[india-drug] Folic acid 5mg Information (2)

["usha gupta" <usha_gupta2@yahoo.com>]

Folic acid 5mg Information (2)
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Dear I-Drug member,

A pertinent issue has been raised. It is well established that supplementation of folic acid does prevent NTD (neural tube defect in the fetus) and that is the indication for which it is prescribed during pregnancy. However the issue of the dose is of concern. I have tried to look at level 1 evidence to find out if 5mg/day dose (commonly prescribed) is superior to 0.4mg/day. I could not find any RCT comparing these doses, both in terms of efficacy & safety outcome. However The CDC (centers for disease control &prevention} as well as FDA recommend that a dose of 0.6-0.8mg/day should be given to all pregnant women whereas those who are at high risk viz having previous history of NTD, suffering from epilepsy may be given high doses i.e. 4mg/day. The recommendation of 4mg /day dose has been made on the basis of a large MCRCT conducted in UK.The CDC also warns on unnecessary use of high doses. According to these guidelines, it is unjustified to give 5mg/day     
 
Dr. (Mrs.) Usha Gupta,
Former Head of Department, Pharmacology, 
Maulana Azad Medical College, New Delhi 110002. INDIA
& Executive Vice President,
Delhi Society for Promotion of Rational Use of Drugs,
Government Dispensary, Vasundhra Enclave,
Delhi 110 092. INDIA.
Tele: + 91 11 2261 2669
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E-mail: dsprud2005@yahoo.com
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Personal e-mail: usha_gupta2@yahoo.com