Uses

This combination of folate, vitamin B12, and vitamin B6 is used as a nutritional supplement to support homocysteine metabolism, prevent neural tube defects in pregnancy, support red blood cell formation, and treat or prevent deficiencies of these vitamins. It is commonly prescribed as a prenatal supplement.

Do not use if

Contraindicated in patients with known hypersensitivity to any ingredient. Folic acid alone (without B12) should not be used in confirmed B12 deficiency as it may correct the anemia while neurological damage progresses.

Side effects

Generally well tolerated. Rare allergic reactions to folic acid following oral or parenteral administration have been reported. High doses of vitamin B6 (pyridoxine) may cause peripheral sensory neuropathy with chronic use. Vitamin B12 injections may rarely cause skin reactions.

Warnings

High-dose folic acid may mask the hematologic signs of vitamin B12 deficiency while neuropathy progresses. Store away from children. Accidental iron overdose warning applies if this supplement is combined with iron in a prenatal formulation.

How it works

Folate (reduced to tetrahydrofolate) participates in one-carbon transfer reactions critical for DNA synthesis and amino acid metabolism, including conversion of homocysteine to methionine. Vitamin B12 (methylcobalamin) is a cofactor in the methionine synthase reaction. Vitamin B6 (pyridoxal phosphate) is required for transsulfuration of homocysteine to cystathionine, collectively reducing plasma homocysteine levels.

Storage

Store between 15–30°C (59–86°F). Protect from extreme temperatures; avoid freezing and excessive heat.