Dietary management of patients being treated for early memory loss, with emphasis on those at risk for neurovascular oxidative stress and/or hyperhomocysteinemia; mild to moderate cognitive impairment with or without Vitamin B12 deficiency, vascular dementia, or Alzheimer's disease.
1 caplet daily.
Avoid if renal stones occur. Do not administer to critically ill patients. Folic acid may mask pernicious anemia. History of peptic ulcer. Chronic liver disease. Pre-term newborns. Nursing mothers: not recommended.
May antagonize first generation anticonvulsants (eg, carbamazepine, fosphenytoin, phenytoin, phenobarbital, primidone, valproic acid, valproate), or pyrimethamine; caution with second generation anticonvulsants. Concomitant nitrates: increased risk of headaches. Capecitabine toxicity increased with addition of leucovorin. May produce false-positive result in nitroprusside test for ketone bodies. Absorption of methylcobalamin may be decreased with antibiotics, metformin, para-aminosalicyclic acid, potassium chloride. Cholestyramine, colchicine, colestipol may decrease re-absorption of methylcobalamin. Nitrous oxide may produce functional methylcobalamin deficiency. Folate levels may be reduced by anticonvulsants, methotrexate, alcohol (excess amounts), sulfasalazine, cholestyramine, colchicine, colestipol, isotretinoin, L-dopa, methylprednisone, NSAIDs (high dose), oral contraceptives, pancreatic enzymes, pentamidine, pyrimethamine, smoking, triamterene, trimethoprim.
GI upset, polycythemia vera, itching, transitory exanthema, swelling, headache, rash (with or without fever); rare: renal stones.