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The following safety information outlines important risks and precautions associated with the use of folic acid. It is crucial to understand these warnings and consult your healthcare provider if you have any questions or concerns.

• Overdose Risk: Consuming excessive amounts of folic acid can lead to serious side effects. Ensure you adhere to your healthcare provider's dosage instructions. Many over-the-counter multivitamins and supplements contain folic acid, so consult with your provider or pharmacist to avoid exceeding the recommended dose. Symptoms of overdose may include poor appetite, nausea, bloating, an unpleasant taste in the mouth, sleep disturbances, concentration difficulties, and irritability. Seek medical advice if you experience these symptoms.

• Concealed Vitamin B12 Deficiency: Folic acid can sometimes mask anemia caused by low vitamin B12 levels, potentially improving red blood cell count without addressing the underlying vitamin B12 deficiency. Your healthcare provider may conduct blood tests to check your vitamin B12 levels before starting folic acid treatment to ensure comprehensive management of your nutritional needs.

• Aluminum Toxicity (Injectable Form Only): The injectable form of folic acid contains aluminum, which can accumulate in individuals with kidney issues, including premature infants whose kidneys are not fully developed. Excessive aluminum can cause brain and bone problems. Inform your healthcare provider if you have kidney problems so they can monitor for signs of aluminum toxicity.

• Gasping Syndrome in Premature Infants (Injectable Form Only): The preservative benzyl alcohol, found in the injectable form of folic acid, can induce a rare and potentially life-threatening condition known as gasping syndrome, particularly in premature infants. Seek immediate medical attention if your child exhibits symptoms such as gasping, slow heart rate, clammy skin, seizures, or limb weakness.

There are no specific contraindications for folic acid usage provided. Always consult with your healthcare provider for personalized medical advice and guidance.

Serious side effects:

• Serious allergic reaction
• Rash
• Itching
• Swelling of the face, tongue, or throat
• Severe dizziness
• Trouble breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Methotrexate

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Fosphenytoin
• Phenytoin

Interactions with low risk that usually do not require a change in therapy:

• Tea