FOLAMIL Caplet

Indication

Supplement of complete multivitamin and mineral during pregnancy and lactating period.

Dosage and administration

Pregnant and lactating women: One film-coated caplet daily after meal

FOLAMIL contraindicated in patients hypersensitive to any component of the product.

There are no serious adverse reactions for using FOLAMIL film-coated caplet at commonly recommended dosage.

• Chronic use of loop diuretics may result in thiamin deficiency. Substances in food (e.g., sulfite, caffeine) may inactivate thiamin. Although the clinical importance is unknown, thiamin reportedly may enhance the effect of neuromuscular blocking agents.

• Probenecid may inhibit the absorption of riboflavin and also inhibit renal tubular secretion of riboflavin. Use of oral contraceptive agents may result in decreased serum levels of riboflavin.

• The use of oral contraceptives may increase vitamin B6 requirements. Chronic and excessive use of alcoholic beverages can result in vitamin B6 deficiency.

• Metformin may decrease the absorption of vitamin B12; this possible effect may be reversed with oral calcium supplementation. Folic acid may work synergistically with vitamin B12 in lowering homocysteine levels. Supplementary vitamin D should be used cautiously in those on digoxin or any cardiac glycoside. Hypercalcemia in those on digoxin may precipitate cardiac arrhythmias.

• Women, who are taking folic acid supplements, especially if they are current or former users of oral contraceptives, are at risk for lower plasma zinc concentrations.

• Concomitant use of lithium salt and potassium iodide may result in an additive or synergistic hypothyroid effect.

Pregnant women and nursing mothers should avoid using FOLAMIL in a dose greater than suggested dose.

• Pregnant women and nursing mothers should avoid using FOLAMIL in a dose greater than suggested dose.

• Beta carotene should be used with caution in patients with impaired renal or liver function because safe use of the drug in the presence of these conditions has not been established.

• Riboflavin absorption is increased in hypothyroidism and decreased in hyperthyroidism.

• Supplementary calcium should not be used in patients with hypercalcemia (conditions causing hypercalcemia include sarcoidosis, hyperparathyroidism, hypervitaminosis D and cancer).

• Vitamin B 12 should not be used in those with Leber's optic atrophy (a congenital disorder associated with chronic cyanide intoxication [e.g., from tobacco smoke]). Decreased levels of vitamin B12 have been associated with reduced ability to detoxify the cyanide in exposed individuals and vitamin B 12 may increase the risk of irreversible neurological damage from optic atrophy in those affected with the disorder.

• Vitamin C is involved in modulating iron absorption and transport.

• Vitamin D should not be used in those with hypercalcemia and vitamin D toxicity.

• Iron supplements should be used with extreme caution in those with chronic liver failure, alcoholic cirrhosis, chronic alcoholism and pancreatic insufficiency.

• Supplementary copper should not be used in patients with Wilson's disease (hepatolenticular degeneration), a disease of abnormal copper accumulation.

• Use of fluoride supplement is contraindicated in areas where fluoride water content is greater than 0.6 parts per million (ppm) or 0.6 milligrams per liter.

FOLAMIL is a supplement containing multivitamin and mineral which are needed by pregnant and lactating women. Addition of multivitamin and mineral are needed to help prevent deficiency because of increased requirements, insufficiency of vitamin and mineral intake or the failure of food absorption.

Beta carotene may have antioxidant activity in some with conditions of increased oxidative stress.

Vitamin B1 plays an essential role in the metabolism of carbohydrates, a major source of energy in our cells. It is used to prevent and to treat beriberi.

Vitamin in B2 may (riboflavin) also work is in important for energy production and tissue repair.

Riboflavin may also work in conjunction with iron to correct iron-deficiency anemia.

Nicotinamide, via its major metabolite NAD+ (nicotinamide adenine dinucleotide), is involved in a wide range of biological processes, including the production of energy, the synthesis of fatty acids, cholesterol and steroids. signal transduction, and the maintenance of the integrity of the genome. It may also have antioxidant activity.

Vitamin B6 is necessary for the production of serotonin and other neurotransmitters in the brain and required by the body to turn iron into hemoglobin. and to produce red blood cells.

Calcium is useful in preventing and treating osteoporosis. It is useful in maintaining strong, healthy bones. It is involved in blood clotting and the transmission of nerve impulses. It aids in the absorption of many nutrients, especially vitamin B12.

Vitamin B12 is required for nucleoprotein and myelin synthesis, cell reproduction, normal growth and the maintenance of normal erythropoiesis.

Vitamin B12 plays a role in blood formation, it is needed to form red blood cells in the marrow.

Vitamin C has antioxidant activity. Vitamin C may also be useful as an immune stimulator and modulator in some circumstances.

Vitamin D supplementation can be of benefit to the neonate, helping to ensure healthy osteogenesis and to prevent low-birth weight. Vitamin D enhances lactational performance in some.

Folic acid lowers the risk of neural tube defects and possibly other types of birth defects. Folate coenzymes play a vital role in DNA metabolism.

Potassium iodide is an antithyroid agent.

The major activity of supplemental iron (ferrous fumarate) is in the prevention and treatment of iron deficiency anemia.

Copper may have antioxidant activity.

Copper helps our body absorbs and use iron to synthesize hemoglobin. It plays a role in maintaining the integrity of myelin.

Sodium fluoride is useful in preventing dental caries.