Appeton Essentials Folic Acid Tablet

Appeton Essentials Folic Acid Tablet is a single-nutrient folic acid supplement from Appeton, a brand of Kotra Pharma (M) Sdn Bhd in Malaysia. Each small tablet provides 400mcg of folic acid, the synthetic form of folate (vitamin B9), which matches the recommended daily intake used for women of childbearing age. This listing is for a pack of 90 tablets, which is about a three-month supply at one tablet a day.

Folate is a water-soluble B vitamin involved in DNA synthesis and normal cell division, and it contributes to normal blood formation. Because the neural tube of a baby forms in the first weeks of pregnancy, often before a pregnancy is confirmed, health authorities advise women who could become pregnant to take 400mcg of folic acid daily in addition to folate from food. The manufacturer describes the product for women who are planning a pregnancy and women in early pregnancy, and suggests starting about three months before trying to conceive.

This product contains folic acid only. It is not a complete prenatal multivitamin, so it does not provide iron, iodine, vitamin D, calcium or DHA. If you are already taking a prenatal multivitamin that contains folic acid, or your doctor has prescribed a higher-strength folic acid tablet (for example 5mg), check the total amount with your doctor or pharmacist before adding this product.

Take one tablet a day, swallowed whole with a glass of water. It can be taken with or without food; taking it with a meal at the same time each day may help you remember it.

If you are planning a pregnancy, the manufacturer suggests starting about three months before trying to conceive and continuing in early pregnancy, or as advised by your doctor.

Adults (women planning a pregnancy or in early pregnancy): 1 tablet (400mcg folic acid) once daily, or as directed by your doctor or pharmacist.

Do not take more than the recommended amount unless advised by a doctor. The tolerable upper intake level for folic acid from supplements and fortified foods for adults is 1,000mcg a day, so remember to count folic acid from any other supplements. If you miss a tablet, take the next one at the usual time; do not take two tablets to make up for a missed one.

Store as stated on the product label. Keep in a cool, dry place away from direct sunlight, heat and moisture, with the container tightly closed. Keep out of reach of children.

• Common: Folic acid at 400mcg a day is generally well tolerated, and most people notice no side effects.
• Common: Mild stomach upset, nausea, bloating or loss of appetite may occasionally occur.
• Serious: Allergic reactions are rare. Stop taking the tablets and seek medical help immediately if you develop a rash, itching, swelling of the face, lips or throat, or difficulty breathing.
• Excess intake: Regularly taking more than 1,000mcg of folic acid a day without medical advice can hide the signs of vitamin B12 deficiency, which may allow nerve damage to progress unnoticed.

• Do not take if you are allergic to folic acid or any other ingredient in the tablet.
• Not suitable as self-treatment for anaemia that has not been diagnosed. Anaemia caused by vitamin B12 deficiency (including pernicious anaemia) needs proper medical assessment, because folic acid alone can improve the blood count while nerve damage continues.

• Antiepileptic medicines (e.g. phenytoin, carbamazepine, valproate): these can lower folate levels, and folic acid supplements may lower the blood levels of some of these medicines. Women taking epilepsy medicines and planning a pregnancy often need a different folic acid dose, so speak to your doctor before starting.
• Methotrexate: folic acid can interfere with methotrexate used for cancer; people on methotrexate for any condition should only take folic acid as directed by their doctor.
• Sulfasalazine: may reduce the absorption of folate; ask your doctor whether you need extra folic acid.
• Other folic acid sources: prenatal multivitamins, B-complex products and fortified foods also contain folic acid. Check the total amount to avoid regularly going above 1,000mcg a day unless your doctor advises it.
• Food: no significant food interactions are known. Heavy alcohol intake reduces folate absorption and should be avoided, particularly when planning a pregnancy.

• Start folic acid before you try to conceive, as the baby’s neural tube forms very early in pregnancy, often before you know you are pregnant.
• Set a daily reminder, such as taking your tablet with breakfast, so you do not miss doses.
• Check the label of any prenatal multivitamin you take; many already contain folic acid, so you may not need this product as well.
• If you have epilepsy, diabetes, a previous pregnancy affected by a neural tube defect, or a BMI of 30 or above, ask your doctor whether you need a higher prescribed dose.
• Continue to eat folate-rich foods such as green leafy vegetables, legumes and oranges; the supplement adds to a balanced diet rather than replacing it.
• Keep the bottle tightly closed and out of reach of children.

Precautions: This product contains folic acid only and does not replace a doctor-recommended prenatal regimen. Women with epilepsy, diabetes, obesity, coeliac disease, sickle cell disease, or a previous pregnancy affected by a neural tube defect may need a higher prescribed dose. People with low vitamin B12 levels, older adults, strict vegetarians or vegans should have their vitamin B12 status considered, as folic acid can mask B12 deficiency. Avoid regularly exceeding 1,000mcg of folic acid a day from all supplements unless advised by a doctor.

When to See a Doctor or Pharmacist: Before starting if you take antiepileptic medicines, methotrexate or sulfasalazine, or if you have a known blood disorder or unexplained anaemia. Seek medical help promptly if you develop signs of an allergic reaction, or symptoms such as numbness, tingling, unusual tiredness or a sore tongue, which may point to vitamin B12 deficiency.