|Composition||L-Methylfolate 1mg + Methylcobalamin 1500 mcg+ Pyridoxal-5-Phosphate 0.5mg|
|Indication||Prevention of Neural tube defects, Preterm birth, Anemia|
|Mechanism of Action||
L-Methylfolate is the primary biologically active isomer of folic acid and the primary form of folate in circulation. L-methylfolate crosses the blood-brain barrier for use in the CNS. L-methylfolate exert its action by enhancing synthesis of monoamine neurotransmitters, and has been categorized as a “trimonoamine modulator” because it is necessary for serotonin, dopamine, and norepinephrine synthesis.
Pyridoxine Phosphate (PLP) Convert levodopa into dopamine. PLP then facilitates the conversion of the excitatory neurotransmitter glutamate to the inhibitory neurotransmitter GABA, and allows SAM to be decarboxylated to form propylamine, which is a precursor to polyamines.
Absorption and Elimination: L-methyl folate is a water soluble molecule which is primarily excreted via the kidneys.8 In a study of subjects with coronary artery disease (n=21), peak plasma levels were reached in 1-3 hours following ORAL/PARENTERAL administration. Peak concentrations of L-methylfolate were found to be more than seven times higher than folic acid (129 ng ml-1 vs. 14.1 ng ml-1) following ORAL/PARENTERAL administration.
Elimination:half-life is approximately 3 hours for Lmethylfolate after the administration of 5mg of oral D,L-methylfolate. The mean values for Cmax, Tmax, and AUC0-12 were 129 ng ml-1, 1.3 hr., and 383 respectively.
Distribution:Red blood cells (RBCs) appear to be the storage depot for folate, as RBC levels remain elevated for periods in excess of 40 days following discontinuation of supplementation.10 Plasma protein binding studies showed that L-methylfolate is 56% bound to plasma proteins.
Folate alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient. Folate in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission may occur while neurological manifestations progress.
Patient with history of bipolar illness
Twice daily or as directed by Physician.