Folic Acid/Cyanocobalamin/Pyridoxine

DEA Class; Rx

Common Brand Names; Foltx, folic acid/vitamin B12/vitamin B6, Folbic, Virt-Vite Forte

• Vitamins, Combos

Folic acid: Plays a role in the formation of coenzymes involved in purine and pyrimidine synthesis as well as other metabolic systems; required for nucleoprotein synthesis and maintenance of erythropoiesis; enhances metabolism of formic acid, the toxic metabolite of methanol, to nontoxic metabolites

Cyanocobalamin: Plays a role in cell replication and hematopoiesis; coenzyme in protein synthesis as well as fat and carbohydrate metabolism

Pyridoxine: Plays a role in carbohydrate, protein, and fat metabolism; aids in the release of liver and muscle stored glycogen and the synthesis of GABA

Indicated for Daily Dietary Supplement

Hypersensitivity to any component

• Allergic reactions
• Bronchospasm
• Flushing
• Malaise
• Erythema
• Rash
• Paresthesias
• Somnolence
• Unsteady gait
• Diarrhea
• Nausea
• Pruritus
• Urticaria
• Altered sleep patterns
• Irritability
• Peripheral vascular thrombosis
• Polycythemia

Caution in patients with history of bipolar illness; mood elevation possible in this population

Caution in patients taking anticonvulsant medications; folate may interfere with anticonvulsant medication, and may lower seizure threshold; it has been reported that anticonvulsant medications interfere with folate metabolism; exact action is unclear; caution recommended with patients in this therapeutic group

Folinic acid may enhance toxicity of fluorouracil; deaths from severe enterocolitis, diarrhea, and dehydration reported in elderly patients receiving weekly formyl-THF and fluorouracil; concomitant granulocytopenia and fever reported present in some but not all of the patients

Concomitant use of formyl-THF with trimethoprim-sulfamethoxazole for acute treatment of Pneumocystis carinii pneumonia in patients with HIV infection associated with increased rates of treatment failure and mortality in a placebo-controlled study

Patients undergoing cancer treatment should consult their licensed medical practitioner for advice

Folate alone is improper therapy in treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient; folate in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission may occur while neurological manifestations progress

Pregnancy

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Lactation

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Folic acid/cyanocobalamin/pyridoxine

capsule

• 1mg/0.4mg/50mg

tablet

• 2.5mg/1mg/25mg
• 2.3mg/2mg/24.5mg
• 2.2mg/1mg/25mg
• 2.5mg/2mg/25mg
• 2.2mg/0.5mg/25mg
• 0.8mg/0.115mg/10mg