Universal reference book for medicines
Product name: FOLIBER (FOLIBER)

Active substance: cyanocobalamin, folic acid

Type: Complex of B vitamins

Manufacturer: ITALFARMACO (Italy)
Composition, form of production and packaging
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Tablets are flat, round, yellow in color.
1 tab.

Folic acid (Vit B c ) 400 μg

cyanocobalamin (Vit B 12 ) 2 μg

Excipients: sodium carboxylic starch type A, magnesium stearate, lactose monohydrate, microcrystalline cellulose, trisodium citrate, citric acid, maltodextrin.

28 pcs.
- blisters (1) - packs of cardboard.
INSTRUCTION FOR THE SPECIALIST.

The product description was approved by the manufacturer for the 2009 print edition.

PHARMACHOLOGIC EFFECT

Complex of B vitamins.

Folate deficiency causes disruption of DNA synthesis in a cell preparing for chromosome replication and fission.
The mechanism of action is due to the participation of folic acid in the form of tetrahydrofolate in the synthesis of nucleic acids and in cell division, and also as a coenzyme in the synthesis of purines and pyrimidines, which makes it the decisive factor in the formation of the central nervous system, which develops in humans 15-28 days after fertilization . The conversion of 5-methyl tetrahydrofolate to tetrahydrofolate in the body can occur only as a result of the addition of the methyl group to the homocysteine ​​to form methionine as a result of the action of methionine synthetase.
In this process, vitamin B 12 participates as a limiting cofactor; therefore, vitamin B 12 deficiency is similar in the effects of insufficient folic acid activation;
In addition, vitamin B 12 also participates in the capture of folic acid by cells, so when a cell is experiencing a primary vitamin B deficiency, 12 it also experiences a deficit in folate.
Pharmacological action of the drug Foliber is that its use allows you to overcome the metabolic blockade, which is observed in mothers of children with neural tube defects.
The specific nature of this metabolic blockade is the metabolism of the essential amino acid methionine, in which folate and vitamin B 12 are key elements, as they are responsible for the re-methylation of homocysteine ​​in methionine. 400 μg of folic acid is the minimum effective daily dose recommended by the Centers for Disease Prevention (US, UK, Australia) to healthy women as an additional daily intake to prevent the development of neural tube defects in the fetus.
The recommended daily intake of vitamin B12 is 2 μg.

PHARMACOKINETICS

Suction

Folic acid is rapidly absorbed in the jejunum, subject to reduction and methylation to 5-methyltetrahydrofolate, which is present in the portal circulation.
C max in the blood plasma is observed after 30-60 minutes. Also, vitamin B 12 can be absorbed after its interaction in the stomach with the "internal factor of Castle", a glycoprotein that is secreted by parietal cells of the stomach. C max in plasma is observed after 8-12 hours. As in the case of folic acid, vitamin B 12 undergoes significant intestinal hepatic recirculation.
Distribution

Vitamin B 12 and its metabolite, 5-methyltetrahydrofolate, bind to a large extent with plasma proteins, excess accumulates in the liver.
Vitamin B 12 passes through the placenta. Vitamin B 12 and folate are excreted in breast milk.
Excretion

Every day, 4-5 μg of folate is excreted in the urine in the form of folic acid, 10-formyltetrahydrofolate and 5-methyl tetrahydrofolate.
The average T 1/2 of vitamin B 12is about 6 days. Part of the administered dose is excreted in the urine for the first 8 hours, although most of it is excreted with bile. 25% is excreted with feces.
INDICATIONS

- Prevention of deficiency of folic acid and vitamin B 12 in women of childbearing age at the stages of pregnancy planning (at least 1 month before conception);

- for the prevention of neural tube defects in the fetus in the first trimester of pregnancy.

DOSING MODE

The drug should be applied 1 tablet / day before meals.

SIDE EFFECT

Possible: allergic reactions


CONTRAINDICATIONS

- Hypersensitivity to the components of the drug.

Caution should be used in patients with impaired absorption of glucose or galactose, galactosemia or lactase deficiency, since the drug contains 23 mg of lactose in 1 tablet.

PREGNANCY AND LACTATION

The drug is used in pregnancy according to the indications.

SPECIAL INSTRUCTIONS

Impact on the ability to drive vehicles and manage mechanisms

Fiber does not affect the ability to drive and work with machinery.

OVERDOSE

Data on overdose are not provided.

DRUG INTERACTION

Foliabra should not be used in combination with methotrexate, as the latter acts as a folic acid antagonist, inhibiting the enzyme hydrophotoreductase.

With the simultaneous use of Foliber with antiepileptic drugs from the hydantoin group can reduce the effects of the latter.

TERMS OF RELEASE FROM PHARMACY

The drug is approved for use as a means of OTC.

TERMS AND CONDITIONS OF STORAGE

The drug should be stored out of reach of children, dry place at a temperature of no higher than 25 ° C.
Shelf life - 2 years.
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