Deplin (Methylfolate or L-methyl folate) is the active form of folic acid that is an essential component of DNA, enzymes, and co-enzyme synthesis.

Deplin (Methylfolate) Uses:

• It is used as a medical food to supplement the nutritional requirements of patients with suboptimal levels and concomitant depression or schizophrenia.

Note:

• Medical food is intended to be administered under the supervision of a physician.
• It is specifically formulated to be administered orally or via a nasogastric tube to meet specific dietary requirements in specific conditions as in conditions that have distinctive nutritional needs.
• It is essential to remember that medical foods are not drugs and are not monitored by drug regulatory authorities like the FDA or DRAP.
• Food and drug regulatory authorities usually do not monitor their dispensing, approval, proof of safety, efficacy, adverse effects, or prescriptions.

Deplin Dose in Adults:

Deplin (Methylfolate) Dose as a medical food in Adults:

• 7.5 to 15 mg orally daily

Deplin (Methylfolate) Dose in Children:

The safety and efficacy of the drug in children have not been established.

Deplin (Methylfolate) Pregnancy Risk Category: A

• Folic acid is required for a number of co-enzymes in many metabolic pathways. 
• It is particularly essential for the synthesis of purines and pyrimidine, nucleoproteins, and erythropoiesis.
• It also stimulates the production of platelets and WBCs in patients with folate deficiency anemia. In methanol intoxication, folic acid helps in converting the toxic metabolite of methanol (formic acid) to non-toxic metabolites.

Deplin (Methylfolate) Dose in Renal Impairment:

Patients with renal impairment do not need to change their dose. However, patients with kidney impairment and especially those on hemodialysis may require higher than usual doses.

Deplin (Methylfolate) Dose in Liver disease:

There are no dosage adjustments mentioned. However, patients with liver disease may require higher than normal doses especially those with alcoholic liver disease.

Side effects of Deplin (Methylfolate):

• Sleep disturbance
• Headache
• Impaired concentrating ability
• Irritability
• hyperactivity
• Excitement and confusion
• Impaired judgment
• Nausea, distaste, and abdominal bloating
• Abdominal fullness and distension
• Weight loss
• Impaired sensation and ataxia (when concomitant B12 deficiency exists)

Contraindications to Deplin (Methylfolate):

Allergy reactions to any component of the drug or the drug itself

Warnings and precautions

• Anemia:

  • Patients with pernicious or other megaloblastic anemia should not use it as a monotherapy.
  • This could lead to permanent neurological damage.

• Pernicious anemia:

  • It can mask anemia, especially if the daily dose is greater than 0.1 mg.
  • There is a risk of irreversible neurologic damage. A neurological evaluation is required.

Methylfolate: Drug Interaction

Monitoring Parameters:

Monitor blood CBC in patients treated for folate deficiency anemia. Assess neurological status and monitor for subacute combined degeneration in patients treated with folic acid (especially when vitamin B12 levels are not known).

How to administer Deplin (Methylfolate)?

It is administered orally with or without food.

Mechanism of action of Deplin (Methylfolate):

• The active form of Folic acid in the body is Methylfolate or L-methyl folate. 
• It crosses the blood-brain barrier to reach the peripheral tissues.
• Folic acid usually referred to as folate or Vitamin B9, is necessary for the efficient operation of several enzymes and coenzymes within a variety of metabolic pathways.
• Folic Acid is essential for the synthesis and maintenance of nucleoproteins, pyrimidine, purines, and pyrimidine.
• It is also essential in maintaining erythropoiesis, as well as in the production and maintenance of leukocytes.

International Brand Names of Methylfolate:

• Deplin 15
• L-Methylfolate Formula 15
• L-Methylfolate Formula 7.5
• Deplin 7.5
• Denovo
• Elfolate
• L-Methylfolate Forte

Methylfolate Brand Names in Pakistan:

No Brands Available in Pakistan.