Pharmax

A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses (poaceae). Folic acid (Pharmax) is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [PubChem]

Vit B (Pharmax) contains specific active ingredients such as carnitine orotate and hepatic extract antitoxic fraction.

Each vial contains: Carnitine orotate 300 mg (equivalent to carnitine 152.4 mg and orotic acid 147.6 mg), carnitine HCl 184 mg (equivalent to carnitine base 150 mg), hepatic (liver) extract antitoxic fraction 25 mg (equivalent to cyanocobalamin 0.25 mcg), pyridoxine HCl (vitamin B₆) 25 mg, adenosine 5 mg, cyanocobalamin (vitamin B₁₂) 250 mcg.

Sometimes, there is color disproportion by physical properties during freeze-drying process but therapeutic effect is not affected.

Each teaspoonful (5 mL) of syrup contains vitamin C 83.33 mg, vitamin B1 8.33 mg, vitamin B6 1.67 mg, vitamin B12 8.33 mcg, riboflavin 4.16 mg, niacinamide 8.33 mg, dl-panthenol 3.33 mg, vitamin A 1500 units and vitamin D 100 units.

Each softgel capsule contains vitamin E 400 IU.

It also contains the following excipients: Soybean oil, gelatin, ethyl vanillin, methyl- and propylparaben.

Provides nutritional dietary supplement for metabolic build-up & restores energy required for extra mental & physical activities. Stimulates appetite & promotes growth & proper development of brain, bones & muscles.

Folic acid (Pharmax) is used in the treatment and prevention of the folate deficiency state. It does not correct folate deficiency due to dihydrofolate reductase inhibitors. Folic acid (Pharmax) is also used in women of child-bearing potential and pregnant women to protect against neural tube defects in their offspring. It is also used for the treatment of folate-deficient megaloblastic anaemia, chronic haemolytic states such as thalassaemia major or sickle-cell anaemia.

Daily supplementation of Mg.

Multivit & lysine supplement for active growth, increased appetite, wt gain, enhanced body resistance to stress & infection.

Tab Prevention or treatment of Vit B (Pharmax)₁, B₆ & B₁₂ deficiencies. Forte tab Neuralgia, neuritis, diabetic neuropathy, sciatica, Vit B (Pharmax) deficiency, trigeminal neuralgia, intercostal neuralgia, hyperemesis gravidarum.

For systemic use of Vit C (Pharmax): prevention and treatment of hypo- and avitaminosis of vitamin C; providing increased need for vitamin C during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.

For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.

Vitamin deficiencies, conditions of convalescence after a disease occurring with a feverish syndrome, high physical activity, older age, disease ligamentous system and muscles. Climacteric autonomic disorders. Neurasthenia with fatigue, asthenia neurasthenic syndrome, primary muscular dystrophy, posttraumatic, postinfectious secondary myopathy. Degenerative and proliferative changes in the joints and ligamentous apparatus spine and large joints.

Zn supplement.

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Folic acid (Pharmax) (vitamin B 9) is necessary for strong blood.

Lack of Folic acid (Pharmax) may lead to anemia (weak blood). Your health care professional may treat this by prescribing Folic acid (Pharmax) for you.

Some conditions may increase your need for Folic acid (Pharmax). These include:

• Alcoholism
• Anemia, hemolytic
• Diarrhea (continuing)
• Fever (prolonged)
• Hemodialysis
• Illness (prolonged)
• Intestinal diseases
• Liver disease
• Stress (continuing)
• Surgical removal of stomach

In addition, infants smaller than normal, breast-fed infants, or those receiving unfortified formulas (such as evaporated milk or goat's milk) may need additional Folic acid (Pharmax).

Increased need for Folic acid (Pharmax) should be determined by your health care professional.

Some studies have found that Folic acid (Pharmax) taken by women before they become pregnant and during early pregnancy may reduce the chances of certain birth defects (neural tube defects).

Claims that Folic acid (Pharmax) and other B vitamins are effective for preventing mental problems have not been proven. Many of these treatments involve large and expensive amounts of vitamins.

Injectable Folic acid (Pharmax) is given by or under the direction of your health care professional. Another form of Folic acid (Pharmax) is available without a prescription.

1 cap daily.

Usual Adult Dose for Megaloblastic Anemia

1 mg orally, intramuscularly, subcutaneously or IV once a day. May continue until clinical symptoms of folate deficiency and the hematological profile have normalized.

Usual Adult Dose for Folic acid (Pharmax) Deficiency

400 to 800 mcg orally, intramuscularly, subcutaneously or IV once a day.

Women of childbearing age, pregnant, and lactating women: 800 mcg orally, intramuscularly, subcutaneously or IV once a day.

Usual Pediatric Dose for Folic acid (Pharmax) Deficiency

Infant:

0.1 mg orally, intramuscularly, subcutaneously or IV once a day.

Child:

Less than 4 years: up to 0.3 mg orally, intramuscularly, subcutaneously or IV once a day.

4 years or older: 0.4 mg orally, intramuscularly, subcutaneously or IV once a day.

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Recommended daily allowance (RDA):

Premature neonates: 50 mcg/day (15 mcg/kg/day).

Full-term neonates and infants 1 to 6 months: 25 to 35 mcg/day.

Children:

1 to 3 years: 150 mcg/day.

4 to 8 years: 200 mcg/day.

9 to 13 years: 300 mcg/day.

14 years and older: 400 mcg/day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Rarely, a dosage of 2 mg/day may be required, particularly in patients with malabsorption, alcoholism, chronic hemolysis, chronic exfoliative skin disease or who are on concomitant anticonvulsant therapy.

Dialysis

Folic acid (Pharmax) is removed by both hemodialysis and peritoneal dialysis. The amount removed varies with type equipment used.

Because folate may accumulate in patients with end-stage renal disease, side effects may be more likely in this patient who is undergoing dialysis. Once this patient's body stores of folate are replete, three times a week dosing may be just as beneficial as once daily dosing but should portend a lower risk of side effects.

Other Comments

The recommended daily allowance of Folic acid (Pharmax) for adult males and females ranges from 150 to 200 and 150 to 180 mcg/day, respectively.

There is a potential danger in administering Folic acid (Pharmax) to patients with undiagnosed anemia, since Folic acid (Pharmax) may obscure the diagnosis of pernicious anemia by alleviating the hematologic manifestations of the disease while allowing the neurologic complications to progress.

Severe megaloblastic anemia may require therapy for 4 to 5 weeks. Once stabilized, if dietary intake is inadequate, maintenance therapy can be started.

Adult & childn >6 yr 1 effervescent tab/day as recommended by doctors.

Childn 7-12 yr 15 mL, 3-6 yr 10 mL, 1-2 yr 5 mL. To be taken once daily.

Inject 2 vials/day through IV instillation after dissolving each vial of the freeze-dried cake with 4 mL water for injection.

Administration: Vit B (Pharmax) can be administered by LVP instillation process by diluting the solution to LVP solution. When using the LVP solution as diluent for Vit B (Pharmax) injection, it has to be cautioned that the LVP solution must be non-electrolyte LVP (eg, 5% dextrose solution). If the electrolyte-containing LVP solution (eg, Ringer's solution) is used, carnitine orotate will precipitate in the solution.

It is recommended that in the administration method, diluted LVP solution must be used because direct instillation without dilution can induce serious pain in the injection site.

As much as possible, inject slowly because blood vessel pain may occur during IV injection.

This medication administered orally, IM, IV, intravaginally.

For the prevention of deficiency conditions Vit C (Pharmax) dose is 25-75 mg / day, for the treatment - 250 mg / day or more in divided doses.

For intravaginal used ascorbic acid drugs in appropriate dosage forms.

Adults: One soft cap daily.

Cystic Fibrosis: 100-200 mg of dl-α-tocopheryl acetate or about 67-135 mg of dl-α-tocopherol.

Abetalipoproteinaemia: 50-100 mg of dl-α-tocopheryl acetate/kg body weight or about 33-67 mg of dl-α-tocopherol/kg.

1 tab daily.

See also:
What is the most important information I should know about Folic acid (Pharmax)?

Because it may mask the hematologic abnormalities while neurological damage progresses, Folic acid (Pharmax) should not be used in the therapy of patients with vitamin B12 deficiency of any cause, unless there is associated folate deficiency. The Folic acid (Pharmax) content of one tablet a day however, is unlikely to mask pernicious anemia should this condition be present. Also, pregnancy during pernicious anemia is very rare.

Hypersensitivity. Patients w/ kidney failure, AV block, unless the patients are using pacemaker.

Hypersensitivity. Large doses (>1 g daily) of vit C in patients w/ G6PD deficiency. History of renal calculi, hyperoxaluria, oxalate dysbolism & thalassemia. Patients w/ Vit A (Pharmax) redundancy.

Hypersensitivity to any of the components of Vit B (Pharmax).

Increased sensitivity to ascorbic acid.

Hypersensitivity to vitamin E or to any of the components of Nature Vit E (Pharmax).

Use Folic acid (Pharmax) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Folic acid (Pharmax) may be administered as an injection by your health care professional.
• If you are using Folic acid (Pharmax) at home, carefully follow the injection procedures taught to you by your health care provider. If the medicine contains particles, is discolored, or if the vial is cracked or damaged in any way, do not use it.
• Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for selecting an appropriate container and properly disposing of the container when full.
• If you miss a dose of Folic acid (Pharmax), use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Folic acid (Pharmax).

Folic acid (Pharmax) is the man-made form of folate. Folate is a B-vitamin naturally found in some foods. It is needed to form healthy cells, especially red blood cells.

Folic acid (Pharmax) supplements may come in different forms (such as L-methylfolate, levomefolate, methyltetrahydrofolate). They are used to treat or prevent low folate levels. Low folate levels can lead to certain types of anemia. Conditions that can cause low folate levels include poor diet, pregnancy, alcoholism, liver disease, certain stomach/intestinal problems, kidney dialysis, among others. Women of childbearing age should receive adequate amounts of Folic acid (Pharmax) either through their diet or supplements to prevent infant spinal cord birth defects.

How to use Folic acid (Pharmax)

Take this product by mouth with or without food as directed by your doctor, usually once daily. If you are taking the over-the-counter product, follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.

Dosage is based on your medical condition and response to treatment. Do not increase your dose or take this product more often than directed.

Take this product regularly to get the most benefit from it. To help you remember, take it at the same time each day. Follow the diet plan recommended by your doctor or dietician. See also Notes section.

If your condition persists or worsens, or if you think you may have a serious medical problem, get medical help right away.

See also:
What other drugs will affect Folic acid (Pharmax)?

Medications that interfere with your bodys ability to use folate may also increase the need for this vitamin. Medications can interfere with folate utilization, including: anticonvulsant medications (such as phenytoin, and primidone) metformin (sometimes prescribed to control blood sugar in type 2 diabetes) sulfasalazine (used to control inflammation associated with Crohns disease and ulcerative colitis) triamterene (a diuretic) Methotrexate There has been concern about the interaction between vitamin B12 and Folic acid (Pharmax). Folic acid (Pharmax) supplements can correct the anemia associated with vitamin B12 deficiency. Unfortunately, Folic acid (Pharmax) will not correct changes in the nervous system that result from vitamin B12 deficiency. Permanent nerve damage could theoretically occur if vitamin B12 deficiency is not treated. Therefore, intake of supplemental Folic acid (Pharmax) should not exceed 1000 micrograms (g, sometimes mcg) per day to prevent Folic acid (Pharmax) from masking symptoms of vitamin B12 deficiency. It is important for older adults to be aware of the relationship between Folic acid (Pharmax) and vitamin B12 because they are at greater risk of having a vitamin B12 deficiency. If you are 50 years of age or older, ask your physician to check your B12 status before you take a supplement that contains Folic acid (Pharmax).

Concommitant use w/ biphosponate (alendronate, etidronate, risedronate), quinolone (ciprofloxacin, gatifloxacin, levofloxacin, lomefloxacin, moxifloxacin, norfloxacin, ofloxacin,sparfloxacin, trofafloxacin), tetracyclines (doxycycline, monocycline, tetracycline) may reduce absorption of these drugs (bisphosphonate, quinolone, tetracycline). Increased Mg level in plasma w/ boron. Ca, manganese, Fe, Na alginate reduces the absorption of Mg. Inositol hexaphosphate suppresses the absorption of Mg. Indigestible oligosaccharide increases the absorption of Mg in the colon. Phosphate reduces the absorption of phosphate & Mg. Concomitant use w/ oxalic acid-rich food (spinach, potatoes, rhubarb, legumes) or phytate acid (legumes) reduces the absorption of Mg.

Vit E increases absorption of Vit A (Pharmax). Inhibits absorption & function of vit K w/ high doses of vit E. Reduced effects of vit E w/ Fe prep. Reduced absorption of Vit A (Pharmax) & E w/ cholestyramine & liqd paraffin.

High doses of Vit B (Pharmax)₆ may decrease the actions of L-dopa.

In an application with barbiturates, primidone increases the excretion of ascorbic acid in the urine.

With the simultaneous use of oral contraceptives reduces the concentration of ascorbic acid in blood plasma.

In an application of Vit C (Pharmax) with iron preparations ascorbic acid, due to its regenerative properties, transforms ferric iron in the bivalent, which improves its absorption.

Ascorbic acid in high doses can decrease urine pH that while the application reduces the tubular reabsorption of amphetamine and tricyclic antidepressants.

With the simultaneous use of aspirin reduces the absorption of ascorbic acid by about a third.

Vit C (Pharmax) in an application with warfarin may decrease effects of warfarin.

With the simultaneous application of ascorbic acid increases the excretion of iron in patients receiving deferoxamine. In the application of ascorbic acid at a dose of 500 mg / day possibly left ventricular dysfunction.

In an application with tetracycline is increased excretion of ascorbic acid in the urine.

There is a described case of reducing the concentration of fluphenazine in plasma in patients treated with ascorbic acid 500 mg 2 times / day.

May increase the concentration of ethinyl estradiol in the blood plasma in its simultaneous application in the oral contraceptives.

Vitamin E increases the absorption, intake and storage of vitamin A, and may protect against the vitamin A redundancy disease. However these effects have not been established yet.

The use of vitamin E dosages >10 IU/kg body weight may slow response to the iron therapy in children suffering from iron deficiency anemia. Vitamin E deficiency in children treated with iron supplements may result to hemolytic anemia. Vitamin E and its metabolites may protect against the action of vitamin K. Patients who take oral anticoagulants have risk of hemorrhage after taking the large dose of vitamin E. In healthy volunteers, vitamin E did not change the blood clotting process.

Excessive use of mineral oil may decrease the vitamin E absorption.

See also:
What are the possible side effects of Folic acid (Pharmax)?

Allergic sensitization has been reported following both oral and parenteral administration of Folic acid (Pharmax).

Folic acid (Pharmax) is relatively nontoxic in man. Rare instances of allergic responses to Folic acid (Pharmax) preparations have been reported and have included erythema, skin rash, itching, general malaise, and respiratory difficulty due to bronchospasm. One patient experienced symptoms suggesting anaphylaxis following injection of the drug. Gastrointestinal side effects, including anorexia, nausea, abdominal distention, flatulence, and a bitter or bad taste, have been reported in patients receiving 15 mg Folic acid (Pharmax) daily for 1 month. Other side effects reported in patients receiving 15 mg daily include altered sleep patterns, difficulty in concentrating, irritability, overactivity, excitement, mental depression, confusion, and impaired judgment. Decreased vitamin B12 serum levels may occur in patients receiving prolonged Folic acid (Pharmax) therapy.

In an uncontrolled study, orally administered Folic acid (Pharmax) was reported to increase the incidence of seizures in some epileptic patients receiving phenobarbital, primidone, or diphenylhydantoin. Another investigator reported decreased diphenylhydantoin serum levels in folate-deficient patients receiving diphenylhydantoin who were treated with 5 mg or 15 mg of Folic acid (Pharmax) daily.

CALL YOUR DOCTOR FOR MEDICAL ADVICE ABOUT SIDE EFFECTS. YOU MAY REPORT SIDE EFFECTS TO THE FDA AT 1-800-FDA-1088 OR LEADING PHARMA, LLC AT 844-740-7500.

Diarrhea (doses >350 mg daily). Nausea & abdominal cramps.

Nausea, vomiting, diarrhoea.

Long-term use of large doses of Vit B (Pharmax)₆ may lead to severe peripheral neuropathies.

CNS: headache, fatigue, insomnia.

Digestive system: stomach cramps, nausea and vomiting.

Allergic reaction: describes a few cases of skin reactions and manifestations of the respiratory system.

Urinary system: when used in high doses - hyperoxaluria and the formation of kidney stones of calcium oxalate.

Local reactions: with intravaginal application - a burning or itching in the vagina, increased mucous discharge, redness, swelling of the vulva. Other: sensation of heat.

Vitamin E is usually well tolerated. Large doses of vitamin E may cause diarrhea, abdominal pain, other gastrointestinal disturbances, and have also been reported to cause fatigue and weakness.