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Is 2000mg of folic acid per day a really high dose for an elderly (age 50-60)? This is what the doctor prescribed. I am assuming the patient has anemia, but I am not sure.
Is 2000mg of folic acid per day a really high dose for an elderly (age 50-60)? This is what the doctor prescribed. I am assuming the patient has anemia, but I am not sure.
I wouldn't consider age 50 to 60 elderly. But that is a high dose. It's usually 1 mg/day. Did you mean 2000 mg or 2000 MCG?
Wow I'm terrible. I read it as mcg. Good catch.
Although I think it is used at doses that high (or higher) in pregnant females with family history of or prior pregnancy with a neural tube defect.
But not for a middle aged dude, as far as I know.
Yeah, on the high end definitely. I've seen it for pregnant women who couldn't be transitioned off their anticonvulsants and those doses can go up to 4mg/day.
I was thinking methotrexate use for RA.
I certainly hope you pause for a second and wonder "WTF am I doing?" before you tell the patient to take 2,000 1 mg tablets by mouth daily or inject 400 mL of 5 mg/mL solution.Is 2000mg of folic acid per day a really high dose for an elderly (age 50-60)? This is what the doctor prescribed. I am assuming the patient has anemia, but I am not sure.
I take 1 mg OTC every day for my anemia.
How are you making a 1mg dose up from available OTC formulations? The 1 mg tablet is RX only.
Yeah, on the high end definitely. I've seen it for pregnant women who couldn't be transitioned off their anticonvulsants and those doses can go up to 4mg/day.
Working with pediatric leukemia patients, Sidney Farber first gave folic acid. After he noticed it made the cancer more aggressive, he concluded he needed an anti-folate. Of my own curiosity and failure to find early data, does anyone know how much folic acid he was giving these original patients?
Farber and colleagues performed dose ranging studies of folic acid (pteroyglutamic acid) from 10 mg to 500 mg daily via several routes (IM, IV, PO) to 90 patients without reports of toxicity. They subsequently recommended dosages of 20-50 mg/day intramuscularly.
Farber et. al. "The action of pteroyglutamic conjugates on man." Science 1946.
Good luck finding that one...
I've seen doses up to 5 mg/daily used for certain hyper coagulable states (I believe they are associated with elevated amounts of homocysteine). I'm too lazy, tired, and sick right now to research it though.
2000 mg is obviously a typo. On the flip side I wouldn't even think twice about 2000 mcg daily.
Homozygous MTHFR mutation is what you're referring to....however usually they give more reduced forms of folic avid as conversion is the primary issue
Off topic but I love the ballsy-ness of leukovorin rescue therapy. We are going to give you enough MTX to kill a horse but don't worry. We have the antidote ready to go!!