# How much folic whilst on steroids?



## Grace72 (Jul 14, 2011)

Hi 

I have been prescribed 20mg predisolone steroid on day 7 of my stimms. I have read that to reduce the risk of cleft palette etc that i should increase my intake of folic from 400mcg . Please can you recommend what dosage is adequate and should the clinic prescribe this for me?

I have EC on Wednesday and am anxious on whether i should have started increasing my intake already?

Hope you can help?

Grace


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## Mistletoe (Holly) (Jan 1, 2007)

I would be interested to see a reference. Where have you read it?

I have checked the manufacturer's data sheet for prednisolone and the one for folic acid, I have also checked the British National Formulary and Stockley's Drug interactions (all the standard reference texts used by medicines information pharmacists) and I cannot find anything about an interaction.

In the data sheet for prednisolone it says that there is no evidence in man of these abnormalities.

''*Pregnancy: *The ability of corticosteroids to cross the placenta varies between individual drugs, however, 88% of prednisolone is inactivated as it crosses the placenta. Administration of corticosteroids to pregnant animals can cause abnormalities of foetal development including cleft palate, intra-uterine growth retardation and affects on brain growth and development. There is no evidence that corticosteroids cause an increased incidence of congenital abnormalities, such as cleft palate/lip in man. However, when administered for prolonged periods or repeatedly during pregnancy, corticosteroids may increase the risk of intrauterine growth retardation. Hypoadrenalism may occur in the neonate following prenatal exposure to corticosteroids but usually resolves spontaneously after birth and is rarely clinically important. As with all other drugs, corticosteroids should only be prescribed when the benefits to the mother and child outweigh the risks.''

In patients on drugs like antiepileptics where there really is an effect on folic acid then we increase the dose to 5mg.

I would discuss it with your doctor and see what they think about the references you have found and whether it is necessary to increase the dose.


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## Grace72 (Jul 14, 2011)

hi Holly - sorry for late reply . I had the ET today so fingers crossed they're sticking.  Thanks for the info. i dug out the info sheet from my clinic and it has mentioned the risk of cleft palate. You post makes me feel heaps better tho. I just dont know whether taking an extra folic 400ug  post ET is detrimental or worth a shot .  

I also wanted to check with taking prednisolone - i was asked to take 20mg but i've taken all 4 tablets (5mg) in one go. Should i be taking them 4 times a day   Does it make a difference 

Thanks again 

Grace


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## mazv (Jul 31, 2006)

You should take the full dose once a day in the morning, with or after food. Best to take it as early as possible, taking steroids later in the day can cause problems with sleep.


Maz x


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## Grace72 (Jul 14, 2011)

mazv - thank you !


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