A fixed-dose combination of micronized Dehydroepiandrosterone (DHEA), a prohormone and neurosteroid, with high-dose Folic Acid. DHEA serves as a precursor to androgens and estrogens, while folic acid is a B-vitamin essential for nucleotide synthesis and methylation reactions. In the Indian context, this combination is primarily used for managing symptoms associated with adrenal insufficiency, perimenopausal syndrome, and as an adjunct in female infertility, particularly in cases of diminished ovarian reserve or poor ovarian response. The micronization of DHEA enhances its oral bioavailability.
Adult: One tablet (DHEA 75mg + Folic Acid 4.5mg) orally once daily, preferably in the morning. Duration is as prescribed by the physician, typically for 3-6 months in fertility protocols, with re-evaluation.
Note: Take with a full glass of water. Can be taken with or without food, but taking folic acid on an empty stomach may improve its absorption. For fertility purposes, it is often advised to take consistently at the same time each day. Do not crush or chew unless advised.
DHEA acts as a prohormone, serving as the primary precursor for the synthesis of androgens (androstenedione, testosterone) and estrogens (estrone, estradiol) in peripheral tissues, including the ovaries, adipose tissue, and brain. This 'intracrine' action boosts local hormone levels without significantly elevating systemic levels initially. Folic Acid, after conversion to 5-MTHF, acts as a cofactor in one-carbon transfer reactions crucial for DNA synthesis, repair, and methylation, and for homocysteine metabolism. The combination aims to support hormonal balance and optimize the follicular environment.
Pregnancy: Category N (Not classified by US FDA for DHEA). DHEA is CONTRAINDICATED during pregnancy due to potential androgenic effects on the female fetus (risk of virilization). Folic Acid (4.5mg) is much higher than the recommended 0.4-0.8mg for prevention of neural tube defects. Use only if clearly needed and under strict supervision of an obstetrician, typically in very specific infertility protocols that cease upon conception.
Driving: Generally no effect. However, if dizziness, fatigue, or visual disturbances occur as side effects, patients should avoid driving or operating machinery.
| Warfarin and other Coumarin Anticoagulants | Folic acid may alter anticoagulant response; DHEA may affect clotting factors. Monitor INR closely. | Major |
| Antiepileptic Drugs (Phenytoin, Phenobarbital, Carbamazepine, Valproate) | These drugs can reduce serum folate levels. Folic acid supplementation may be needed, but high doses may reduce antiepileptic drug levels, potentially increasing seizure risk. | Major |
| Methotrexate | Folic acid reduces the toxicity (especially hematological and mucosal) of methotrexate used for rheumatoid arthritis or psoriasis, but may reduce its efficacy in cancer chemotherapy. Use under strict supervision. | Major |
| Tamoxifen, Aromatase Inhibitors | DHEA, by converting to estrogens, may antagonize the effects of these breast cancer therapies. Contraindicated. | Major |
| Corticosteroids (e.g., Prednisolone) | May have additive effects on adrenal axis suppression or stimulation. Monitor. | Moderate |
| Insulin, Oral Hypoglycemics | DHEA may affect insulin sensitivity. Monitor blood glucose levels. | Moderate |
| 5-Fluorouracil (5-FU) | Folic acid (as leucovorin) is used to enhance 5-FU toxicity in cancer therapy, but self-administration can interfere with regimen. | Major |
| Sulfasalazine | Reduces folate absorption. Increased folic acid requirement. | Moderate |
Same composition (Dehydroepiandrosterone (Micronized) (75mg) + Folic Acid (4.5mg)), different brands: