Dosing and uses of Folvite (folic acid)
Adult dosage forms and strengths
tablet
- 400mcg
- 800mcg
- 1mg
injectable solution
- 5mg/mL
Nutritional Supplementation
Recommended daily allowance (RDA)
Males: 400 mcg/day PO
Females: 400-800 mcg/day PO
Pregnant women: 600 mcg/day PO
Nursing women: 500 mcg/day PO
Upper limit: 1 mg/day PO
Neural Tube Defects Prophylaxis
Females of childbearing potential: 400 mcg/day PO
Pregnancy women: 600 mcg/day PO
Females with high risk or family history of neural tube defects: 4 mg/day PO
Folic Acid Deficiency
0.4-1 mg PO/IV/IM/SC once daily
Methanol Toxicity
50-75 mg IV q4hr for 24 hr
Methotrexate Toxicity Prophylaxis (Off-label)
1 mg PO qDay; may increase up to 5 mg/day if toxicity emerges
Pediatric dosage forms and strengths
tablet
- 400mcg
- 800mcg
- 1mg
injectable solution
- 5mg/mL
Nutritional Supplementation
RDA
0-6 months: 65 mcg/day PO
7-12 months: 80 mcg/day PO
1-4 years: 150 mcg/day PO
4-9 years: 200 mcg/day PO
9-14 years: 300 mcg/day PO
14-18 years: 400 mcg/day PO
Upper limit: 1-4 years, 300 mcg/day PO; 4-8 years, 400 mcg/day PO
Folic Acid Deficiency
Infants: 15 mcg/kg/day or 50 mcg/day IV/PO/IM/SC
1-10 years: 1 mg/day IV/PO/IM/SC initially, then 0.1-0.4 mg/day
Methanol Toxicity
1 mg/kg IV q4hr for 24 hr
Folvite (folic acid) adverse (side) effects
Frequency not defined
Bronchospasm
Erythema
Malaise
Pruritus
Rash
Slight flushing
Warnings
Contraindications
Hypersensitivity
Cautions
Undiagnosed anemias
May mask anemia at dosages >0.1 mg/day
In presence of vitamin B12 deficiency, not appropriate for monotherapy in pernicious, normocytic, or aplastic anemia
Vials must be protected from heat and light
Injection contains benzyl alcohol as preservative (benzyl alcohol is associated with gasping syndrome in neonates)
Pregnancy and lactation
Pregnancy category: A
Lactation: Drug enters breast milk; safe for nursing
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Folvite (folic acid)
Mechanism of action
Necessary for formation of coenzymes in metabolic systems (purine and pyrimidine synthesis required for maintenance in erythropoiesis); stimulates platelet production in folate deficiency anemia
Enhances elimination of formic acid in methanol toxicity via provision of coenzyme to folate dehydrogenase
Absorption
Absorbed in proximal part of small intestine
Onset: PO, 0.5-1 hr
Metabolism
Metabolized in liver
Elimination
Excretion: Urine
Administration
IV/IM/SC Administration
Administer by IV/IM/SC injection only when PO administration is not feasible or when malabsorption is suspected
Most individuals with malabsorption can absorb oral folic acid
For IM use, administer by deep injection
