Treatment & prevention of folate deficiency. Megaloblastic anemia due to folate deficiency. Prevention of neural tube defects in offspring of women planning a pregnancy & known to be at risk.
Adult & elderlyFolate deficient megaloblastic anemia 5 mg daily for 4 mth. Chronic hemolytic states 5 mg every 1-7 days depending on underlying disease. Pregnancy 5 mg daily continued to term & 3 mth after delivery.
Not to be given alone or in conjunction w/ inadequate amounts of vit B12 for the treatment of pernicious anemia, undiagnosed megaloblastic anemia or other vit B12 deficiency states. May produce hematopoietic response in patients w/ megaloblastic anemia due to vit B12 deficiency w/o preventing aggravation of neurologic symptoms which may lead to subacute combined degeneration of the spinal cord. Never use to treat anemia w/o full investigation of cause. Patients w/ folate dependent tumors. Consider using more suitable dosage form for childn ≤12 yr.
Decreased plasma conc of phenytoin & barbiturate. Induced folate deficiency w/ prolonged phenytoin use, other anti-seizure drugs including Na valproate, carbamazepine & barbiturates. Inhibited absorption w/ sulphasalazine. Interference of metabolism w/ co-trimoxazole (ie, trimethoprim, sulfamethoxazole). May enhance the efficacy of lithium therapy. Antagonized by MTX which may result to folate deficiency. May decrease MTX plasma conc. May induce acute deficiency due to intracellular transport failure & enhanced excretion w/ nitrous oxide anesth.
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