Folic Acid / Cobalamin / Pyridoxine Hydrochloride

Pronunciation

Pronunciation: FOLE-ic acid/koe-BAL-uh-min/peer-ih-DOX-een HIGH-droe-KLOR-ide
Class: Nutritional combination

Trade Names

Foltx
- Tablets 25 mg vitamin B 6 , 1 mg vitamin B 12 , 2.5 mg folic acid

Pharmacology

Folic acid and cobalamin

Reduces homocysteine by metabolizing it to methionine.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Pyridoxine

Facilitates breakdown of homocysteine to cysteine and other byproducts.

Indications and Usage

For nutritional requirement of patients with end-stage renal failure, dialysis, hyperhomocysteinemia, homocystinuria, nutrient malabsorption or inadequate dietary intake, particularly for patients with or at risk for cardiovascular disease, cerebrovascular disease, peripheral vascular disease, arteriosclerotic vascular disease, neurological disorders, Alzheimer disease, and renal disease.

Contraindications

Standard considerations.

Dosage and Administration

Adults

PO 1 tablet every day or as directed by health care provider.

General Advice

  • Administer daily without regard to meals. Administer with food if GI upset occurs.

Storage/Stability

Store tablets at controlled room temperature (59° to 86°F). Protect from light and moisture.

Drug Interactions

Hydantoins (eg, phenytoin)

Pharmacologic effect of hydantoins may be decreased.

Levodopa

Pharmacologic activity of levodopa may be antagonized (interaction does not occur with levodopa/carbidopa combination with pyridoxine).

Laboratory Test Interactions

Pyridoxine

May result in false-positive urobilinogen in the spot test using Ehrlich's reagent.

Adverse Reactions

Cardiovascular

Peripheral vascular thrombosis.

CNS

Paresthesia; somnolence.

Dermatologic

Itching; transitory exanthema.

GI

Mild transient diarrhea.

Hematologic

Polycythemia vera.

Miscellaneous

Allergy; feeling of body swelling.

Precautions

Lactation

Folic acid

Excreted in breast milk.

Cobalamin

Excreted in breast milk.

Pyridoxine

Excreted in breast milk and may inhibit lactation.

Pernicious anemia

Folic acid may obscure pernicious anemia; however, cyanocobalamin present in product should address this precaution.

Overdosage

Symptoms

Pyridoxine

Ataxia, sensory neuropathy

Patient Information

  • Instruct patient to take prescribed dose every day.
  • Advise patient that medication can be taken without regard to meals, but to take with food if GI upset occurs.
  • Caution patient not to change the dose or stop taking unless advised by health care provider.
  • Advise patient to notify health care provider if any of the following are noted: rash, itching, drowsiness, abnormal skin or body sensations, diarrhea.

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