Folic acid

CLINICAL USE

Folate-deficient megaloblastic anaemia Supplement in

HD : patients

DOSE IN NORMAL RENAL FUNCTION

5 mg daily for 4 months, then weekly according to responseMaintenance: 5 mg every 1–7 days

PHARMACOKINETICS

Molecular weight :441.4

%Protein binding :70

%Excreted unchanged in urine : Varies with daily dose

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :2.5/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Dialysed. Dose as in normal renal function

HD :Dialysed. Dose as in normal renal function

HDF/high flux :Dialysed. Dose as in normal renal function

CAV/VVHD :Dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anti-epileptics: reduces phenytoin, primidone and phenobarbital levels

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

If seriously folate deficient, give 10 mg/day for 1 month, then 5 mg/dayDoses up to 15 mg daily have been used in cases of malabsorptionMost nutritionists recommend 0.5–1 mg folic acid daily for patients on

HD : or

CAPD

; may accumulate in uraemic patientsDosage used by dialysis units varies from 5 mg daily to 5 mg once weekly.

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