Folate depletion
Folate (vitamin B9) depletion
- ↓ folate → megaloblastic anemia, ↑ homocysteine
- Neural tube defects if depleted in early pregnancy → supplement folic acid
- The route differs by drug: DHFR block, ↓ absorption, ↑ catabolism by enzyme inducers
- ↓ folate → megaloblastic anemia, ↑ homocysteine
- Neural tube defects if depleted in early pregnancy → supplement folic acid
- The route differs by drug: DHFR block, ↓ absorption, ↑ catabolism by enzyme inducers
Drugs with this mechanism (12)
- Carbamazepine — Anticonvulsant/mood stabilizer and potent autoinducer; HLA-B*1502 rash risk.
- Carbamazepine ER capsules — Bead-filled extended-release carbamazepine capsule that can be opened and sprinkled.
- Carbamazepine ER (Equetro) — Carbamazepine ER capsule - the only carbamazepine approved for acute bipolar mania.
- Eslicarbazepine — Once-daily sodium-channel anticonvulsant related to oxcarbazepine.
- Ethanol — Alcohol; CNS depressant acting on GABA-A and NMDA, the most-used intoxicant.
- Methotrexate — Antifolate; low-dose anchor DMARD for rheumatoid arthritis, high-dose chemotherapy.
- Phenobarbital — Oldest barbiturate anticonvulsant; sedating, enzyme-inducing, largely historical.
- Phenytoin — Classic sodium-channel anticonvulsant with nonlinear kinetics and many interactions.
- Pyrimethamine — Antifolate antiparasitic for toxoplasmosis.
- Sulfasalazine — DMARD/anti-inflammatory for rheumatoid arthritis and ulcerative colitis.
- Carbamazepine XR — Extended-release carbamazepine for seizures and trigeminal neuralgia; potent enzyme inducer.
- Triamterene — Potassium-sparing diuretic (ENaC blocker), often with hydrochlorothiazide.
All mechanisms · Open Folate depletion in the interactive console ↗