Folistar Tablet 5mg

✔️ Uses of Folistar Capsule

1. Megaloblastic Anemia: Treats anemia caused by folate deficiency.
2. Folic Acid Deficiency: Corrects folate depletion due to poor diet, diseases, or other conditions.
3. Supplementation During Pregnancy: Supports fetal neural tube development and prevents neural tube defects.

Other uses include treating:

• Anemia due to kidney dialysis.
• Liver diseases.
• Alcoholism.
• Poor nutrient absorption by the bowel.

✔️ Mechanism of Action

Folistar is essential for synthesizing purine and pyrimidine, which are crucial for producing healthy blood cells and supporting cell division. It ensures the formation of new cells and helps maintain other critical body functions.

✔️ Words of Advice:

1. Doses above 0.1 mg/day may obscure symptoms of pernicious anemia while allowing irreversible nerve damage to progress.
2. Patients should be encouraged to consume foods rich in folic acid (e.g., nuts, dried beans, vegetables, fruits).
3. Toxicity can occur from high doses; follow the prescribed dosage strictly and report any side effects like skin rash or yellowing of urine.

✔️ Overdose Effects

• No significant adverse effects have been reported from excessive Folinic Acid administration. However, large doses may nullify the therapeutic effects of folic acid antagonists.
• In case of overdose, supportive care should be provided.

✔️ Common side effects include:

• Rash.
• Nausea.
• Flatulence.
• Skin flushing.
• Allergic reactions (e.g., pruritus, bronchospasm).
• Mucositis, stomatitis, diarrhea, and leukopenia (dose-limiting side effects).

✔️ Dosage and Administration

Folinic Acid Rescue Therapy

• After Methotrexate Overdose:
  • Administer Folinic Acid 15 mg (10 mg/m²) every 6 hours for 10 doses.
  • Start within 24 hours of methotrexate administration for maximum effectiveness.

Neutralizing Folic Acid Antagonists:

• For Trimethoprim or Pyrimethamine Toxicity:
  • A daily dose of 5–15 mg Folinic Acid is recommended.

Treatment of Megaloblastic Anemia:

• A daily dose of 5–15 mg Folinic Acid is commonly prescribed.

Children and Adolescents:

• Safety and efficacy have not been established. Consult a physician for appropriate use.

✔️

Interactions

1. Large doses of Folinic Acid may reduce the effectiveness of antiepileptic drugs like phenobarbital, phenytoin, and primidone, potentially increasing seizure frequency.
2. When combined with fluoropyrimidines (e.g., 5-FU), Folinic Acid can increase the risk of seizures and syncope.

✔️ Folistar is contraindicated for:

1. Patients with hypersensitivity to calcium folinate or its components.
2. Pernicious anemia or other Vitamin B12-deficient megaloblastic anemias.
3. Individuals with rare hereditary conditions such as galactose intolerance or glucose-galactose malabsorption.

✔️ Pregnancy and Lactation

• Adequate studies on Folistar use during pregnancy are lacking. Use only if the potential benefits outweigh the risks.
• It is unknown if Folistar is excreted in human milk, so caution is advised when administered to breastfeeding mothers.

✔️ Precautions and Warnings

1. Folistar must only be used with methotrexate or 5-FU under the direct supervision of an experienced clinician.
2. If treating an overdose of a folic acid antagonist, administer Folistar promptly; delayed administration (beyond 4 hours) may render it ineffective.
3. Avoid simultaneous use of Folistar with folic acid antagonists like methotrexate unless necessary, as it may neutralize their therapeutic effect.
4. Excessive alcohol consumption can increase folate requirements, so intake should be minimized.

✔️ Storage Conditions

• Store below 30°C.
• Keep away from light and out of the reach of children.