Folic acid (folate) interactions

VYKOURA is contraindicated in patients who have had a severe hypersensitivity reaction to leucovorin (folinic acid), levoleucovorin, or folic acid [see Warnings and Precautions (5.1) ]. (Leucovorin label, Contraindications)

KHAPZORY is contraindicated in patients who have had severe hypersensitivity to leucovorin products, folic acid, or folinic acid [see Adverse Reactions ( 6.2 )] . (Levoleucovorin label, Contraindications)

…Phenytoin and antacids should not be taken at the same time of day Antineoplastic agents (usually in combination) Bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate Antiviral agents Fosamprenavir, nelfinavir, ritonavir Antiepileptic drugs Carbamazepine, vigabatrin Other Chronic alcohol abuse, diazepam, diazoxide, folic acid, reserpine, rifampin, St. (Phenytoin label, Drug interactions)

Use of the drug is also contraindicated in patients with documented megaloblastic anemia due to folate deficiency. (Pyrimethamine label, Contraindications)

Effects of Other Drugs on SEPHIENCE Avoid concomitant use of drugs known to inhibit folate synthesis dihydrofolate reductase (DHFR) (e.g., trimethoprim, methotrexate, trimetrexate, pemetrexed, pralatrexate, raltitrexed, and piritrexim) while taking SEPHIENCE. (Sepiapterin label, Drug interactions)

CONTRAINDICATIONS Sulfamethoxazole and trimethoprim is contraindicated in patients with a known hypersensitivity to trimethoprim or sulfonamides, in patients with a history of drug-induced immune thrombocytopenia with use of trimethoprim and/or sulfonamides, and in patients with documented megaloblastic anemia due to folate deficiency. (Sulfamethoxazole and trimethoprim label, Contraindications)

CONTRAINDICATIONS Trimethoprim is contraindicated in individuals hypersensitive to trimethoprim and in those with documented megaloblastic anemia due to folate deficiency. (Trimethoprim label, Contraindications)

Acetazolamide may increase the effects of other folic acid antagonists. (Acetazolamide label, Drug interactions)

Leucovorin The concentration of fluorouracil is increased and its toxicity may be enhanced by leucovorin, folic acid, or folate analog products. (Capecitabine label, Drug interactions)

These antiepileptic drugs lower folate levels, and folic acid supplements can in turn lower blood levels of the drug. (NIH Office of Dietary Supplements, Folate)

Folic acid antagonists have similar effects and may increase the incidence of hematologic reactions; if co-administered with dapsone the patient should be monitored more frequently. (Dapsone label, Warnings)

Evidence suggests that folic acid supplementation prior to conception and during the first trimester of pregnancy decreases the risk for congenital neural tube defects in the general population [see Use in Specific Populations ( 8.1 )] . (Divalproex (valproate) label, Warnings and precautions)

…proteins may be elevated in the serum. d) Sex-steroid binding globulins are increased and result in elevated levels of total circulating sex steroids and corticoids; however, free or biologically active levels remain unchanged. e) Triglycerides and phospholipids may be increased. f) Glucose tolerance may be decreased. g) Serum folate levels may be depressed. (Ethynodiol diacetate and ethinyl estradiol label, Precautions)

…trazodone, warfarin Drugs that may decrease phenytoin serum levels Antineoplastic agents usually in combination Bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate Antiviral agents Fosamprenavir, nelfinavir, ritonavir Antiepileptic drugs Carbamazepine, vigabatrin Other Chronic alcohol abuse, diazepam, diazoxide, folic acid, reserpine, rifampin, St. (Fosphenytoin label, Drug interactions)

Nitrous Oxide The use of nitrous oxide anesthesia potentiates the effect of methotrexate on folate-dependent metabolic pathways, resulting in the potential for increase toxicity. (Methotrexate label, Drug interactions)

Initiate supplementation with oral folic acid and intramuscular vitamin B 12 to reduce the severity of hematologic and gastrointestinal toxicity of PEMFEXY. (Pemetrexed label, Warnings and precautions)

These antiepileptic drugs lower folate levels, and folic acid supplements can in turn lower blood levels of the drug. (NIH Office of Dietary Supplements, Folate)

Because trimethoprim may interfere with folic acid metabolism, trimethoprim should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. (Polymyxin B and trimethoprim ophthalmic label, Precautions)

Administer vitamin B 12 and instruct patients to take folic acid to reduce the risk of treatment-related myelosuppression [see Dosage and Administration ( 2.1 )]. (Pralatrexate label, Warnings and precautions)

These antiepileptic drugs lower folate levels, and folic acid supplements can in turn lower blood levels of the drug. (NIH Office of Dietary Supplements, Folate)

Inhibitors of Folate Synthesis (e.g., methotrexate, valproic acid, phenobarbital, trimethoprim) Clinical Impact In vitro and in vivo nonclinical data suggest that drugs that inhibit folate synthesis may decrease the bioavailability of endogenous BH4 by inhibiting the enzyme dihydrofolate reductase, which is involved in the recycling (regeneration) of BH4. (Sapropterin label, Drug interactions)

Reductions in Vitamins D, E, K (clotting factors) and Folic Acid Levels In preclinical studies in rats and dogs, sevelamer hydrochloride, which contains the same active moiety as sevelamer carbonate, reduced vitamins D, E, and K (coagulation parameters) and folic acid levels at doses of 6–10 times the recommended human dose. (Sevelamer label, Warnings and precautions)

Drug Interactions: Reduced absorption of folic acid and digoxin have been reported when those agents were administered concomitantly with sulfasalazine. (Sulfasalazine label, Drug interactions)

Evidence suggests that folic acid supplementation prior to conception and during the first trimester of pregnancy decreases the risk for congenital neural tube defects in the general population . (Valproic acid label, Warnings and precautions)

Serum folate levels may be depressed by oral contraceptive therapy. (Desogestrel and ethinyl estradiol label, Precautions)

Drug Interactions There was no evidence of drug interactions in clinical studies in which dobutamine was administered concurrently with other drugs, including digitalis preparations, furosemide, spironolactone, lidocaine, glyceryl trinitrate, isosorbide dinitrate, morphine, atropine, heparin, protamine, potassium chloride, folic acid, and acetaminophen. (Dobutamine label, Drug interactions)

The morphologic change resembles pernicious anemia, but is not related to vitamin B12 or folic acid deficiency. (Hydroxyurea label, Warnings and precautions)

In RA, concomitant medications besides MTX were nonsteroidal anti-inflammatory agents (NSAIDs), folic acid, corticosteroids and/or narcotics. (Infliximab label, Drug interactions)

Interactions with Laboratory Tests Therapeutic concentrations of rifampin have been shown to inhibit standard microbiological assays for serum folate and Vitamin B 12 . (Rifapentine label, Drug interactions)