Medication Summary
The 2 most common causes of megaloblastic anemia are vitamin B-12 (cobalamin) deficiency and folinic acid deficiency. Treatment may require supplemental administration of these vitamins.
Vitamins
Class Summary
Vitamins are organic substances required by the body in small amounts for various metabolic processes. Vitamins may be synthesized in small or insufficient amounts in the body or not synthesized at all, thus requiring supplementation. Use folic acid and vitamin B-12 supplements as indicated.
Folic acid (Folacin-800)
A member of the vitamin B group, folic acid is reduced in the body to 5 methyl tetrahydrofolate (THF), which is a coenzyme for various metabolic processes including purine and pyrimidine nucleotides synthesis essential for DNA. Folic acid is an important cofactor for enzymes used in production of red blood cells.
Cyanocobalamin (CaloMist, Nascobal, Ener-B)
Deoxyadenosylcobalamin and hydroxocobalamin are active forms of vitamin B-12 in humans. Vitamin B-12 is synthesized by microbes but not humans or plants. Vitamin B-12 deficiency may result from inadequate dietary intake, intrinsic factor deficiency (pernicious anemia), partial or total gastrectomy, or diseases of the distal ileum.
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Bone marrow aspirate from a patient with untreated pernicious anemia. Megaloblastic maturation of erythroid precursors is shown. Two megaloblasts occupy the center of the slide with a megaloblastic normoblast above. Photo courtesy of Marcel E Conrad, MD.
