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Folic Acid, Cyanocobalamin, and Pyridoxine

Pronunciation

Pronunciation

(FOE lik AS id, sye an oh koe BAL a min, & peer i DOKS een)

Index Terms

  • Cyanocobalamin, Folic Acid, and Pyridoxine
  • Folacin, Vitamin B12, and Vitamin B6
  • Folic Acid/Cyanocob/Pyridoxine
  • Pyridoxine, Folic Acid, and Cyanocobalamin

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Generic: Folic acid 1 mg, cyanocobalamin 400 mcg, and pyridoxine hydrochloride 50 mg

Tablet, Oral:

Airavite: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Av-VITE FB: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

CenFol: Folic acid 2.3 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 24.5 mg

FaBB: Folic acid 2.2 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Folastin: Folic acid 2.5 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 25 mg [DSC]

Folbee: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg [dye free, lactose free, and sugar free]

Folbic: Folic acid 2.5 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 25 mg

Folcaps: Folic acid 2.2 mg, cyanocobalamin 500 mcg, and pyridoxine hydrochloride 25 mg [sugar free] [DSC]

Folgard RX: Folic acid 2.2 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Folplex 2.2: Folic acid 2.2 mg, cyanocobalamin 500 mcg, and pyridoxine hydrochloride 25 mg

Foltabs 800: Folic acid 0.8 mg, cyanocobalamin 115 mcg, and pyridoxine hydrochloride 10 mg [gluten free]

Homocysteine Formula: Folic acid 0.8 mg, cyanocobalamin 100 mcg, and pyridoxine hydrochloride 50 mg

Niva-Fol: Folic acid 2.5 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 25 mg

NuFol: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Virt-Gard: Folic acid 2.2 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Virt-Vite: Folic acid 2.5 mg, cyanocobalamin 1000 mcg, and pyridoxine hydrochloride 25 mg

Virt-Vite Forte: Folic acid 2.5 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 25 mg

Vita-Respa: Folic acid 2.2 mg, cyanocobalamin 1300 mcg, and pyridoxine hydrochloride 25 mg [dye free and sugar free]

Generic: Folic acid 0.5 mg, cyanocobalamin 200 mcg, pyridoxine hydrochloride 5 mg; Folic acid 0.8 mg, cyanocobalamin 100 mcg, and pyridoxine hydrochloride 50 mg; Folic acid 2.2 mg, cyanocobalamin 500 mcg, and pyridoxine hydrochloride 25 mg; Folic acid 2.5 mg, cyanocobalamin 200 mcg, and pyridoxine hydrochloride 25 mg

Brand Names: U.S.

  • Airavite
  • Av-VITE FB
  • CenFol
  • FaBB
  • Folastin [DSC]
  • Folbee
  • Folbic
  • Folcaps [DSC]
  • Folgard Rx
  • Folplex 2.2
  • Foltabs 800 [OTC]
  • Homocysteine Formula [OTC]
  • Virt-Gard
  • Virt-Vite
  • Virt-Vite Forte
  • Vita-Respa

Pharmacologic Category

  • Vitamin

Use: Labeled Indications

Nutritional supplement in end-stage renal failure, dialysis, hyperhomocysteinemia, homocystinuria, malabsorption syndromes, dietary deficiencies

Contraindications

Hypersensitivity to folic acid, cyanocobalamin, pyridoxine, or any component of the formulation

Dosing: Adult

Dietary supplement: Oral: One tablet daily

Dosing: Geriatric

Refer to adult dosing.

Storage

Store at controlled room temperature of 15°C to 30°C (59°F to 96°F).

Drug Interactions

Altretamine: Pyridoxine may diminish the therapeutic effect of Altretamine. Specifically when altretamine is used in combination with Cisplatin the response duration may be diminished. Consider therapy modification

Barbiturates: Pyridoxine may increase the metabolism of Barbiturates. Apparent in high pyridoxine doses (eg, 200 mg/day) Monitor therapy

Chloramphenicol: May diminish the therapeutic effect of Vitamin B12. Monitor therapy

Colchicine: May decrease the serum concentration of Cyanocobalamin. Monitor therapy

Fosphenytoin: Folic Acid may decrease the serum concentration of Fosphenytoin. Monitor therapy

Fosphenytoin: Pyridoxine may increase the metabolism of Fosphenytoin. This is most apparent in high pyridoxine doses (e.g., 80 mg to 200 mg daily) Monitor therapy

Green Tea: May decrease the serum concentration of Folic Acid. Monitor therapy

Levodopa: Pyridoxine may diminish the therapeutic effect of Levodopa. Management: The concomitant use of pyridoxine and levodopa (in the absence of a dopa decarboxylase inhibitor (DDI)) should be avoided. Use of a DDI (e.g., carbidopa) with levodopa will essentially eliminate the risk of this interaction. Consider therapy modification

PHENobarbital: Folic Acid may decrease the serum concentration of PHENobarbital. Monitor therapy

Phenytoin: Folic Acid may decrease the serum concentration of Phenytoin. Monitor therapy

Phenytoin: Pyridoxine may increase the metabolism of Phenytoin. This is most apparent in high pyridoxine doses (e.g., 80 mg to 200 mg daily) Monitor therapy

Primidone: Folic Acid may decrease the serum concentration of Primidone. Additionally, folic acid may decrease concentrations of active metabolites of primidone (e.g., phenobarbital). Monitor therapy

Raltitrexed: Folic Acid may diminish the therapeutic effect of Raltitrexed. Avoid combination

SulfaSALAzine: May decrease the serum concentration of Folic Acid. Monitor therapy

Adverse Reactions

See individual agents.

Warnings/Precautions

See individual agents.

Pregnancy Considerations

See individual agents.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Have patient report immediately to prescriber severe nausea, severe vomiting, severe diarrhea, burning or numbness feeling, change in balance, or abnormal gait (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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