FAQ for Mteryti® Folic 5
- What is Mteryti® Folic 5
- Mteryti® Folic 5 is a prenatal high dose folic acid MultiVitamin/MultiMineral Supplement Tablet formulated for use in women who are planning pregnancy or are pregnant and may have risk factors for NTDs, such as, but not limited to:
- previous pregnancy affected by a NTD, or
- family history of NTD,
- diabetes or malabsorption disorders,
- taking medications used for seizure control or that are known to decrease folate levels.
- require a high dose folic acid supplement in the opinion of their physician or healthcare professional.
- What is the recommended dosage schedule for Mteryti® Folic 5?
- Women are to take one pink (a.m.) and one dark blue (p.m.) Mteryti® Folic 5 tablet daily at least 2‐3 months prior to conception, continuing up to 10 to 12 weeks after the last menstrual period, or throughout pregnancy, based on the judgment of the physician or healthcare professional.
One pink (a.m.) tablet should be taken every morning on an empty stomach, one hour before breakfast, with a glass of water. One dark blue (p.m.) tablet should be taken with a glass of water close to the evening meal (before or after), i.e. within one hour of the evening meal.
- Should Mteryti® Folic 5 be taken with or without food?
- Mteryti® Folic 5 pink (a.m.) tablet should be taken on an empty stomach with a glass of water. Patient should avoid food and beverages for one (1) hour after taking the pink (a.m.) tablet to optimize iron absorption.
Mteryti® Folic 5 dark blue (p.m.) tablet should be taken within one (1) hour of the evening meal to optimize calcium absorption. For example, if a woman has her dinner at 6p.m., it is recommended that she takes her Mteryti® Folic 5 dark blue (p.m.) tablet anytime between 5p.m. and 7p.m., even with her evening meal.
- Can the pink (a.m.) and the dark blue (p.m.) tablets be taken at the same time?
- We do not recommend to take Mteryti® Folic 5 pink (a.m.) and dark blue (p.m.) tablet at the same time. The purpose of taking the two tablets at different times is to optimize the absorption of the most essential nutrients during pregnancy (i.e. folic acid, iron, calcium). As calcium can prevent the iron from being properly absorbed, Mteryti® Folic 5 provides iron in the morning tablet and calcium in the evening tablet to allow for optimal iron absorption.
- Can Mteryti® Folic 5 tablets be crushed/split/chewed?
- We do not have absorption or stability data available on split, crushed or chewed tablets. Splitting, crushing, or chewing the tablets is not recommended.
- What can be done to decrease the risk of having a child with a neural tube defect (NTD)?
- The increased intake of folic acid has been shown to decrease the chances of having a child with a NTD. It is recommended that women who are at risk of having a child with NTD take a prenatal multivitamin supplement containing 4-5 mg of folic acid at least 2 to 3 months prior to conception continuing up to 10 to 12 weeks after the last menstrual period.
It is important to check if you have a prior history of NTD and any family history of NTD in the first, second and third degree generation.
- Prior history of NTD: previous pregnancy affected by an NTD
- First Degree Generation: child, brothers, sisters, mother, father
- Second Degree Generation: grandparents, aunts, uncles, nieces, nephews, half siblings
- Third Degree Generation: first cousins, great grandparents
- Siblings: brother/sisters
- Why take Mteryti® Folic 5 prior to conception?
- If you are planning a pregnancy, it is important to take sufficient amount of folic acid in order to have proper level of folic acid at the time of conception and when the neural tube normally closes (which starts approximately 21 days post‐conception and is usually complete by 28 days; around the time a woman may first recognize her pregnancy by a missed menstrual period).
- Who should take a prenatal multivitamin with 5 mg of folic acid?
- Some women are at greater risk of having a child born with neural tube defects. Taking a supplement with 5 mg of folic acid can decrease this risk. Mteryti® Folic 5 is formulated for women who have had a previous pregnancy resulting in a child with a neural tube defect (NTD), who have a family history of NTDs, who have diabetes, who have gastrointestinal disorders (e.g. Crohn’s disease, ulcerative colitis) resulting in malabsorption or who are taking drugs that interfere with folic acid metabolism such as epilepsy drugs.
If you have any of the medical conditions or situations described above, discuss folic acid supplementation with your healthcare professional.
- Should all women at risk go back to a standard dose of folic acid after using Mteryti® Folic 5 during the first trimester?
- Mteryti® Folic 5 is labelled for use preconceptionally until the end of first trimester. Mteryti® Folic 5 should be used until 10-12 weeks gestation. At this time, patients should be instructed to switch to Mteryti® for the remainder for their pregnancy, and during the post-partum period. In certain situations, a healthcare professional may advise otherwise. Always follow the instructions provided by your healthcare professional.
- Why does Mteryti® Folic 5 have this 2‐step approach?
- In Mteryti® Folic 5, calcium is contained in the dark blue (p.m.) tablet and iron in the pink (a.m.) tablet. The purpose of taking two tablets at different times is:
- to prevent calcium inhibition on the absorption of iron*
- to have vitamin C facilitate the absorption of iron*
- How should Mteryti® Folic 5 be taken when it is concurrently taken with levothyroxine hormone (thyroid medication)?
- Absorption of thyroid medication could be reduced if taken at the same time as iron or calcium supplements. Therefore, for women taking levothyroxine hormone in the morning on an empty stomach, it is recommended to take the Mteryti® Folic 5 pink (a.m.) tablet at least four (4) hours apart to optimize the absorption of levothyroxine hormone. In this case, it is preferable to stay on an empty stomach at least 2 hours before taking the pink (a.m.) tablet and 1 hour after to ensure iron absorption optimization.
For women taking levothyroxine hormone at bedtime, it is recommended to take the Mteryti® Folic 5 dark blue (p.m.) tablet at least four (4) hours apart to optimize the absorption of levothyroxine hormone. [It should be kept in mind that it is recommended that the dark blue (p.m.) tablet be taken within 1 hour of an evening meal.
- If you cannot take the pink (a.m.) tablet on an empty stomach, can you reverse the order by taking the dark blue (p.m.) tablet in the morning and the pink tablet at night with Mteryti® Folic 5?
- We do not recommend this dosage schedule. The Mteryti® Folic 5 dosage schedule is based on scientific knowledge. The body best absorbs iron on an empty stomach and the calcium carbonate contained in the dark blue (p.m.) tablet is best absorbed when taken with food.
If for any reason you can’t take the pink (a.m.) tablet one hour before your breakfast (e.g. on thyroid medication, feels nauseated in the morning), the pink (a.m.) tablet may be taken two (2) hours or more after breakfast. Following administration of the pink (a.m.) tablet a wait of one (1) additional hour is recommended before eating or drinking in order to optimize the absorption of iron. It is preferable to have at least 4 hours in between the intake of the tablets.
- What if you forget to take Mteryti® Folic 5 pink (a.m.) or dark blue (p.m.) tablet?
- It is important to note that taking vitamin and mineral supplements during pregnancy does not eliminate the need for a complete and balanced diet. When a dose has been missed, it should be taken as soon as possible: one pink (a.m.) and one dark blue (p.m.) tablets should be taken within a 24 hour period. It is recommended that Mteryti® Folic 5 pink (a.m.) and dark blue (p.m.) tablets be taken at least four (4) hours apart in order to optimize the absorption of nutrients.
If you realize you forgot to take one or both Mteryti® Folic 5 tablets on the next day, you should not try to catch up. An occasional omission should not pose a problem. It is important that only one pink (a.m.) tablet and one dark blue (p.m.) tablet be taken per day.
The dosing schedule should then continue as directed by your healthcare professional.
- Does Mteryti® Folic 5 contain other vitamins and minerals beside folic acid?
- Yes. Mteryti® Folic 5 is designed to ensure pregnant women get the vitamins and minerals generally needed during pregnancy.
It is important to note that taking vitamin and mineral supplements during pregnancy does not eliminate the need for a complete and balanced diet.
- Do Mteryti® and Mteryti® Folic 5 have the same ingredients?
- Yes, other than the amount of folic acid in the blue/dark blue (p.m.) tablet, ingredients are the same.
- Why is folic acid in the evening tablet?
- Mteryti® Folic 5 provides folic acid in the evening tablet to ensure that a woman will continue to receive her daily requirement of folic acid in the rare event that she is unable to tolerate the level of iron found in the morning tablet for a short period of time. Concurrent ingestion of folic acid and iron may result in the formation of stable complexes. Folic acid is provided separately from iron so potential interaction may be avoided.*
- Why is there no DHA (Docosahexaenoic acid) in Mteryti® Folic 5?
- Because the benefits of DHA (Docosahexaenoic acid) during pregnancy have not been proven, Dietary Reference Intakes (DRIs) have not been established in the United States. However, many expert groups suggest 200 mg of DHA intake daily. This may be achieved in a number of ways but is ideally derived by eating 1 to 2 portions of fish per week. Approximately 1 g of EPA/DHA can be obtained from 100 g (3.5 oz) of oily fish. Because of the risk of mercury exposure, pregnant women should avoid shark, king mackerel, swordfish, and tilefish.
In short, pregnant women should consume at least 2 meals of fish per week to achieve a DHA goal of 200 mg/day. Supplementation with DHA and EPA cannot be definitively recommended during pregnancy because of lack of data. However, evidence of risk is low. If you or the patient feel that DHA is appropriate both the animal and plant forms are available OTC at a very reasonable price.
- Why do you have "Zinc" logo on the package?
- The International Zinc Association states that zinc is a trace‐element especially important during pregnancy, for the growing fetus whose cells are rapidly dividing. Zinc also helps to avoid congenital abnormalities and pre‐term delivery. Since our goal was to develop a prenatal/postpartum multivitamin that meets the highest standards, we made sure to meet their recommendations with regard to the inclusion of zinc.
- Is Mteryti® Folic 5 suitable for people with food constraints?
- Yes. Mteryti® Folic 5 is Lactose, gluten and tartrazine free and has received the Kosher, Kosher for Passover, and Halal certifications.
- Is Mteryti® Folic 5 certified Kosher/Halal?
- Yes. Mteryti® Folic 5 has received the Kosher, Kosher for Passover, and Halal certifications. Our suppliers confirmed that the ingredients sourced for this formulation of Mteryti® Folic 5 do not contain pork, bovine and chicken by‐products.
- Is Mteryti® Folic 5 suitable for Passover?
- Yes, Mteryti® Folic 5 is certified Chometz Free. To be certified Kosher, the Kashruth Council of Canada has acknowledged that Mteryti® Folic 5 is also in full compliance with Passover requirements.
- Is it safe to take Mteryti® Folic 5 during breastfeeding?
- Mteryti® Folic 5 should not be used after delivery or during breastfeeding. If you are breastfeeding, and plan to become pregnant, discuss your risk for NTDs with your healthcare professional.
- What are the contraindications for Mteryti® Folic 5?
- Mteryti® Folic 5 is contraindicated in women with known hypersensitivity to any of the ingredients in the formulation or component of the container.
- Is it safe to take Mteryti® Folic 5 passed the expiration date?
- Regulatory agencies such as FDA and Health Canada fix a certain expiration date from the time Mteryti® Folic 5 is manufactured based on the stability data on this product. After that date we do not know if it will remain safe and effective. Therefore, we do not recommend that Mteryti® Folic 5 be used after the expiration date. However, it can safely be taken until the expiration date inclusively.
- Is it safe to take 5 mg folic acid?
- Mteryti® Folic 5 should only be used in women at higher risk of a NTD-affected pregnancy, and after consultation with a healthcare professional to determine if this product is right for you. Mteryti® Folic 5 should be used 2-3 months prior to conception until 10-12 weeks of gestation.
- Why does Mteryti® Folic 5 have an iron warning?
- Because Mteryti® Folic 5 contains iron, the U.S. Food and Drug Administration (FDA) regulations require, as a precautionary measure, that an iron warning statement appears on the labeling of iron-containing dietary supplements and drugs in solid oral dosage form (e.g., tablets, capsules, or caplets).
If you suspect an overdose or seek additional overdose information, you should contact a poison control center at 1-800-222-1222.
KEEP YOUR SUPPLEMENTS STORED IN A SAFE PLACE OUT OF THE REACH OF YOUNG CHILDREN.
- What are the side effects associated with Mteryti® Folic 5?
- The most common adverse reactions associated with vitamin‐mineral supplements are gastro‐intestinal symptoms such as constipation, diarrhea, nausea and gastric irritation. At high doses (e.g. 15 mg/day) folic acid has been associated on rare occasion with various gastrointestinal symptoms and central nervous system (CNS) effects such as sleep disturbances, difficulty concentrating, irritability, hyperactivity, excitement, mental depression, confusion, and impaired judgment.
- What should I do if I experience an adverse event?
- Always tell your healthcare professional about any adverse events. You are encouraged to report negative side effects to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
You can also contact our Medical Information Department:
Phone: 1 855 722-7734
- What if you suspect an overdose?
- If you suspect an overdose or seek additional overdose information, you can contact a poison control center at 1-800-222-1222.
Important Risk Information
Warning: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately.
Women who consume healthful diets with adequate folate may reduce their risk of having a child with birth defects of the brain or spinal cord. Public health authorities recommend that women consume 0.4 mg folic acid daily from fortified foods or dietary supplements, or both, to reduce the risk of neural tube defects. The safe upper limit of daily intake value for folic acid is 1,000 mcg (1 mg). This product exceeds the DV (1,000 mcg) of folic acid. Folate intake should not exceed 250% of the DV (1,000 mcg). However, Mteryti® and Mteryti® folic 5 tablets may be appropriate for some women under a healthcare professional's supervision.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.