Indications
L-Methylfolate Calcium (also called levomefolate calcium) is the active, ready-to-use form of folate (vitamin B9). It is used to prevent and treat folate deficiency, especially in people whose bodies convert ordinary Folic Acid poorly (for example because of MTHFR gene variants). It is also included in some combined oral contraceptive pills so that women have good folate levels if they become pregnant soon after stopping the pill, lowering the risk of neural tube defects (birth defects of the brain and spine). It may also be used, on a doctor’s advice, as support in some types of anaemia and alongside treatment for depression.
How It Works
Folate is needed to make DNA, form healthy red blood cells and help the developing baby’s spine and brain form properly. Ordinary Folic Acid must be converted in the body through several steps before it can be used. L-Methylfolate is already in the final active form, so it can be used directly by the body, and it also helps keep homocysteine (an amino acid linked to heart and pregnancy problems) at normal levels.
Dosage and Administration
Use as directed on the label or by your doctor. As a supplement, common amounts range from about 400 micrograms to 1 mg a day; higher strengths are used only on medical advice. In contraceptive pills, it is already included in each tablet, and the pill should be taken exactly as instructed in the pack, one tablet daily at the same time.
Interactions
- Some seizure medicines (Phenytoin, Phenobarbital, Primidone, Carbamazepine): folate may lower their levels, and they may lower folate.
- Methotrexate, Pyrimethamine and Trimethoprim work by blocking folate; folate may affect their action.
- Sulfasalazine and some antacids may reduce folate absorption.
- When part of a contraceptive pill, the interactions of the pill’s hormones also apply (for example Rifampicin and some seizure medicines reduce contraceptive effect).
Contraindications
- Allergy to L-Methylfolate or any ingredient.
- Untreated vitamin B12 deficiency (pernicious anaemia), unless B12 is also given.
- When part of a contraceptive pill, the contraindications of the pill apply, such as a history of blood clots, some migraines with aura, certain cancers and severe liver disease.
Side Effects
L-Methylfolate itself is usually very well tolerated; mild stomach upset, bloating, nausea or allergic skin reactions can occur rarely. Side effects of combined pills (such as nausea, breast tenderness, headache and spotting) come from the hormones.
Get urgent medical help for swelling of the face or throat, difficulty breathing, or, if taking a pill containing it, sudden chest pain, breathlessness, painful swelling of one leg, severe headache, or sudden problems with vision or speech.
Pregnancy and Lactation
Folate is important before and during early pregnancy and is safe at usual doses. It passes into breast milk and is suitable while breastfeeding. Note that contraceptive pills containing L-Methylfolate must be stopped if pregnancy occurs; folate supplements should then be continued as advised by the doctor.
Precautions and Warnings
- High doses of folate can hide vitamin B12 deficiency; ask your doctor to check B12 if you have numbness, tingling or anaemia.
- Folate supplements do not replace a balanced diet.
- Take only one folate-containing product unless advised.
Overdose
Folate is water soluble and serious overdose is rare. Very large amounts may cause stomach upset, sleep problems or irritability. Seek medical advice if a large amount has been taken, especially by a child.
Therapeutic Class
Vitamin (folate, vitamin B9), active form; also used as a folate component in some oral contraceptives.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.