Folic Acid

Prevention of folic acid deficiency

Treatment of megaloblastic anemia

Experimental treatment for major depressive disorder

Treatment of folic acid deficiency caused by anorexia, chronic use of oral contraceptive and some antiepileptic drugs, alcoholism, malabsorption diseases (e.g., sprue), bowel resection, and diverticulosis

Reduces incidence of neural tube defects (spina bifida) and congenital heart defects in developing fetus

Reduces homocysteine; may have cardiovascular benefits (no evidence of such from randomized trials, but much anecdotal evidence)

Chronic overdosage increases proliferation of cancer as demonstrated in epidemiologic studies and in vitro studies of breast cancer.

Exposure to nitrous oxide disrupts folic acid metabolism; repeated exposure can cause deficiency.

Supraphysiologic doses (>15 mg/d) may decrease seizure threshold in pts taking some antiepileptic medications.

Allergic reactions (rare); most in response to the parenteral form.

Loss of appetite, nausea, lethargy, stomach pain, insomnia.

Supraphysiologic doses (>15 mg/d) increase all symptoms listed above.

May cause seizures (>15 mg/d); higher risk in epileptic pts.