L-Methylfolate Calcium Risks, Warnings, and Complications

Precautions Before Starting L-Methylfolate Calcium

Tell your healthcare provider if you have a known hypersensitivity to L-methylfolate calcium, any of the active or inactive ingredients in L-methylfolate calcium tablets, or any other medications. Inactive ingredients include croscarmellose sodium, magnesium stearate, di-calcium phosphate, microcrystalline cellulose, stearic acid, silicon dioxide, polyethylene glycol, FD&C Blue #2, polyvinyl alcohol, titanium dioxide, and talc.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions.

Give your doctor a complete medical history. L-methylfolate calcium may not be safe for people with certain medical conditions, such as bipolar disorder.

Tell your doctor if you are pregnant, might be pregnant, planning a pregnancy soon, or breastfeeding.

Precautions During Use of L-Methylfolate Calcium

Keep all your healthcare appointments while on L-methylfolate calcium supplementation. 

Seek emergency medical attention if you develop signs and symptoms of a serious allergic reaction.

Tell all your healthcare providers you are on L-methylfolate calcium, including before any procedures or dental treatments.

Tell your doctor if you become pregnant while on this medication.

L-Methylfolate Calcium Drug Interactions

L-methylfolate calcium can interact with certain medications and affect how they work. Interactions between L-methylfolate calcium and other drugs can increase the risk of severe adverse reactions. Your doctor may change the dose, switch you to a different medication, and/or monitor you carefully for adverse effects if there are known interactions between L-methylfolate and your other medications. Some of the drugs that can interact with L-methylfolate include:

• Anti-seizure medications such as carbamazepine, lamotrigine, phenytoin, phenobarbital, valproic acid, primidone, and others. Concurrent use of these antiepileptic drugs can impair folate absorption and increase the breakdown of circulating folate. Also, the use of folate and phenytoin together can result in enhanced phenytoin metabolism, which can result in lower plasma levels of this antiepileptic drug, allowing breakthrough seizures.
• Folinic acid can increase the risk of toxicity from chemotherapy drugs such as capecitabine. 
• Dihydrofolate reductase inhibitors (DHFRIs) block the conversion of folic acid to its active forms, thereby lowering folate levels in plasma and red blood cells. Examples of DHFRIs include methotrexate, pyrimethamine, aminopterin, triamterene, and trimethoprim.
• The selective serotonin reuptake inhibitor (SSRI) fluoxetine exerts noncompetitive inhibition of the active transport of 5-methyltetrahydrofolate in the intestines.
• Patients taking isotretinoin may have reduced folate levels.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, sulindac, and indomethacin may inhibit certain folate-dependent enzymes. 
• Oral contraceptive therapy may lower serum folate levels.
• Corticosteroids such as methylprednisolone may cause reduced serum folate levels.
• Patients taking pancreatic extracts may have low folate levels.
• Prolonged intravenous pentamidine can result in reduced folate levels.
• Decreased serum folate has been noted in patients with type 2 diabetes mellitus taking the oral diabetes drug metformin.
• Six months of therapy with blood thinners (anticoagulants) such as warfarin can produce significant impairment of folate status.

The above list may not include all possible interactions of L-methylfolate calcium. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, OTC (non-prescription) medications, dietary supplements, and herbal remedies. Also, tell your healthcare professionals if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with dietary supplements and prescription medications.