Has your doctor prescribed you a folic acid injection? Maybe you are pregnant, or maybe you have been prescribed it for another health problem. Hearing this name probably raises a lot of questions. It is normal for things like "What is this for?", "What will happen to it?", "Is it safe?" to come to mind. So today, let's talk about this injection, its importance, and the things to be careful about while using it, in a very simple and friendly way.
First, let's see, what is folic acid?
Simply put, folic acid is a B vitamin that is essential for our body. To be precise, it is the synthetic form of vitamin B9 . Think of our body as a house. We need different types of bricks to build this house, right? Similarly, these vitamins are needed to build and maintain the most important things in our body.
Folic acid performs several important functions in our body:
- Making red blood cells: Folic acid is essential for making red blood cells, which carry oxygen throughout our bodies. When these are depleted, we develop a condition called anemia.
- Brain health: This also helps maintain good brain function.
- During pregnancy: Folic acid is essential for both the mother and the unborn child. It is especially important for the development of the baby's brain and spinal cord. Folic acid deficiency greatly reduces the risk of serious birth defects in the nervous system.
We usually get this in pill form. But in some cases, when the body cannot absorb it properly through food, or when you need to quickly increase your body's folic acid levels, doctors recommend it as an injection.
Things you need to tell your doctor before getting vaccinated
Even though this is a vitamin, it's important to keep your doctor fully informed about your health, especially the following:
| Your situation | Why is that important? |
|---|---|
| Kidney disease | Since the medication is eliminated from the body through the kidneys, the dosage may need to be adjusted. |
| Pernicious anemia or vitamin B12 deficiency | This is very important. Folic acid can suppress the symptoms of vitamin B12 deficiency. But the underlying nerve damage continues. Therefore, this information is essential for the doctor to make an accurate diagnosis. |
| Allergies | Tell your doctor if you have any allergies to folic acid, other B vitamins, other ingredients in the vaccine (e.g. benzyl alcohol), or any other medicines or foods. |
| Pregnancy or trying to get pregnant | Although this is often recommended during pregnancy, it is important that your doctor is aware of your condition. |
| Breastfeeding | It is important to talk to your doctor about using medication while breastfeeding. |
How is this vaccine used?
The folic acid vaccine is usually given in a hospital or clinic. It is given by a doctor or nurse. There are several ways to get the vaccine:
- Intravenous (IV) - `(Into a vein)`
- Intramuscular (IM)
- Under the skin - `(Subcutaneous or SC)`
Sometimes, your doctor may instruct you on how to administer the vaccine at home. If so, follow the instructions exactly . It is very important to take the correct dose at the correct time.
Very important: Never throw used needles and syringes in the trash. They can be dangerous to others. There is a special sharps container for them. If you don't have one, ask your doctor about it.
What to do if you take too much medicine?
If you think you have accidentally taken too much of this medicine, go to the nearest hospital Emergency Department (ETU) immediately . Or call the National Poisons Information Centre at the Colombo National Hospital .
What if I miss a medication appointment?
Take the dose as soon as you remember. But if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take two doses at once.
Other things that may interact with this medicine
Some medications you take can affect the way folic acid works, and folic acid can affect those medications. Some examples are:
- Chloramphenicol (an antibiotic)
- `Cholestyramine` (a cholesterol-lowering drug)
- Some medications for seizures
- `Methotrexate` (a medicine used for cancer and other diseases)
- Nitrofurantoin (an antibiotic)
- Pyrimethamine (a medicine used to treat diseases such as malaria)
This list is not exhaustive. Therefore, be sure to tell your doctor about any other medications, vitamins, herbal remedies, or dietary supplements you are taking. Also, tell your doctor if you smoke or drink alcohol.
What are the possible side effects?
Like any medicine, folic acid injections can cause side effects in some people. However, these are not very common. Let's take a look at what these side effects are.
| Type of side effect | Symptoms |
|---|---|
| If you experience these symptoms, tell your doctor immediately. | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Difficulty breathing | Difficulty breathing, shortness of breath, etc. |
| Neurological symptoms | Pain, numbness, or loss of sensation in the limbs. |
| These are usually not serious, but if they persist, tell your doctor. | |
| General discomfort | Feeling lifeless and tired. |
| Anorexia | Decreased appetite. |
| Nausea | Feeling like vomiting. |
If you experience any other unusual symptoms that are not on this list, talk to your doctor about them as well.
Take-Home Message
- Folic acid (vitamin B9) is essential for our body, especially for the production of red blood cells, brain function, and the development of the baby during pregnancy.
- Be sure to tell your doctor about all other medications you are taking and any other medical conditions you have (especially kidney disease, vitamin B12 deficiency).
- If you think you have taken too much medicine, go to the Emergency Department (ETU) immediately.
- If you experience symptoms of an allergic reaction (skin rash, itching, swelling of the face/throat, difficulty breathing), seek medical advice immediately.
- Even though this is a vitamin, use it only under the advice of a doctor, in the prescribed dosage. Talk openly with your doctor about your concerns.
👩🏽⚕️ Additional questions (FAQs)
💬 Dofetilide (Dofetilide / Tikosyn) tablets/capsules are a very powerful medicine used for which disease?
This is no ordinary medicine! This is the most powerful and last resort medicine (Class III Antiarrhythmic) that doctors use to somehow bring the heart back to 'Normal Sinus Rhythm' when a patient's upper chambers suddenly beat abnormally fast (Atrial Fibrillation / Atrial Flutter), a very dangerous condition in which the upper chambers of the heart suddenly and uncontrollably beat abnormally fast!
💬 When the heart is beating like crazy, how can this medicine (Dofetilide) normalize the heart rhythm?
The heart beats through electrical signals (Action Potentials). When it beats wildly, the electrical cells charge rapidly! What this pill (Potassium channel blocker) does when it enters the heart is to forcibly extend and delay the time it takes for the heart's electrical cells to charge and reset/rest again (Repolarization phase / QT interval)! Then the heart cannot beat the next time quickly and the heart rate suddenly returns to normal (slow).
💬 Why does it say 'You must stay in the hospital for 3 days (Black Box Warning)' when you start taking this medicine (Tikosyn)?
That is the biggest danger and fatality! This is just like creating a heart rhythm, and as soon as you take a couple of pills, a 'new deadly heart rhythm (Torsades de pointes / Proarrhythmia)' can occur and the patient can suddenly die/go into a coma! Therefore, for the first 3 days, doctors definitely keep the patient on an ECG and check the kidneys before adjusting the dosage.
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