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Folic acid

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VOL: 102, ISSUE: 21, PAGE NO: 29

GENERIC AND PROPRIETARY NAMES

- Folic acid.

- Lexpec.

- Folicare.

- Several combined iron and folic acid preparations are available.

ACTION

- Folic acid is a water-soluble vitamin in the B-complex group.

- Folic acid is essential for the activity of several enzymes.

- It is required for the manufacture of nucleic acids and therefore for growth and reproduction, as well as the formation of red blood cells and the function of the central nervous system.

CLASSIFICATION

- Nutrition and blood.

- Vitamin B-complex group.

CAUTION

- Pregnancy.

INDICATIONS

- Women planning pregnancy.

- Chronic haemolytic states.

- Renal dialysis.

- Sickle cell anaemia.

- With vitamin B12 in the treatment of megaloblastic anaemia. 

CONTRAINDICATIONS

- Folic acid should not be used in undiagnosed megaloblastic anaemia unless vitamin B12 is administered concurrently, otherwise neuropathy may be precipitated.

SIDE-EFFECTS

- Toxicity does not normally result from excessive folic acid intake, as folic acid is water-soluble and regularly excreted by the body.

ADMINISTRATION

- Tablets.

- Syrup.

NURSING CONSIDERATIONS

- The use of vitamins as general pick-me-ups is of unproven value and, in the NHS, they should only be prescribed to prevent or to treat deficiency.

- Most causes of folate deficiency are self-limiting and therefore folic acid has few indications for long-term use.

- Women who are planning a pregnancy should be advised to take folic acid daily before conception to prevent occurrence of neural tube defects.

- Women who are receiving antiepileptic therapy need individual counselling before starting folic acid.

- Women who have not been taking folic acid supplements and who suspect they are pregnant should start at once.

- A woman is at higher risk of having a baby with a neural tube defect if she has previously had a child with a neural tube defect; if she has a neural tube defect herself; if her partner or a first-degree relative has a neural tube defect; or if she has coeliac disease or epilepsy. In these cases higher doses of folic acid are recommended.

PATIENT TEACHING

- A varied diet that contains fresh fruit and vegetables usually provides sufficient folic acid.

- Folic acid supplements should be continued until the 12th week of pregnancy.

- Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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