Summary: Folic acid is prescribed/advised for pregnant people & those with folate deficiency anaemia
Who’s it for: GPs and Pharmacists
What is Folic Acid?
Folic acid is the synthetic version of Vitamin B9, or folate.
Folic acid is used:
- To treat folate deficiency anaemia
- Help baby’s brain, skull and spinal cord development during pregnancy
- Help reduce side effects from methotrexate
Who should have Folic Acid prescribed?
Always refer to the BNF when prescribing doses
- If pregnant or trying to get pregnant, it's recommended to take folic acid until you're 12 weeks pregnant (400µg OD). It can be purchased OTC in 400ug strength (See Over-The-Counter Medication Prescribing)
- If there is a higher chance of neural tube defects it is advised to prescribe a higher dose (5mg OD) throughout pregnancy. Patients falling in this category include:
- Previous pregnancy affected by a neural tube defect
- The patient has diabetes
- The patient is overweight
- The patient has sickle cell disease, thalassemia or thalassemia trait
- A family history of neural tube defects with either parent
- Patients on certain epilepsy medicines
- Patients on antiretrovirals for HIV
- Folic acid is often advised & initiated by midwives at the first booking appointment, however this should be discussed with patients if counselling about pregnancy
- To treat anaemia, the usual dose for adults and children over 1 year old is 5mg, taken once a day
- Treatment should be give for 16 weeks in total - the patient can be given the full course at the initial consultation to aid compliance
- There is no need to repeat bloods after the course is complete unless the patient continues to experience symptoms
- If taking methotrexate, it is usual to take 5mg once a week, on a different day of the week to methotrexate
- Depending on side effects, this may be increased, following advice from the specialist to every day except the day of methotrexate