CerefolinNAC tablets contain Methylfolate, methylcobalamin, and acetylcysteine. Methylfolate and methylcobalamin are involved in the breakdown of homocysteine, thus lowering plasma homocysteine levels. Acetylcysteine reduces oxidative stress and lowers plasma homocysteine levels.

CerefolinNAC (Methylfolate, methylcobalamin, and acetylcysteine) Uses:

• It is used as a medical food in patients with neurovascular oxidative stress, cognitive impairment, and/or hyperhomocysteinemia

Note:

• Unlike pharmaceuticals, medical foods are not subject to FDA regulation. Before dispensing, there is no need for an oral or written prescription, review or approval before marketing, or proof of their efficacy and safety.
• Medical foods are formulated to be administered per oral for the management of specific diseases or conditions for which distinctive nutritional requirements are established by medical evaluation.

Methylfolate, methylcobalamin, and acetylcysteine Dose in Adults:

CerefolinNAC (Methylfolate, methylcobalamin, and acetylcysteine) Dose in Adults as a medical food:

• Oral: One tablet daily

Dose in children:

Not indicated.

Use in Pregnancy and breastfeeding:

See specific drug's monographs (Methylfolate, methylcobalamin, and acetylcysteine)

Dose in renal disease:

No dosage adjustments are required.

Dose in Liver disease:

No dosage adjustments are required.

Side effects of CerefolinNAC (Methylfolate, methylcobalamin, and acetylcysteine):

• Allergic reactions may occur following the use of oral L-methyl folate Calcium.
• Diarrhea
• Itching
• Transient rash
• Body swelling
• Nausea
• Vomiting
• Diarrhea
• Flushing
• Epigastric pain
• Constipation.

Contraindications to CerefolinNAC (Methylfolate, methylcobalamin, and acetylcysteine):

• Allergies to any ingredient of the formulation.
• Patients with vitamin B-12 deficiencies associated with neurological manifestations (subacute mixed degeneration of the chord) should avoid methyl folate. 
• It may also mask an underlying vitamin B-12 deficit.
• Patients on nitrates can develop headaches or symptoms that may be exacerbated by a preexisting nitrate-induced migraine.
• Patients with cysteine renal stones should avoid Acetylcysteine. 
• Acetylcysteine should be avoided by patients in critical condition and those with peptic ulcer disease.
• It may cause disruption of the mucosal barrier. Acetylcysteine may also give false-positive results for ketones. 

Methylfolate, methylcobalamin, and acetylcysteine: Drug Interaction

Monitoring Parameters:

None mentioned. May need to monitor plasma homocysteine levels.

How to administer CerefolinNAC (Methylfolate, methylcobalamin, and acetylcysteine)?

Administer one caplet daily as recommended by the physician.

Mechanism of action of CerefolinNAC (Methylfolate, methylcobalamin, and acetylcysteine):

See individual agents:

• Deplin (Methylfolate) Tablets
• Methylcobalamine
• Acetylcysteine (mucolator)

International Brand Names of Methylfolate, methylcobalamin, and acetylcysteine:

• CerefolinNAC
• Metafolbic Plus
• Metafolbic Plus RF

Methylfolate, methylcobalamin, and acetylcysteine Brand Names in Pakistan:

No Brands Available in Pakistan.