• 5 mg folic acid

• water for injections
• Sodium hydroxide for pH adjustment
• sodium chloride

For folic acid deficiency

Composition:
1 ampoule of 2 ml contains: folic acid 5 mg
Other ingredients: sodium chloride, sodium hydroxide solution, water for injections.

Areas of application:
Prophylaxis and therapy of folic acid deficiencies when oral folic acid substitution is not possible or the rapid elimination of a pronounced deficiency is urgently required.

Dosage:
Unless otherwise prescribed, inject 1 ampoule daily intravenously or intramuscularly for therapy in severe folic acid deficiency states. For prophylaxis, inject 1 ampoule 1-3 times a week as required.

Contraindications:
The increase in young red blood cells (reticulocytes) caused by folic acid administration can mask a vitamin B12 deficiency. Because of the risk of irreversible neurological disorders, before treating anemia due to impaired development of the red blood cells (megaloblastic anemia), it must be ensured that this is not due to a vitamin B12 deficiency. The cause of megaloblastic anemia must be clarified before starting therapy.

Pregnancy and lactation:
There are no known risks.

Side effects:
In individual cases, hypersensitivity reactions can occur, for example in the form of reddening of the skin (erythema), itching, shortness of breath (bronchospasm), nausea or circulatory collapse (anaphylactic shock). At very high doses, gastrointestinal disorders, sleep disorders, agitation and depression can occur.

Interactions:
Treatment with antiseizure drugs (anticonvulsants) can lead to an increase in the likelihood of convulsions. When high doses are administered, it cannot be ruled out that "Folic Acid Hevert 5 mg" and simultaneously administered folic acid inhibitors (folic acid antagonists), such as certain drugs against bacterial infections or malaria (trimethoprim, proguanil, pyrimethamine) and methotrexate (active ingredient for the treatment of of tumours), mutually inhibit their effect.

Severe diarrhea can occur if used at the same time as fluorouracil (a drug used to treat tumours). Chloramphenicol (active substance used to treat infections) can prevent the response to treatment with Folsäure Hevert 5 mg and should therefore not be given to patients with severe folic acid deficiency symptoms.

A folic acid deficiency can be remedied quickly and effectively with »Hevert 5 mg folic acid« solution for injection.

Folic acid belongs to the group of B vitamins and is involved as a cofactor in many metabolic processes, especially in protein and nucleic acid metabolism. Folic acid is found in metabolically active tissues of the body such as the liver, bone marrow, nerves, but also in the muscles.

Covering the folic acid requirement is difficult because a significant proportion of the food folate is destroyed during cooking due to the influence of heat and oxygen or, due to its water solubility, passes into the washing or cooking water and is discarded. In individual cases, the folate losses due to the technical preparation can be up to 100%. Inadequate intake of folic acid leads to symptoms of folic acid deficiency caused by an unbalanced diet, e.g. with increased alcohol consumption, or insufficient absorption due to rapid gastrointestinal passage (diarrheal diseases), or after resection of the upper small intestine or increased consumption, e.g. during dialysis Hyperfunction of the thyroid gland, during pregnancy, or reduced utilization due to liver diseases and antagonistic effects of drugs, e.g. various antibiotics,

During pregnancy, large amounts of folate are needed to supply the embryo with folate, to form placental tissue and to replace increased renal (kidney related) folate losses. The folate requirement of pregnant women is therefore double that of the normal female population. The folate requirement of breastfeeding mothers is also essentially increased due to the release of folic acid into the milk.

Symptoms of folic acid deficiency manifest themselves in neurological (nervous) and psychiatric disorders (organic brain syndrome, disturbance of the pyramidal tracts, neuropathies) with general weakness, insomnia, forgetfulness, paresthesia and tingling, as well as in pale complexion, painful, swollen and shiny tongue.

Other symptoms of folic acid deficiency are mucosal changes in the oral cavity and gastrointestinal disorders that lead to diarrhea. Folic acid must therefore be supplied to the organism in high doses.
Advanced folic acid deficiency is always expressed by changes in the red blood count (macrocytic anemia). The disorders are particularly pronounced when folic acid and vitamin B 12 deficiencies occur at the same time. In this case, the combination treatment with »Vitamin B12-Hevert plus Folsäure-Hevert« injection solution is recommended.

Notes:
"Hevert folic acid 5 mg" ampoules can also be used as drinking ampoules if required. "Folic Acid Hevert" tablets (5 mg folic acid per tablet) are used for long-term oral therapy.