprotein synthesis and the maintenance of normal erythropoiesis. Folic Acid is the precursor of tetrahydrofolic acid, which is involved as a cofactor for transformylation reactions in the biosynthesis of purines and thymidylates of nucleic acids. Impairment of thymidylate synthesis in patients with Folic Acid deficiency is thought to account for the defective deoxyribonucleic acid (DNA) synthesis that leads to megaloblast formation and megaloblastic and macrocytic anemias. Folic Acid is absorbed rapidly from the small intestine, primarily from the proximal portion. Naturally occurring conjugated folates are reduced enzymatically to Folic Acid in the gastrointestinal tract prior to absorption. Folic Acid appears in the plasma approximately 15 to 30 minutes after an oral dose; peak levels are generally reached within 1 hour. After intravenous administration, the drug is rapidly cleared from the plasma. Cerebrospinal fluid levels of Folic Acid are several times greater than serum levels of the drug. Folic Acid is metabolized in the liver to 7,8-dihydroFolic Acid and eventually to 5,6,7,8tetrahydrofolic acid with the aid of reduced diphosphopyridine nucleotide (DPNH) and folate reductases. TetrahydroFolic Acid is linked in the N5 or N10 positions with formyl, hydroxymethyl, methyl, or formimino groups. N5-formyltetrahydroFolic Acid is leucovorin. TetrahydroFolic Acid derivatives are distributed to all body tissues but are stored primarily in the liver. Normal serum levels of total folate have been reported to be 5 to 15 ng/mL; normal cerebrospinal fluid levels are approximately 16 to 21 ng/mL. Normal erythrocyte folate levels have been reported to range from 175 to 316 ng/mL. In general, folate serum levels below 5 ng/mL indicate folate deficiency, and levels below 2 ng/mL usually result in megaloblastic anemia. After a single oral dose of 100 g of Folic Acid in a limited number of normal adults, only a trace amount of the drug appeared in the urine. An oral dose of 5 mg in 1 study and a dose of 40 g/kg of body weight in another study resulted in approximately 50% of the dose appearing in the urine. After a single oral dose of 15 mg, up to 90% of the dose was recovered in the urine. A majority of the metabolic products appeared in the urine after 6 hours; excretion was generally complete within 24 hours. Small amounts of orally administered Folic Acid have also been recovered in the feces. Folic acid is also excreted in the milk of lactating mothers.

Indications and Usage for Folic Acid

Folic Acid is effective in the treatment of megaloblastic anemias due to a deficiency of Folic Acid (as may be seen in tropical or nontropical sprue) and in anemias of nutritional origin, pregnancy, infancy, or childhood.

Contraindications
Folic Acid is contraindicated in patients who have shown previous intolerance to the drug.

Warnings
Administration of Folic Acid alone is improper therapy for pernicious anemia and other megaloblastic anemias in which vitamin B12 is deficient.

Precautions
General

Folic Acid in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurologic manifestations remain progressive. There is a potential danger in administering Folic Acid to patients with undiagnosed anemia, since Folic Acid may obscure the diagnosis of pernicious anemia by alleviating the hematologic manifestations of the disease while allowing the neurologic complications to progress. This may result in severe nervous system damage before the correct diagnosis is made. Adequate doses of vitamin B12 may prevent, halt, or improve the neurologic changes caused by pernicious anemia.
Drug Interactions

There is evidence that the anticonvulsant action of phenytoin is antagonized by Folic Acid. A patient whose epilepsy is completely controlled by phenytoin may require increased doses to prevent convulsions if Folic Acid is given. Folate deficiency may result from increased loss of folate, as in renal dialysis and/or interference with metabolism (e.g., Folic Acid antagonists such as methotrexate); the administration of anticonvulsants, such as diphenylhydantoin, primidone, and barbiturates; alcohol consumption and especially, alcoholic cirrhosis; and the administration of pyrimethamine and nitrofurantoin. False low serum and red cell folate levels may occur if the patient has been taking antibiotics, such as tetracycline, which suppress the growth of Lactobacillus casei.
Carcinogenesis, Mutagenesis, Impairment of Fertility

Long-term studies in animals to evaluate carcinogenic potential and studies to evaluate the mutagenic potential or effect on fertility have not been conducted.
Pregnancy Teratogenic Effects

Pregnancy Category A Folic Acid is usually indicated in the treatment of megaloblastic anemias of pregnancy. Folic acid requirements are markedly increased during pregnancy, and deficiency will result in fetal damage (see INDICATIONS AND USAGE).

Studies in pregnant women have not shown that Folic Acid increases the risk of fetal abnormalities if administered during pregnancy. If the drug is used during pregnancy, the possibility of fetal harm appears remote. Because studies cannot rule out the possibility of harm, however, Folic Acid should be used during pregnancy only if clearly needed.
Nursing Mothers

Folic Acid is excreted in the milk of lactating mothers. During lactation, Folic Acid requirements are markedly increased; however, amounts present in human milk are adequate to fulfill infant requirements, although supplementation may be needed in low-birthweight infants, in those who are breast-fed by mothers with folic acid deficiency (50 g daily), or in those with infections or prolonged diarrhea.

Adverse Reactions
Allergic sensitization has been reported following both oral and parenteral administration of folic acid. Folic Acid is relatively nontoxic in man. Rare instances of allergic responses to Folic Acid preparations have been reported and have included erythema, skin rash, itching, general malaise, and respiratory difficulty due to bronchospasm. One patient experienced symptoms suggesting anaphylaxis following injection of the drug. Gastrointestinal side effects, including anorexia, nausea, abdominal distention, flatulence, and a bitter or bad taste, have been reported in patients receiving 15 mg Folic Acid daily for 1 month. Other side effects reported in patients receiving 15 mg daily include altered sleep patterns, difficulty in concentrating, irritability, overactivity, excitement, mental depression, confusion, and impaired judgment. Decreased vitamin B12 serum levels may occur in patients receiving prolonged Folic Acid therapy. In an uncontrolled study, orally administered Folic Acid was reported to increase the incidence of seizures in some epileptic patients receiving Phenobarbital, primidone, or diphenylhydantoin. Another investigator reported decreased diphenylhydantoin serum levels in folate-deficient patients receiving diphenylhydantoin who were treated with 5 mg or 15 mg of Folic Acid daily.

Overdosage
Except during pregnancy and lactation, Folic Acid should not be given in therapeutic doses greater than 0.4 mg daily until pernicious anemia has been ruled out. Patients with pernicious anemia receiving more than 0.4 mg of Folic Acid daily who are inadequately treated with vitamin B12 may show reversion of the hematologic parameters to normal, but neurologic manifestations due to vitamin B12 deficiency will progress. Doses of Folic Acid exceeding the Recommended Dietary Allowance (RDA) should not be included in multivitamin preparations; if therapeutic amounts are necessary, Folic Acid should be given separately.

Folic Acid Dosage and Administration

Oral administration is preferred. Although most patients with melabsorption cannot absorb food folates, they are able to absorb Folic Acid given orally. Parenteral administration is not advocated but may be necessary in some individuals (e.g., patients receiving parenteral or enteral alimentation). Doses greater than 0.1 mg should not be used unless anemia due to vitamin B12 deficiency has been ruled out or is being adequately treated with a cobalamin. Daily doses greater than 1 mg do not enhance the hematologic effect, and most of the excess is excreted unchanged in the urine. The usual therapeutic dosage in adults and children (regardless of age) is up to 1 mg daily. Resistant cases may require larger doses. When clinical symptoms have subsided and the blood picture has become normal, a daily maintenance level should be used, i.e., 0.1 mg for infants and up to 0.3 mg for children under 4 years of age, 0.4 mg for adults and children 4 or more years of age, and 0.8 mg for pregnant and lactating women, but never less than 0.1 mg/day. Patients should be kept under close supervision and adjustment of the maintenance level made if relapse appears imminent. In the presence of alcoholism, hemolytic anemia, anticonvulsant therapy, or chronic infection, the maintenance level may need to be increased.

How is Folic Acid Supplied

Folic Acid Tablets USP 1 mg are 10/32, scored, round, yellow tablets imprinted DAN DAN and 5216 supplied in bottles of 100 and 1000.

NDC 15338-170-00 Folic Acid Tablets, USP

1 mg 100 Tablets Rx Only Each Tablet Contains: 1 mg Folic Acid, USP Dispense in a well - closed container with child resistant closure. Store at 20- 25C (68- 77F). [See USP controlled room temperature.] USUAL DOSAGE: See drug product literature

Folic Acid Folic Acid tablet Product Information HUMAN PRESCRIPTION DRUG ORAL 15338-170 (0591-5216)

Product Type

NDC Product Code (Source)

Route of Administration

DEA Schedule

Active Ingredient/Active Moiety Ingredient Name Folic Acid (Folic Acid) Inactive Ingredients Ingredient Name LACTOSE MONOHYDRATE CELLULOSE, MICROCRYSTALLINE SODIUM STARCH GLYCOLATE TYPE A POTATO STEARIC ACID Strength Basis of Strength Folic Acid Strength 1 mg

Product Characteristics Color Shape Flavor Contains Packaging # NDC 1 15338-17000 Package Description 48 BOTTLE In 1 CARTON 100 TABLET In 1 BOTTLE Multilevel Packaging contains a BOTTLE This package is contained within the CARTON (15338170-00) YELLOW ROUND Score Size Imprint Code 2 pieces 8mm DAN;DAN;5216

Marketing Information Marketing Category NDA Application Number or Monograph Citation NDA080680 Marketing Start Date 12/23/2009 Marketing End Date

Labeler - Apace Packaging (361961142) Establishment Name Apace Packaging Establishment Name Watson Laboratories, Inc. Revised: 12/2009Apace Packaging Address ID/FEI 840054118 Operations MANUFACTURE Address ID/FEI 361961142 Operations REPACK, RELABEL

More Folic Acid resources

Folic Acid Side Effects in More Detail Folic Acid Use in Pregnancy & Breastfeeding Drug Images Folic Acid Drug Interactions Support Group Q & A 0 Reviews for Folic Acid - Add your own review/rating Folic Acid Professional Patient Advice (Wolters Kluwer) Folic Acid Medfacts Consumer Leaflet (Wolters Kluwer) folic acid Concise Consumer Information (Cerner Multum) folic acid Oral, Injection Advanced Consumer (Micromedex) - Includes Dosage Information FA-8 Medfacts Consumer Leaflet (Wolters Kluwer) Detailed Side Effects Pregnancy & Breastfeeding Drug Interactions Drug Images Support Group Q & A

Drug Class vitamins Related Drugs vitamins Vitamin D, Niaspan, niacin, cyanocobalamin, calcitriol, Vitamin B-12 Folic Acid Deficiency Deplin l-methylfolate Zervalx FA-8 Folacin-800 More... Anemia, Megaloblastic leucovorin FA-8 Folacin-800 More...

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Folic Acid Late in Pregnancy Tied to Asthma in Kids 1 Dec 2009

Children born to women who take folic acid in late pregnancy are at increased risk for asthma, Australian researchers say. The University of Adelaide study ... Children (under 18 years old) U.S. Recommended Dietary Allowance (RDA) or Adequate Intake (AI) for children (oral): For infants 0-6 months-old the AI is 65 micrograms per day; for infants 7-12 months-old the AI is 80 micrograms per day; for children 1-3 years-old the RDA is 150 micrograms per day; for children 4-8 years-old the RDA is 200 micrograms per day; for children 9-13 years-old the RDA is 300 micrograms per day. Given as dietary folate equivalents (DFE). Tolerable upper intake levels (UL) per day: The UL is the maximum daily level of intake that is likely not to pose a risk of adverse effects. For children 1-3 years-old the UL is 300 micrograms; for children 4-8 years-old the UL is 400 micrograms; for children 9-13 years-old the UL is 600 micrograms; for adolescents 14-18 years-old the UL is 800 micrograms. Caution: Folic acid injection contains benzyl alcohol (1.5%) as a preservative and extreme care should be used in administration to neonates. Folic acid injections should be administered by a qualified healthcare provider.

Nutritional supplements that may be helpful: Acute diarrhea can damage the lining of the intestine. Folic acid helps repair this damage. Supplementing with large amounts of folic acid (5,000 mcg, three times per day for several days) has been shown to shorten the duration of acute infectious diarrhea by 42%.6 These larger amounts are probably needed because diarrhea can cause malabsorption problems. However, folic acid should not routinely be taken in amounts greater than 800 mcg per day.
6. Haffejee IE. Effect of oral folate on duration of acute infantile diarrhoea. Lancet 1988;ii:334-5 (letter).

PEDIATRICS Vol. 33 No. 5 May 1964, pp. 694-699 This Article

Full Text (PDF)

STUDIES ON FOLIC ACID IN INFANCY

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II. Folic and Folinic Acid Blood Levels in Infants With Alert me if a correction is posted Diarrhea, Malnutrition, and Infection Yehuda Matoth M.D.1, Rina Zamir M.Sc.1, Shulamith BarShani M.D.1, , Nathan Grossowicz Ph.D.1 Services
1

Department of Pediatrics, Sharon Hospital and the Laboratory for Pediatric Research of the Rogoff Medical Research Institute, Beilinson Medical Center, Petah Tikva, and the Department of Bacteriology, Hebrew UniversityHadassah Medical School, Jerusalem, Israel.

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Folic acid was assayed microbiologically in whole blood in a Alert me to new issues of the journal group of infants hospitalized for diarrhea, various infections, and malnutrition. Folic acid activity was Add to My File Cabinet decreased in the majority of cases. In some of the infants very low levels were observed. The value of the Download to citation manager determination of folic acid in whole blood as a sensitive index of the folic acid status of an individual was confirmed Request Permissions by parallel observations on bone marrow morphology and the level of folic acid in serum. Folinic acid levels were within the normal range in most cases. Low folinic acid levels were common only when folic acid was extremely low. Many patients with low folic acid levels were not anemic, or mildly anemic. In the anemic patients a hypochromic microcytic blood picture was the rule. The effect of treatment with folic acid on the general condition of the patients was more striking than the hematological response.
Submitted on July 6, 1962 Accepted on September 26, 1963

STUDIES IN FO;IC ACID IN INFANCY MATOTH Y, PINKAS A, ZAMIR R, MOOALLEM F, GROSSOWICZ N. Pediatrics. 1964 Apr;33:507-11. No abstract available. PMID: 14166530 [PubMed - indexed for MEDLINE]Related articles

FOLIC ACID DEF IN INFANTILE GASTRO ENTERITIS

FRIEDMAN R, MCKENZIE D, TURNER T, WITTMANN W. S Afr J Lab Clin Med. 1964 Sep 19;10:69-73. No abstract available. PMID: 14211185 [PubMed indexed for MEDLINE]Related articles

FOLATE MALNUTRITION IN TROPICAL DIARRHEA Tomkins AM. Trans R Soc Trop Med Hyg. 1979;73(5):498-502. Review. No abstract available. PMID: 394409 [PubMed - indexed for MEDLINE]

8.
[Diarrhea and infant malnutrition] Ariztia A. Rev Med Chil. 1972 Oct;100(10):1293-7. Spanish. No abstract available. PMID: 4652720 [PubMed indexed for MEDLINE]Related articl

171.
[Infantile diarrhea and malnutrition] Graham GG, Baertl JM, Cordano A. Bol Oficina Sanit Panam. 1966 Jan;60(1):46-50. Spanish. No abstract available. PMID: 4221314 [PubMed - indexed for MEDLINE]Related articles

Folinic acid requirment of strains of the genus Pedicoccus. GARVIE EI, GREGORY ME. Nature. 1961 May 6;190:563-4. No abstract available. PMID: 13703797 [PubMed - indexed for MEDLINE]Related articles