Folic acid is given to treat megaloblastic anemia due to
folic aciddeficiency. This type of anemia usually occurs in patients who have
tropical or nontropical sprue, although it can also result from poor
nutritional intake during pregnancy, infancy, or childhood.
Folic acid is absorbed rapidly in the first third
of the small intes-tine, distributed into all body tissues, and metabolized in
the liver. Excess folate is excreted unchanged in urine, and small amounts of
folic acid are excreted in stool. Folic acid also appears in breast milk.
Synthetic folic acid is readily absorbed, even in malabsorp-tion syndromes
Folic acid is an essential component for normal RBC
production and growth. A deficiency in folic acid results in megaloblastic
ane-mia and low serum and RBC folate levels.
Folic acid is used to treat folic acid deficiency.
Patients who are pregnant or undergoing treatment for liver disease, hemolytic
ane-mia, alcohol abuse, or skin or renal disorders typically need folic acid
supplementation. Serum folic acid levels below 5 ng/ml indi-cate folic acid
Leucovorin is a folic acid derivative used to treat
folic acid de-ficiencies resulting from administration of methotrexate.
sulfasalazine, hormonal contraceptives, aspirin, triamterene, pentamidine, and
trimethoprim reduce the effective-ness of folic acid.
In large doses, folic
acid may counteract the effects of anticon-vulsants, such as phenytoin,
potentially leading toseizures. (See Adverse
reactions to folic acid.)