Dehydroepiandrosterone + Folic Acid + Vitamin D3

Usage

• This combination drug is primarily prescribed for female infertility, particularly in the context of assisted reproductive technology (ART) like in-vitro fertilization (IVF). It aims to improve fertility rates by enhancing egg quality and promoting a healthy reproductive environment.
• Pharmacological Classification: This is a combination product containing a steroid hormone precursor (DHEA), a vitamin (folic acid), and a prohormone (vitamin D3). It could be classified under “Hormonal agents,” “Vitamins,” and “Dietary supplements.”
• Mechanism of Action: Dehydroepiandrosterone (DHEA) acts as a precursor to androgens and estrogens, potentially improving ovarian function and egg quality. Folic acid is crucial for cell growth and development, supporting the developing fetus. Vitamin D3 plays a role in calcium absorption and bone health, which are important for reproductive health.

Alternate Names

• While this specific combination might not have an official international nonproprietary name (INN), it can be referred to by its constituent parts: Dehydroepiandrosterone, Folic Acid, and Vitamin D3 (or Cholecalciferol).
• Brand Names: Several brands market this combined formulation. Examples found in the source include Evaserve, Safeova, Adorefem, and Gynonorm DHEA.

How It Works

• Pharmacodynamics: DHEA is metabolized into androgens (like testosterone) and estrogens in the body. In women with diminished ovarian reserve, DHEA supplementation may increase the number and quality of oocytes. Folic acid is essential for DNA synthesis, cell division, and red blood cell formation. Vitamin D3 facilitates calcium absorption and bone health.

• Pharmacokinetics:

  • DHEA: Administered orally, DHEA is readily absorbed and metabolized primarily in the liver. It undergoes extensive first-pass metabolism. DHEA and its metabolites are excreted in urine and feces.
  • Folic acid: Absorbed primarily in the small intestine.
  • Vitamin D3: Absorbed in the small intestine and further metabolized in the liver and kidneys.

• Mode of Action/Receptor Binding/Enzyme Inhibition/Neurotransmitter Modulation: DHEA exerts its effects by conversion to downstream sex hormones. It does not have specific receptor binding in its original form. Folic acid is a cofactor for enzymes involved in DNA synthesis. Vitamin D3 acts by binding to vitamin D receptors (VDRs).

• Elimination Pathways: DHEA metabolites are eliminated through renal and hepatic routes. Folic acid is eliminated primarily in urine. Vitamin D3 and its metabolites are excreted in bile and feces.

Dosage

Dosage information for the combination product is limited in the sources. Dosing is generally tailored to individual patient needs and may vary based on the specific formulation and brand. Consult with a healthcare provider for appropriate dosage recommendations.

Standard Dosage

Information regarding standard dosing is not detailed in provided sources. It is advised to follow the dosage prescribed by your doctor.

Adults:

The dosage in adults varies depending on the intended use and individual patient response.

Children:

This combination is not typically recommended for children unless specifically prescribed by a doctor.

Special Cases:

Dosage adjustments may be necessary for elderly patients and those with renal or hepatic impairment. Consult with a doctor for specific recommendations.

Clinical Use Cases

Dosing guidelines for specific clinical situations (intubation, surgical procedures, etc.) are not provided in the resources. It is crucial to consult with a physician to determine the appropriate usage and dosage in these scenarios.

Dosage Adjustments

Dose modifications may be necessary based on patient-specific factors like renal/hepatic function and other medical conditions. Consultation with a doctor is essential for personalized recommendations.

Side Effects

Common Side Effects

• Oily skin
• Acne
• Mood changes
• Hair loss or increased hair growth
• Facial hair growth in women
• Headaches
• Fatigue
• Changes in menstrual cycle
• Nausea
• Bloating
• Abdominal cramps
• Sleep disturbances

Rare but Serious Side Effects

Limited information on rare or serious side effects is available. Consult a healthcare professional if unusual or severe reactions occur.

Long-Term Effects

Potential long-term effects are not fully characterized in the sources. Long-term monitoring is recommended.

Adverse Drug Reactions (ADR)

Clinically significant ADRs requiring immediate intervention are not specifically outlined. Any severe or unexpected reactions should be reported to a healthcare provider.

Contraindications

• Hypersensitivity to any component of the medication.
• Hormone-sensitive cancers (breast, ovarian, uterine).

Drug Interactions

• Estrogen and testosterone medications
• Antidepressants (e.g., fluoxetine, sertraline)
• Anticoagulants (e.g., warfarin, heparin)
• Anti-seizure medications (e.g., carbamazepine, phenytoin)
• Melatonin hormone
• Anti-epileptics
• Antipsychotics
• Anti-diabetic medications
• Antacids
• Chemotherapy agents
• Anti-inflammatory bowel disease drugs
• Anti-tuberculosis drugs
• Antibiotics
• Cholesterol-reducing drugs

Pregnancy and Breastfeeding

• This combination is generally not recommended during pregnancy and breastfeeding unless specifically advised by a doctor. DHEA’s potential impact on fetal androgen levels raises concerns.

Drug Profile Summary

• Mechanism of Action: DHEA acts as a precursor to sex hormones, folic acid supports cell development, vitamin D3 aids calcium absorption.
• Side Effects: Oily skin, acne, mood changes, gastrointestinal issues, and potential hormonal effects.
• Contraindications: Hormone-sensitive cancers, hypersensitivity.
• Drug Interactions: Numerous potential interactions, consult a healthcare professional.
• Pregnancy & Breastfeeding: Generally not recommended.
• Dosage: Determined by the physician based on individual needs.
• Monitoring Parameters: Monitor hormone levels, liver function, and other relevant parameters as needed.

Popular Combinations

Often combined with other fertility treatments as part of a comprehensive approach.

Precautions

• Pre-existing medical conditions, especially hormone-related or liver/kidney issues.
• Caution in pregnancy/breastfeeding.
• Monitoring for side effects.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Dehydroepiandrosterone + Folic Acid + Vitamin D3?

A: The recommended dosage varies depending on individual patient needs and the specific formulation used. It’s crucial to consult with a doctor for personalized dosage recommendations.

Q2: What are the primary uses of this combination?

A: It’s primarily used to address female infertility, particularly in the context of assisted reproductive technologies like IVF.

Q3: Are there any serious side effects I should be aware of?

A: While generally well-tolerated, potential side effects include hormonal changes, acne, mood swings, and gastrointestinal disturbances. Consult your doctor if you experience any unusual or severe reactions.

Q4: Can I take this combination if I am pregnant or breastfeeding?

A: It’s generally not recommended during pregnancy or breastfeeding due to potential hormonal effects on the developing fetus or infant. Consult your doctor for personalized advice.

Q5: How does DHEA contribute to female fertility?

A: DHEA serves as a precursor to androgens and estrogens, potentially improving ovarian function and egg quality, although the exact mechanisms are still being studied.

Q6: What role does folic acid play in this combination?

A: Folic acid is essential for cell growth and development, supporting a healthy pregnancy and reducing the risk of neural tube defects in the developing fetus.

Q7: Why is vitamin D3 included in this formulation?

A: Vitamin D3 plays a crucial role in calcium absorption and bone health, contributing to overall reproductive health and well-being.

Q8: Does this combination interact with other medications?

A: Yes, it has potential interactions with a wide range of medications, including hormones, antidepressants, anticoagulants, and others. Always inform your doctor about all other medications and supplements you are taking.

Q9: Is it safe to take this combination long-term?

A: Long-term safety data is limited. Regular monitoring by a healthcare professional is recommended.

Q10: Are there any dietary restrictions while taking this medication?

A: While no specific dietary restrictions are mentioned, maintaining a balanced diet is generally recommended for overall health.