prenatal multivitamin

• L-dopa, triamterene, colchicine, and trimethoprim may decrease plasma folate levels. Caution should be exercised with the concomitant use of folinic acid and trimethoprim- sulfamethoxazole for the acute treatment of Pneumocystis carinii pneumonia in patients with HIV infection as it is associated with increased rates of treatment failure and mortality in a placebo-controlled study.

Mechanism: Trimethoprim can lower the amount of folate, an important B-vitamin, in your blood. This can make the folate in your prenatal vitamin less effective.

What to do: Your doctor should use caution when prescribing these together and may need to monitor your vitamin levels.

Drugs which may interact with folate include: • Antiepileptic drugs (AED): The AED class including, but not limited to, phenytoin, carbamazepine, primidone, valproic acid, fosphenytoin, valproate, phenobarbital and lamotrigine have been shown to impair folate absorption and increase the metabolism of circulating folate. • Additionally, concurrent use of folic acid has been associated with enhanced phenytoin metabolism, lowering the level of the AED in the blood and allowing breakthrough seizures to occur. Caution should be used when prescribing this product among patients who are receiving ...

Mechanism: The folic acid in the vitamin speeds up how fast your body breaks down the seizure medicine. This can lower the amount of medicine in your blood and make it less effective at preventing seizures.

What to do: Your doctor may need to check your blood levels and adjust your seizure medicine dose. Do not start or stop vitamins without talking to your healthcare provider first.

Metformin treatment in patients with type 2 diabetes decreases serum folate. Drugs which may interact with vitamin B 12 (Methylcobalamin): • Antibiotics, cholestyramine, colchicines, colestipol, metformin, para-aminosalicylic, and potassium chloride may decrease the absorption of vitamin B 12 .

Mechanism: Metformin can make it harder for your body to absorb vitamin B12 and can lower the amount of folate in your blood. This may reduce the benefits of the vitamins in your supplement.

What to do: Your doctor may need to monitor your vitamin levels with blood tests. You should continue taking your prenatal vitamins to help maintain healthy nutrient levels.

• Fluoxetine: Fluoxetine exerts a noncompetitive inhibition of the 5-methyltetrahydrofolate active transport in the intestine.

Mechanism: Fluoxetine can block the system that moves folate from your intestines into your body. This means you might not get the full amount of folate from your multivitamin.

What to do: Your doctor may monitor your folate levels while you are taking these together. Make sure to take your vitamins daily as directed by your healthcare provider.

• NSAIDs include ibuprofen, naproxen, indomethacin and sulindac.

Mechanism: Ibuprofen is a type of NSAID that can interfere with how your body absorbs or uses certain vitamins in your prenatal supplement.

What to do: Talk to your doctor about whether you should take these medications at different times of the day.