Indications

B-9 is indicated for the treatment of:

• B-9 (folic acid) deficiency.
• Megaloblastic anemia.
• Anemia of nutritional origins, pregnancy, infancy, or childhood.

Pharmacology

Folic acid, which is biologically inactive, is converted in the body to its active forms, such as tetrahydrofolic acid and methyltetrahydrofolate. These active forms are essential for maintaining normal red blood cell production (erythropoiesis), synthesizing nucleic acids (purine and thymidylate), interconverting amino acids, and other metabolic processes. With vitamin B12 as a cofactor, folic acid can also help normalize high homocysteine levels by converting it back into methionine.

Dosage & Administration

• Adults:
  • Initially: 5 mg daily for 4 months.
  • Maintenance: 5 mg every 1-7 days, depending on the underlying condition.
• Children:
  • Up to 1 year: 500 mcg/kg daily.
  • Over 1 year: The dose is the same as for adults.

Interaction

No interactions have been reported.

Contraindications

Folic acid is contraindicated in patients with a history of intolerance to the drug.

Side Effects

B-9 is generally well-tolerated. Gastrointestinal disturbances may occur, and hypersensitivity reactions have been reported rarely.

Pregnancy & Lactation

No special precautions are known for use during pregnancy and lactation.

Precautions & Warnings

• B-9 should be used with caution in patients who may have folate-dependent tumors.
• It should never be given alone for the treatment of undiagnosed megaloblastic anemia, especially if it is due to a vitamin B12 deficiency. Although B-9 may improve blood cell counts in these cases, it can mask the B12 deficiency and potentially lead to subacute combined degeneration of the spinal cord.
• In elderly people, a cobalamin absorption test should be performed before long-term folate treatment to rule out vitamin B12 deficiency.

Therapeutic Class

B-9 is classified as a drug for megaloblastic anemia and a vitamin-B preparation.

Storage Conditions

Store below 30°C in a dry place, away from light. Keep out of the reach of children.