FOLIC ACID (VITAMIN B 9) (Systemic)

Some commonly used brand names are:

In the U.S.—

• Folvite

In Canada—

• Apo-Folic
• Folvite
• Novo-Folacid

Generic name product may be available in the U.S. and Canada.

Another commonly used name is Vitamin B 9 .

• Diagnostic aid, folate deficiency
• Nutritional supplement, vitamin

Vitamins (VYE-ta-mins) are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Folic acid (FOE-lik AS-id)(vitamin B 9 ) is necessary for strong blood.

Lack of folic acid may lead to anemia (weak blood). Your health care professional may treat this by prescribing folic acid for you.

Some conditions may increase your need for folic acid. These include:

• Alcoholism
• Anemia, hemolytic
• Diarrhea (continuing)
• Fever (prolonged)
• Hemodialysis
• Illness (prolonged)
• Intestinal diseases
• Liver disease
• Stress (continuing)
• Surgical removal of stomach

In addition, infants smaller than normal, breast-fed infants, or those receiving unfortified formulas (such as evaporated milk or goat's milk) may need additional folic acid.

Increased need for folic acid should be determined by your health care professional.

Some studies have found that folic acid taken by women before they become pregnant and during early pregnancy may reduce the chances of certain birth defects (neural tube defects).

Claims that folic acid and other B vitamins are effective for preventing mental problems have not been proven. Many of these treatments involve large and expensive amounts of vitamins.

Injectable folic acid is given by or under the direction of your health care professional. Another form of folic acid is available without a prescription.

Folic acid is available in the following dosage forms:

• Oral
• Tablets (U.S. and Canada)

• Parenteral
• Injection (U.S. and Canada)

Folic acid is found in various foods, including vegetables, especially green vegetables; potatoes; cereal and cereal products; fruits; and organ meats (for example, liver or kidney). It is best to eat fresh fruits and vegetables whenever possible since they contain the most vitamins. Food processing may destroy some of the vitamins. For example, heat may reduce the amount of folic acid in foods.

Vitamins alone will not take the place of a good diet and will not provide energy. Your body also needs other substances found in food such as protein, minerals, carbohydrates, and fat. Vitamins themselves often cannot work without the presence of other foods.

The daily amount of folic acid needed is defined in several different ways.

• For U.S.—
• Recommended Dietary Allowances (RDAs) are the amount of vitamins and minerals needed to provide for adequate nutrition in most healthy persons. RDAs for a given nutrient may vary depending on a person's age, sex, and physical condition (e.g., pregnancy).
• Daily Values (DVs) are used on food and dietary supplement labels to indicate the percent of the recommended daily amount of each nutrient that a serving provides. DV replaces the previous designation of United States Recommended Daily Allowances (USRDAs).

• For Canada—
• Recommended Nutrient Intakes (RNIs) are used to determine the amounts of vitamins, minerals, and protein needed to provide adequate nutrition and lessen the risk of chronic disease.

Normal daily recommended intakes in micrograms (mcg) for folic acid are generally defined as follows:

Persons

U.S.

(mcg)

Canada

(mcg)

Infants and children

Birth to 3 years of age

25-100

50-80

4 to 6 years of age

75-400

90

7 to 10 years of age

100-400

125-180

Adolescent and adult males

150-400

150-220

Adolescent and adult females

150-400

145-190

Pregnant females

400-800

445-475

Breast-feeding females

260-800

245-275

In deciding to use folic acid, the risks of taking it must be weighed against the good it will do. This is a decision you and your health care professional will make. For folic acid, the following should be considered:

Allergies—Tell your health care professional if you have ever had any unusual or allergic reaction to folic acid. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—It is especially important that you are receiving enough vitamins when you become pregnant and that you continue to receive the right amount of vitamins, especially folic acid, throughout your pregnancy. The healthy growth and development of the fetus depend on a steady supply of nutrients from the mother. However, taking large amounts of a dietary supplement in pregnancy may be harmful to the mother and/or fetus and should be avoided.

Your health care professional may recommend that you take folic acid alone or as part of a multivitamin supplement before you become pregnant and during early pregnancy. Folic acid may reduce the chances of your baby being born with a certain type of birth defect (neural tube defects).

Breast-feeding—It is especially important that you receive the right amounts of vitamins so that your baby will also get the vitamins needed to grow properly. However, taking large amounts of a dietary supplement while breast-feeding may be harmful to the mother and/or baby and should be avoided.

Children—Problems in children have not been reported with intake of normal daily recommended amounts.

Older adults—Problems in older adults have not been reported with intake of normal daily recommended amounts.

Medicines or other dietary supplements—Although certain medicines or dietary supplements should not be used together at all, in other cases they may be used together even if an interaction might occur. In these cases, your health care professional may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other dietary supplement or any prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of folic acid. Make sure you tell your health care professional if you have any other medical problems, especially:

• Pernicious anemia (a type of blood problem)—Taking folic acid while you have pernicious anemia may cause serious side effects. You should be sure that you do not have pernicious anemia before beginning folic acid supplementation

Dosing—The amount of folic acid needed to meet normal daily recommended intakes will be different for different individuals. The following information includes only the average amounts of folic acid.

• For oral dosage form (tablets):
  • To prevent deficiency, the amount taken by mouth is based on normal daily recommended intakes:
    • For the U.S.
    • Adult and teenage males—150 to 400 micrograms (mcg) per day.
    • Adult and teenage females—150 to 400 mcg per day.
    • Pregnant females—400 to 800 mcg per day.
    • Breast-feeding females—260 to 800 mcg per day.
    • Children 7 to 10 years of age—100 to 400 mcg per day.
    • Children 4 to 6 years of age—75 to 400 mcg per day.
    • Children birth to 3 years of age—25 to 100 mcg per day.
    • For Canada
    • Adult and teenage males—150 to 220 mcg per day.
    • Adult and teenage females—145 to 190 mcg per day.
    • Pregnant females—445 to 475 mcg per day.
    • Breast-feeding females—245 to 275 mcg per day.
    • Children 7 to 10 years of age—125 to 180 mcg per day.
    • Children 4 to 6 years of age—90 mcg per day.
    • Children birth to 3 years of age—50 to 80 mcg per day.
  • To treat deficiency:
    • Adults, teenagers, and children—Treatment dose is determined by prescriber for each individual based on the severity of deficiency.

Missed dose—If you miss taking a vitamin for one or more days there is no cause for concern, since it takes some time for your body to become seriously low in vitamins. However, if your health care professional has recommended that you take this vitamin, try to remember to take it as directed every day.

Storage—To store this dietary supplement:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the dietary supplement to break down.
• Do not keep outdated dietary supplements or those no longer needed. Be sure that any discarded dietary supplement is out of the reach of children.

Along with its needed effects, a dietary supplement may cause some unwanted effects. Although folic acid does not usually cause any side effects, check with your health care professional as soon as possible if any of the following side effects occur:

Rare

Other side effects not listed above may also occur in some individuals. If you notice any other effects, check with your health care professional.

Revised: 12/30/1999

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