What happens if I overdose Folacal?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately.
Proper storage of Folacal capsules:
Store Folacal capsules at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Folacal capsules out of the reach of children and away from pets.
Overdose of Folacal in details
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: mental/mood changes.
Notes
Do not share this medication with others.
Laboratory and/or medical tests (such as complete blood count, folate blood level, vitamin B-12 blood level) should be performed periodically to monitor your progress. Consult your doctor for more details.
Folate is naturally found in leafy green vegetables, organ meats (liver, kidney), citrus fruits, and other foods. Folacal is added to enriched grain products such as bread, pasta, and cereal. Consult your doctor or dietician for a diet plan rich in folate/Folacal.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Storage
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
What should I avoid while taking Folacal?
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Folacal warnings
Use Folacal IVAX with caution in patients with bronchial asthma, COPD, bronchitis, decompensated heart failure, diabetes, renal and / or liver failure, hyperthyroidism, depression, myasthenia gravis, psoriasis, occlusive peripheral vascular disease, pregnancy, lactation, elderly patients, children (efficacy and safety are not defined).
During the period of treatment it may been exacerbation of psoriasis.
When pheochromocytoma propranolol can be applied only after taking alpha-blockers.
After a lengthy course of treatment Folacal IVAX should be lifted gradually, under medical supervision.
During treatment with this drug it should be avoided in the intravenous administration of verapamil, diltiazem.
A few days before the anesthesia it is necessary to stop taking propranolol or find a means of anesthesia with minimal negative inotropic effects.
Patients whose work requires more attention, the application of this medication outpatients should be addressed only after the evaluation of individual patient response.
What should I discuss with my healthcare provider before taking Folacal?
Some medical conditions may interact with Folacal capsules. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a long-term infection, seizure disorder (eg, epilepsy), or liver problems (eg, alcoholic cirrhosis), or if you are on kidney dialysis
- if you drink alcohol regularly
- if you have other types of anemia (eg, anemia due to low vitamin B levels)
Some MEDICINES MAY INTERACT with Folacal capsules. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Fluorouracil because its actions and side effects may be increased by Folacal capsules
- Hydantoins (eg, phenytoin) because their effectiveness may be decreased by Folacal capsules
- Barbiturates (eg, phenobarbital), methotrexate, nitrofurantoin, phenytoin, primidone, or pyrimethamine because the effectiveness of Folacal capsules may be decreased
This may not be a complete list of all interactions that may occur. Ask your health care provider if Folacal capsules may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Folacal precautions
General
Folacal in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurologic manifestations remain progressive.
There is a potential danger in administering Folacal to patients with undiagnosed anemia, since Folacal may obscure the diagnosis of pernicious anemia by alleviating the hematologic manifestations of the disease while allowing the neurologic complications to progress. This may result in severe nervous system damage before the correct diagnosis is made. Adequate doses of vitamin B12 may prevent, halt, or improve the neurologic changes caused by pernicious anemia.
Drug Interactions
There is evidence that the anticonvulsant action of phenytoin is antagonized by Folacal. A patient whose epilepsy is completely controlled by phenytoin may require increased doses to prevent convulsions if Folacal is given.
Folic deficiency may result from increased loss of folate, as in renal dialysis and/or interference with metabolism (e.g., Folacal antagonists such as methotrexate); the administration of anticonvulsants, such as diphenylhydantoin, primidone, and barbiturates; alcohol consumption and, especially, alcoholic cirrhosis; and the administration of pyrimethamine and nitrofurantoin.
False low serum and red cell folate levels may occur if the patient has been taking antibiotics, such as tetracycline, which suppress the growth of Lactobacillus casei.
Carcinogenesis, Mutagenesis, Impairment of Fertility
Long-term studies in animals to evaluate carcinogenic potential and studies to evaluate the mutagenic potential or effect on fertility have not been conducted.
Pregnancy
Teratogenic Effects
Pregnancy Category A
Folacal is usually indicated in the treatment of megaloblastic anemias of pregnancy. Folacal requirements are markedly increased during pregnancy, and deficiency will result in fetal damage.
Studies in pregnant women have not shown that Folacal increases the risk of fetal abnormalities if administered during pregnancy. If the drug is used during pregnancy, the possibility of fetal harm appears remote. Because studies cannot rule out the possibility of harm, however, Folacal should be used during pregnancy only if clearly needed.
Nursing Mothers
Folacal is excreted in the milk of lactating mothers. During lactation, Folacal requirements are markedly increased; however, amounts present in human milk are adequate to fulfill infant requirements, although supplementation may be needed in lowbirth-weight infants, in those who are breast-fed by mothers with folic deficiency (50 mcg daily), or in those with infections or prolonged diarrhea.
What happens if I miss a dose of Folacal?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
References
- DailyMed. "ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PHYTONADIONE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN 5'-PHOSPHATE SODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DrugBank. "folic acid". http://www.drugbank.ca/drugs/DB00158 (accessed September 17, 2018).
- MeSH. "Vitamin B Complex". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
