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Folic acid in large amounts may counteract the antiepileptic effect of phenobarbitone, phenytoin, primidone and succinimides, and increase the frequency of seizures in susceptible children. Clinical monitoring, possibly monitoring of the plasma concentrations and, if necessary, dose adaptation of the anti-epileptic drug during folinic acid administration and after discontinuation.
High oral, intravenous or intramuscular doses of folinic acid may reduce the efficacy of intrathecally administered methotrexate.
Folinic acid may enhance the toxicity of fluorouracil. When folinic acid is given in conjunction with a folic acid antagonist (e.g. cotrimoxazole, pyrimethamine) the efficacy of the folic acid antagonist may either be reduced or completely neutralized.
