Adjunct in endothelial dysfunction in patients who present with loss of protective sensation and neuropathic pain associated with diabetic peripheral neuropathy. Adjunct in endothelial dysfunction and/or hyperhomocysteinemia in patients who present with lower extremity ulcerations.
1 tablet twice daily.
Folic acid may mask pernicious anemia (may be mitigated by B12 component).
Antagonizes levodopa, pyrimethamine, first generation anticonvulsants (eg, carbamazepine, fosphenytoin, phenytoin, phenobarbital, primidone, valproic acid, valproate). May be antagonized by antibiotics, cholestyramine, colchicine, colestipol, metformin, para-aminosalicylic acid, potassium chloride. Folate levels may be decreased by first generation anticonvulsants, lamotrigine, methotrexate, alcohol (in excess), sulfasalazine, L-dopa, methylprednisone, NSAIDs (high dose), pancreatic enzymes, pentamidine, pyrimethamine, smoking, triamterene, trimethoprim, warfarin.
Paresthesia, somnolence, GI upset, headache, polycythemia vera, itching, transitory exanthema, swelling.