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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Folic Acid
Generic Name
Folic Acid
Active Ingredient
Folic AcidCategory
Vitamin C [EPC]
Variants
56
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 1 mg/1 | TABLET | ORAL | 62135-210 |
| 1 mg/1 | TABLET | ORAL | 71610-235 |
| 1 mg/1 | TABLET | ORAL | 72162-2556 |
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Folic Acid, you must consult a qualified healthcare professional.
| 5 mg/mL | INJECTION, SOLUTION | INTRAMUSCULAR, INTRAVENOUS, SUBCUTANEOUS | 63323-184 |
| 1 mg/1 | TABLET | ORAL | 68071-4602 |
| 1 mg/1 | TABLET | ORAL | 70752-231 |
| 1 mg/1 | TABLET | ORAL | 71335-0613 |
| 1 mg/1 | TABLET | ORAL | 82804-110 |
| 1 mg/1 | TABLET | ORAL | 0615-8589 |
| 1 mg/1 | TABLET | ORAL | 68071-3513 |
| 1 mg/1 | TABLET | ORAL | 50090-3119 |
| 1 mg/1 | TABLET | ORAL | 58657-151 |
+ 38 more variants
Detailed information about Folic Acid
Folic acid is a synthetic B-complex vitamin (B9) essential for DNA synthesis and red blood cell production, primarily used to treat folate deficiency and prevent neural tube defects.
The dosage of folic acid varies significantly based on the condition being treated and the patient's nutritional status.
Folic acid is approved for use in children, but doses must be carefully calibrated by a pediatrician based on age and weight.
Patients with chronic kidney disease (CKD), particularly those on hemodialysis, often lose water-soluble vitamins during the dialysis process. Healthcare providers typically prescribe 1 mg of folic acid daily to these patients to prevent deficiency and manage homocysteine levels. No specific downward adjustment is usually required as the drug is generally non-toxic at standard doses.
No specific dosage adjustments are mandated for patients with liver disease. However, because the liver is the primary site of folate storage and metabolism, patients with severe cirrhosis or hepatitis may require closer monitoring of their folate status.
In the elderly, the primary concern is not the toxicity of folic acid itself, but its ability to mask a Vitamin B12 deficiency (pernicious anemia). Healthcare providers usually ensure B12 levels are checked before starting high-dose folic acid in older adults.
To ensure maximum efficacy, follow these administration guidelines:
If you miss a dose of folic acid, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular dosing schedule. Do not double the dose to catch up, as this increases the risk of minor side effects.
Folic acid is a water-soluble vitamin, meaning excess amounts are usually excreted in the urine. Therefore, acute toxicity is extremely rare. However, massive doses (over 15 mg per day) may lead to:
In the event of a suspected massive overdose, contact your local poison control center or seek emergency medical care immediately.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance, especially if you are taking it for pregnancy or to manage a chronic blood disorder.
Folic acid is remarkably well-tolerated by the vast majority of patients. Because it is a substance naturally required by the body, 'common' side effects in the traditional sense are rare at standard doses (400 mcg to 1 mg). However, some patients may experience:
These effects are more likely to occur with higher therapeutic doses (5 mg or more):
The most critical warning regarding folic acid is its relationship with Vitamin B12. Folic acid should never be used as the sole treatment for megaloblastic anemia unless Vitamin B12 deficiency has been definitively ruled out. While folic acid will correct the hematological abnormalities (the low red blood cell count), it will not prevent—and may actually accelerate—the progression of subacute combined degeneration of the spinal cord associated with B12 deficiency. This can lead to permanent neurological damage.
No FDA black box warnings for Folic Acid. It is generally recognized as safe (GRAS) for its intended uses in supplementation and fortification.
There are no absolute 'do not use' contraindications involving folic acid that result in immediate fatality; however, the following combination is strongly discouraged due to therapeutic failure:
Folic acid must NEVER be used in the following circumstances:
These conditions require a careful risk-benefit analysis by a physician:
Folic acid is perhaps the most critical nutrient during the early stages of pregnancy. It is classified as FDA Pregnancy Category A, meaning adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester, and there is no evidence of risk in later trimesters.
Folate is naturally excreted into human breast milk. Supplementation with folic acid is generally considered safe and even recommended for breastfeeding mothers to maintain their own health and ensure the infant receives adequate folate for growth. No adverse effects have been observed in nursing infants whose mothers were taking standard doses of folic acid.
Folic acid is the synthetic precursor to various folate coenzymes. Once ingested, it is reduced by the enzyme dihydrofolate reductase (DHFR) into dihydrofolic acid and then into tetrahydrofolic acid (THF). THF is the active 'shuttle' for one-carbon units.
Specifically, it acts in the following ways:
Common questions about Folic Acid
Folic acid is primarily used to treat and prevent folate deficiency, which can lead to a type of anemia called megaloblastic anemia. It is also critically important for women who are pregnant or planning to become pregnant, as it helps prevent major birth defects of the baby's brain and spine, known as neural tube defects. Additionally, healthcare providers may prescribe it to help manage the side effects of certain medications like methotrexate used for rheumatoid arthritis. In some cases, it is used to help lower high levels of homocysteine in the blood, which may be linked to heart disease. Always use folic acid under the guidance of a healthcare professional to ensure the correct dosage for your needs.
For most people, folic acid causes very few side effects because it is a vitamin that the body naturally requires. When side effects do occur, they are usually mild and may include nausea, gas, bloating, or a bitter taste in the mouth. Some people taking very high doses might experience sleep problems, irritability, or a general feeling of being unwell. Serious allergic reactions are extremely rare but require immediate medical attention if they occur. If you notice any persistent or bothersome symptoms, you should contact your doctor. Most mild side effects can be managed by taking the supplement with food.
While there is no dangerous 'reaction' between alcohol and folic acid, chronic alcohol use is a major cause of folate deficiency. Alcohol interferes with how your body absorbs folic acid from the gut and increases the amount that is flushed out through your urine. If you are taking folic acid to correct a deficiency or for pregnancy health, drinking alcohol can prevent the supplement from working effectively. It is generally recommended to limit or avoid alcohol consumption while trying to replenish your body's folate stores. Discuss your alcohol intake with your doctor to determine what is safe for your specific health situation.
Yes, folic acid is not only safe but is considered essential during pregnancy. It is classified as FDA Pregnancy Category A, which is the safest rating for medications used during pregnancy. Taking 400 to 800 mcg of folic acid daily before and during early pregnancy can reduce the risk of neural tube defects like spina bifida by up to 70%. Most prenatal vitamins already contain the recommended amount of folic acid. Some women with specific risk factors may be prescribed much higher doses by their obstetrician. It is one of the most important supplements a woman can take for fetal development.
The time it takes for folic acid to work depends on the condition being treated. If you are taking it for anemia, your body will start producing new red blood cells within a few days, but it may take 2 to 4 weeks for your energy levels to improve and several months for your blood counts to fully return to normal. For the prevention of birth defects, folic acid needs to be in your system at least one month before conception to be most effective. If you are taking it to reduce methotrexate side effects, you may notice an improvement within one or two dosing cycles. Consistency is key to seeing the full benefits of the medication.
Yes, you can generally stop taking folic acid suddenly without experiencing withdrawal symptoms, as it is a water-soluble vitamin and not a habit-forming drug. However, if your doctor prescribed it for a specific reason, such as treating a deficiency or supporting a pregnancy, stopping it could cause your folate levels to drop again. This could lead to the return of anemia symptoms or increase the risk of birth defects if you are pregnant. You should always talk to your healthcare provider before stopping any prescribed supplement. They can help you determine if you are getting enough folate from your diet alone.
If you miss a dose of folic acid, simply take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time to make up for the one you missed, as this is unnecessary and could lead to mild stomach upset. Missing a single dose is unlikely to cause any significant health problems, but the supplement works best when taken consistently. Setting a daily reminder on your phone can help you stay on track with your treatment.
There is no clinical evidence to suggest that folic acid causes weight gain. In fact, because folic acid helps your body convert food into energy and supports the health of your red blood cells, it may actually help you feel more active if you were previously fatigued from anemia. Some people might notice a slight increase in appetite as their health improves and their anemia is corrected, which could lead to minor weight changes, but the vitamin itself does not contain calories or promote fat storage. If you experience sudden or unexplained weight gain, you should consult your doctor to find the underlying cause.
Folic acid can interact with several medications, so it is important to be cautious. It can lower the effectiveness of certain seizure medications like phenytoin, and some antibiotics or anti-inflammatory drugs like sulfasalazine can prevent your body from absorbing folic acid properly. Additionally, taking folic acid while on chemotherapy requires strict doctor supervision, as it can interfere with the way some cancer drugs work. Always provide your doctor or pharmacist with a full list of all the medicines, herbs, and supplements you are currently taking. This allows them to check for any potential interactions that could affect your health.
Yes, folic acid is widely available as a generic medication and is typically very affordable. It can be purchased over-the-counter in lower strengths (usually up to 800 mcg) and is also available by prescription in higher strengths (1 mg and above). Generic versions are required by the FDA to have the same active ingredient, strength, and effectiveness as brand-name versions. Whether you choose a store brand or a name brand, the folic acid will work the same way in your body. Most insurance plans cover prescription-strength folic acid if it is deemed medically necessary by your healthcare provider.
Other drugs with the same active ingredient (Folic Acid)
Rarely, patients may develop hypersensitivity or neurological symptoms:
While folic acid is safe, certain reactions require urgent intervention:
> Warning: Stop taking Folic Acid and call your doctor immediately if you experience any of these.
There is ongoing clinical debate regarding the long-term use of very high-dose folic acid supplements (above the Tolerable Upper Intake Level of 1,000 mcg per day for adults). Some observational studies have suggested a potential 'U-shaped' relationship between folate and certain cancers. While folate is protective against DNA damage, excessive synthetic folic acid might theoretically 'fuel' the growth of pre-existing undiagnosed precancerous lesions, particularly in the colon or prostate. However, current consensus from major health organizations like the NIH suggests that standard doses are safe and beneficial for the general population.
No FDA black box warnings for Folic Acid. Folic acid is considered a safe medication when used as directed. Unlike many pharmacological agents, it does not carry a high risk of severe, life-threatening toxicity that would warrant a boxed warning.
Report any unusual symptoms to your healthcare provider. Even mild symptoms that persist should be discussed with a medical professional to ensure they are not related to an underlying condition or a drug interaction.
If you are taking therapeutic doses of folic acid, your healthcare provider may order the following tests:
Folic acid generally does not cause drowsiness or cognitive impairment. It is considered safe to drive or operate heavy machinery while taking this medication. However, if you experience rare side effects like dizziness or irritability, wait until you know how the medication affects you before engaging in these activities.
Chronic alcohol consumption severely interferes with the absorption, utilization, and storage of folic acid. Alcohol acts as a folate antagonist and increases the excretion of folate through the kidneys. Patients taking folic acid to correct a deficiency should limit or avoid alcohol to allow the body to replenish its stores effectively.
Folic acid does not cause physical dependence or a withdrawal syndrome. You can generally stop taking it without a tapering schedule. However, if you are taking it to prevent neural tube defects or to manage a chronic condition like hemolytic anemia, stopping the medication may result in a return of the deficiency or increased health risks. Always consult your doctor before discontinuing a prescribed supplement.
> Important: Discuss all your medical conditions with your healthcare provider before starting Folic Acid, especially if you have a history of anemia, seizures, or recent surgery.
To manage these interactions, healthcare providers often employ a 'monitor and adjust' strategy. This involves regular blood tests to check drug levels (especially for phenytoin) and adjusting the folic acid dose to the minimum required to prevent deficiency while maintaining the efficacy of other medications.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete list helps prevent dangerous interactions and ensures your treatment plan is effective.
There is no significant cross-sensitivity between folic acid and other unrelated drug classes. However, patients who are sensitive to other B-complex vitamins (like Thiamine or Pyridoxine) should be monitored for similar hypersensitivity reactions when starting folic acid, as the manufacturing processes for these vitamins often overlap.
> Important: Your healthcare provider will evaluate your complete medical history, including any previous allergic reactions and your family history of anemia, before prescribing Folic Acid. Never start this medication if you have an unexplained 'tingling' sensation in your extremities until a B12 deficiency is ruled out.
Folic acid is safe and effective for children when used to treat folate deficiency or as part of a nutritional program. It is commonly included in pediatric multivitamins. However, it is not approved for the 'enhancement' of growth in children who are already nutritionally sufficient. Over-supplementation in children should be avoided unless directed by a pediatrician.
The primary concern in patients over age 65 is the high prevalence of atrophic gastritis, which reduces the absorption of Vitamin B12. Because the elderly are at higher risk for B12 deficiency, the risk of folic acid 'masking' this deficiency is much greater. Geriatric patients should have their B12 levels screened annually if they are taking folic acid supplements.
In patients with end-stage renal disease (ESRD), folic acid is often lost during dialysis. Supplementation is standard practice. However, since the kidneys are the primary route of excretion for excess folic acid, patients with moderate to severe renal impairment (GFR < 30 mL/min) should avoid massive doses (e.g., >5 mg/day) to prevent potential accumulation.
Patients with liver disease, particularly those with alcoholic cirrhosis, are often severely folate-deficient. Folic acid is a critical part of 'banana bags' (IV vitamin infusions) used in hospitals for these patients. While no specific dose adjustment is needed for the liver disease itself, the underlying malnutrition in these patients often necessitates higher-than-normal doses (1-5 mg daily).
> Important: Special populations, particularly pregnant women and the elderly, require individualized medical assessment. Always consult with a specialist to determine the appropriate dose for your life stage.
The pharmacodynamic effect of folic acid is not immediate. While serum levels rise quickly, the biological effect—such as the improvement of anemia—takes time. A 'reticulocyte response' (the bone marrow's production of new red cells) typically peaks 5 to 10 days after starting therapy. Hemoglobin levels usually begin to rise within 2 weeks and may take 2 months to fully normalize.
| Parameter | Value |
|---|---|
| Bioavailability | 85% - 100% (Synthetic) |
| Protein Binding | ~70% - 90% (to Albumin) |
| Half-life | ~3 hours (Plasma); Weeks (Tissue) |
| Tmax | 1 - 1.5 hours |
| Metabolism | Hepatic (DHFR enzyme) |
| Excretion | Renal (primarily); Biliary |
Folic acid is classified as a Vitamin B Complex Member and a Folate Analog. It is therapeutically categorized as a Hematopoietic Agent because of its role in blood cell production. It shares this class with other agents like Cyanocobalamin (B12) and Erythropoiesis-Stimulating Agents (ESAs), though its mechanism is distinct as a nutritional building block rather than a hormonal stimulant.