Nutrifol

Indications

6S-5-Methyltetrahydrofolate (also called L-methylfolate or bio-active folate) is the natural, active form of folate (vitamin B9) that the body uses directly. It is used to prevent and treat folate deficiency, to support women before and during early pregnancy (to lower the risk of birth defects of the baby's brain and spine), for people who convert folic acid poorly (for example those with MTHFR gene variants), and to help lower raised homocysteine levels. A doctor may also prescribe it alongside other treatment in some cases of depression.

How It Works

Ordinary folic acid has to be changed by enzymes in the body into methylfolate before it can work. This product is already in the active form, so it can be used straight away. Folate is needed to make DNA and healthy red blood cells, to support the baby's developing nervous system, and to convert homocysteine into methionine.

Dosage and Administration

Take as directed on the label or as prescribed by your doctor. Common supplement strengths provide about 400 to 1,000 micrograms (mcg) a day. Higher prescription strengths are used only under medical supervision. It can be taken with or without food.

Interactions

• Folate may lower blood levels of some epilepsy medicines such as Phenytoin, Phenobarbital and Primidone, so seizure control should be checked.
• It may reduce the effect of Methotrexate when used for cancer, and can increase side effects of Fluorouracil or Capecitabine. Tell your cancer doctor.
• Medicines such as Methotrexate, Sulfasalazine, Trimethoprim and some epilepsy medicines can lower folate levels.

Contraindications

• Allergy to any ingredient.
• Untreated vitamin B12 deficiency or pernicious anaemia, unless B12 is given at the same time.

Side Effects

Usually well tolerated. Occasional effects include nausea, bloating, loss of appetite, sleep problems, irritability and allergic skin rash.

Get urgent medical help if you have signs of a serious allergic reaction, such as swelling of the face or throat, wheezing or difficulty breathing.

Pregnancy and Lactation

Folate is recommended before conception and in early pregnancy, and is safe during breastfeeding at usual doses. Women with a previous pregnancy affected by a neural tube defect, epilepsy or diabetes may need a higher dose: follow your doctor's advice.

Precautions and Warnings

• Folate can correct anaemia caused by vitamin B12 deficiency while nerve damage from low B12 continues. Have B12 levels checked if anaemia or numbness is present.
• If you take it for depression, do not stop or change other medicines without your doctor.

Overdose

Folate has low toxicity. Very large amounts may cause stomach upset or sleep problems. Contact a doctor if a large amount has been taken.

Therapeutic Class

Vitamin (active folate, vitamin B9).

Storage

Store below 30°C in a dry place, away from light. Keep out of the reach of children.