Prescription drugs and folic acid: a warning for all women - KGWN –Cheyenne, WY– Scottsbluff, NE News,Weather, Sports

By Amanda Genge, Staff Writer, myOptumHealth

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Taking a daily dose of folic acid can help prevent serious birth defects of the brain and spine. These are called neural tube defects. They include spina bifida and anencephaly.

But did you know that some medications can keep folic acid from being absorbed? Studies show that several drugs can lead to folic acid deficiency. Some are medicines used to treat common problems such as high blood pressure and acid reflux.

All women of childbearing age should take 400-800 micrograms of folic acid each day. Higher doses are suggested if you are pregnant or nursing. If you're thinking about becoming pregnant, talk to your doctor. He or she will want to review your medicines and your medical history with you. If you have had a prior pregnancy affected by a neural tube defect, your doctor may also tell you to take a higher dose of folic acid.

Drugs to watch

Below are some of the drugs that may hold back the absorption of folic acid. But never stop taking any medicine on your own. Always talk to your doctor first. He or she will decide the safest option for both you and your baby. Your doctor may prescribe a folic-acid supplement.

• Phenobarbital, phenytoin (Dilantin), valproic acid (Depakene), carbamazapine (Tegretol) and primidone (Mysoline): used mostly to prevent seizures
• Combined trimethoprim and sulfonamide (Bactrim, Septra): common antibiotic for urinary tract infections
• Triamterene (Dyrenium): a diuretic for high blood pressure
• Sulfasalazine (Azulfidine): for ulcerative colitis and certain other bowel conditions
• Cimetidine (Tagamet): to treat reflux
• Beta-blockers and calcium channel-blockers: for high blood pressure and some heart problems
• Cholestyramine (Locholest, Questran): to lower cholesterol levels

Getting enough folic acid

Each year, about 2,500 babies are born with neural tube defects. Many other affected pregnancies end in miscarriage or stillbirth.

That's why women should take folic acid before conceiving. It helps prevent birth defects mainly during the first weeks of pregnancy. By the time a woman knows she's pregnant, her baby's brain and spine are formed and the damage could already be done.

One way to make sure you get enough folic acid is to take a multivitamin. These vitamins, breakfast cereals and grain products fortified with folic acid are easily absorbed by the body. If you eat fortified cereal with milk, be sure to drink the milk, too, since the vitamin dissolves in liquid.

You can also eat foods that are rich in folate, the natural form of folic acid. These include:

• Citrus fruits and juices
• Leafy greens and broccoli
• Beans, peas and lentils
• Peanuts
• Asparagus
• Whole-grain products

Ask your doctor how much folic acid is right for you.

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SOURCES:

• U.S. Food and Drug Administration. Folic acid fortification: fact and folly. Accessed: 07/30/2008

• National Women's Health Information Center. Folic acid. Accessed: 07/30/2008

• U.S.Department of Health and Human Services. Folic acid for the prevention of neural tube defects: recommendations. Accessed: 06/02/2009

• March of Dimes. Folic acid. Accessed: 07/30/2008

• National Institutes of Health. Office of Dietary Supplements. Dietary supplement fact sheet: folate. Accessed: 07/30/2008