l-methylfolate

	What is the most important information I should know about l-methylfolate?
	What is l-methylfolate?
	What should I discuss with my health care provider before taking l-methylfolate?
	How should I take l-methylfolate?
	What happens if I miss a dose?
	What happens if I overdose?
	What should I avoid while taking l-methylfolate?
	What are the possible side effects of l-methylfolate?
	What other drugs will affect l-methylfolate?
	Where can I get more information?
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Do not use l-methylfolate without the advice of a doctor. Never share this medication with another person, even if you believe they have the same condition you have.

You should not use this medication if you have ever had an allergic reaction to l-methylfolate.

Before you take this medication, tell your doctor if you have a vitamin B12 deficiency, pernicious anemia, a history of bipolar disorder (manic depression), or if you are pregnant or breast-feeding.

Avoid drinking alcohol while you are taking l-methylfolate.

Tell your doctor about all other medications you use, especially seizure medications. Do not start a new medication without telling your doctor.

Use only the brand and strength of l-methylfolate that your doctor has prescribed. Do not switch brands without your doctor's advice.

Folate is a form of B vitamin that occurs naturally in many foods. Folic acid is the man-made form of folate that is added to processed foods or vitamin and mineral supplements. Folate is needed in the human body for production of red blood cells.

A lack (deficiency) of folate in the human body can be caused by certain diseases, by taking certain medications, or by not getting enough folate in your diet. Folate deficiency can lead to decreased red blood cells, or anemia.

L-methylfolate is a medical food for use in people who have conditions related to folate deficiency.

The Zervalx brand of l-methylfolate is used in the following situations:

• in people who have high levels of a certain amino acid in their blood, a condition called hyperhomocysteinemia (HYE-per-HOE-moe-sis-tin-EE-mee-a). This condition can be related to folate deficiency or may be caused by receiving methotrexate (Rheumatrex, Trexall);
• in women with high-risk pregnancies who need additional folate in their diets to prevent hyperhomocysteinemia; or
• in people with certain types of anemia (a lack of red blood cells) that may be complicated by a folate deficiency.

The Deplin brand of l-methylfolate is used in the following situations:

• in people with major depressive disorder who have folate deficiency. Deplin is used together with anti-depressant medications in people with major depressive disorder and low folate levels.
• in people with schizophrenia who have hyperhomocysteinemia related to folate deficiency.

Deplin is not an antidepressant. However, it may enhance the effects of antidepressant medications.

L-methylfolate may also be used for other purposes not listed in this medication guide.

You should not use this medication if you have ever had an allergic reaction to l-methylfolate.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before using l-methylfolate, tell your doctor if you have:

• a history of bipolar disorder (manic depression);
• vitamin B12 deficiency; or
• pernicious anemia.

Zervalx may be used throughout pregnancy or while you are trying to get pregnant.

Before you take Deplin, tell your doctor if you are pregnant or breast-feeding.

Do not use l-methylfolate without the advice of a doctor. Never share this medication with another person, even if you believe they have the same condition you have.

Use this product exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Use only the brand and strength of l-methylfolate that your doctor has prescribed. Do not switch brands without your doctor's advice.

You may take l-methylfolate with or without food. Follow your doctor's instructions.

L-methylfolate is only part of a complete program of treatment that may also include other medications, and psychological counseling when used in people with depression or schizophrenia. Follow your medication and counseling routines very closely.

Store l-methylfolate at room temperature away from moisture, heat, and light.

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention if you think you have used too much of this medicine.

An overdose of l-methylfolate is not likely to cause life-threatening symptoms.

Avoid drinking alcohol while you are taking l-methylfolate.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

• nausea;
• loss of appetite;
• bloating;
• gas; or
• bitter taste in your mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all other medications you use, especially seizure medication such as:

• carbamazepine (Carbatrol, Tegretol);
• ethosuximide (Zarontin);
• fosphenytoin (Cerebyx);
• lamotrigine (Lamictal);
• phenobarbital (Solfoton);
• phenytoin (Dilantin);
• primidone (Mysoline); or
• valproic acid valproate.

Other drugs that can interact with l-methylfolate include:

• birth control pills;
• cholestyramine (Prevalite, Questran), colestipol (Colestid);
• colchicine;
• isotretinoin (Accutane);
• methylprednisolone (Medrol);
• methotrexate (Rheumatrex, Trexall);
• pancreatin (Hi-Vegi-Lip), pancrelipase (Cotazym, Pancrease, Ultrase);
• pentamidine (Nebupent);
• pyrimethamine (Daraprim);
• sulfasalazine (Azulfidine);
• triamterene (Dyrenium);
• trimethoprim (Proloprim, Bactrim, Septra); or
• a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin), indomethacin (Indocin), naproxen (Aleve, Naprosyn), or sulindac (Clinoril).

This list is not complete and there may be other drugs that can interact with l-methylfolate. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Your pharmacist can provide more information about l-methylfolate.