Is It Okay to Take Metformin & Folic Acid?
You need to consume a regular amount of folic acid per day to prevent folic acid anemia or folic acid deficiency. The prescription drug metformin is mainly prescribed to people with Type 2 diabetes, and it is safe to take along with folic acid 1.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Metformin
Metformin is a medication that helps control blood glucose levels 1. Type 2 diabetics who are noninsulin-dependent are often prescribed metformin, and metformin may be given to treat other conditions such as polycystic ovary syndrome 1. Women with this condition have a higher insulin level that normal and run an increased risk of developing diabetes.
Folic Acid
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Folic acid supplements, in addition to folate-rich foods, work to prevent or treat folic acid deficiency, minimizing the risk of developing folic acid anemia. During pregnancy, women are required to take folic acid supplements to minimize the risk of birth defects. According to Drugs.com, folic acid does not interact with metformin, so you can take both together safely 12. However, you should consult with your physician if you are taking multivitamins that contain folic acid or if you are taking any other medication.
- Folic acid supplements, in addition to folate-rich foods, work to prevent or treat folic acid deficiency, minimizing the risk of developing folic acid anemia.
- During pregnancy, women are required to take folic acid supplements to minimize the risk of birth defects.
Considerations
Although there are no known drug interactions between folic acid and metformin, if you do not feel comfortable taking both medications together, take your folic acid in the morning along with a meal and your metformin at a later time with a separate meal 1. Do not exceed your prescribed dose of metformin or folic acid since exceeding either can have adverse effects on your health 1.
Concerns
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These are symptoms of a severe allergic reaction called anaphylaxis. Anaphylaxis left untreated can result in respiratory arrest or cardiac arrest.
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References
- Drugs.com: Metformin
- Drugs.com: Folic Acid Interaction List
- Donnelly JG. Folic acid. Crit Rev Clin Lab Sci. 2001;38(3):183-223.
- Scaglione F, Panzavolta G. Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. Xenobiotica. 2014;44(5):480-8.
- Figueiredo JC, Grau MV, Haile RW, et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst. 2009;101(6):432–435. doi:10.1093/jnci/djp019
- Spina bifida and anencephaly before and after folic acid mandate--United States, 1995-1996 and 1999-2000. MMWR Morb Mortal Wkly Rep. 2004;53(17):362-5.
- Bastian H. Lucy Wills (1888-1964): the life and research of an adventurous independent woman. J R Coll Physicians Edinb. 2008;38(1):89-91.
- Visentin M, Zhao R, Goldman ID. The antifolates. Hematol Oncol Clin North Am. 2012;26(3):629–ix. doi:10.1016/j.hoc.2012.02.002
- Greenberg JA, Bell SJ, Guan Y, Yu YH. Folic Acid supplementation and pregnancy: more than just neural tube defect prevention. Rev Obstet Gynecol. 2011;4(2):52–59.
- Northrup H, Volcik KA. Spina bifida and other neural tube defects. Curr Probl Pediatr. 2000;30(10):313-32.
- Crider KS, Bailey LB, Berry RJ. Folic acid food fortification-its history, effect, concerns, and future directions. Nutrients. 2011;3(3):370–384. doi:10.3390/nu3030370
- Fousekis FS, Theopistos VI, Katsanos KH, Tsianos EV, Christodoulou DK. Hepatobiliary Manifestations and Complications in Inflammatory Bowel Disease: A Review. Gastroenterology Res. 2018;11(2):83–94. doi:10.14740/gr990w
- Hariz A, Bhattacharya PT. Megaloblastic Anemia. [Updated 2019 Jan 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537254/
- Maron BA, Loscalzo J. The treatment of hyperhomocysteinemia. Annu Rev Med. 2009;60:39–54. doi:10.1146/annurev.med.60.041807.123308
- Tinelli C, Di Pino A, Ficulle E, Marcelli S, Feligioni M. Hyperhomocysteinemia as a Risk Factor and Potential Nutraceutical Target for Certain Pathologies. Front Nutr. 2019;6:49. Published 2019 Apr 24. doi:10.3389/fnut.2019.00049
- Juhlin L, Olsson MJ. Improvement of vitiligo after oral treatment with vitamin B12 and folic acid and the importance of sun exposure. Acta Derm Venereol. 1997;77(6):460-2.
- Merle BM, Silver RE, Rosner B, Seddon JM. Dietary folate, B vitamins, genetic susceptibility and progression to advanced nonexudative age-related macular degeneration with geographic atrophy: a prospective cohort study. Am J Clin Nutr. 2016;103(4):1135-44.
- Tian T, Yang KQ, Cui JG, Zhou LL, Zhou XL. Folic Acid Supplementation for Stroke Prevention in Patients With Cardiovascular Disease. Am J Med Sci. 2017;354(4):379-387.
- Hsu CY, Chiu SW, Hong KS, et al. Folic Acid in Stroke Prevention in Countries without Mandatory Folic Acid Food Fortification: A Meta-Analysis of Randomized Controlled Trials. J Stroke. 2018;20(1):99–109. doi:10.5853/jos.2017.01522
- McRae MP. High-dose folic acid supplementation effects on endothelial function and blood pressure in hypertensive patients: a meta-analysis of randomized controlled clinical trials. J Chiropr Med. 2009;8(1):15–24. doi:10.1016/j.jcm.2008.09.001
- Zhao G, Ford ES, Li C, Greenlund KJ, Croft JB, Balluz LS. Use of folic acid and vitamin supplementation among adults with depression and anxiety: a cross-sectional, population-based survey. Nutr J. 2011;10:102.
- Gisondi P, Fantuzzi F, Malerba M, Girolomoni G. Folic acid in general medicine and dermatology. J Dermatolog Treat. 2007;18(3):138-46.
- Reynolds EH. Folic acid, ageing, depression, and dementia. BMJ. 2002;324(7352):1512–1515. doi:10.1136/bmj.324.7352.1512
- Nucera E, Aruanno A, Mezzacappa S, Pascolini L, Buonomo A, Schiavino D. Hypersensitivity reactions to folic acid: Three case reports and a review of the literature. Int J Immunopathol Pharmacol. 2018;32:2058738418817704. Published 2018 Dec 17. doi:10.1177/2058738418817704
- Pieroth R, Paver S, Day S, Lammersfeld C. Folate and Its Impact on Cancer Risk. Curr Nutr Rep. 2018;7(3):70–84. doi:10.1007/s13668-018-0237-y
- Lewis DP, Van dyke DC, Willhite LA, Stumbo PJ, Berg MJ. Phenytoin-folic acid interaction. Ann Pharmacother. 1995;29(7-8):726-35.
- Selhub J, Dhar GJ, Rosenberg IH. Inhibition of folate enzymes by sulfasalazine. J Clin Invest. 1978;61(1):221-4.
- Kennedy DO. B Vitamins and the Brain: Mechanisms, Dose and Efficacy--A Review. Nutrients. 2016;8(2):68. Published 2016 Jan 27. doi:10.3390/nu8020068
- Starr RR. Too little, too late: ineffective regulation of dietary supplements in the United States. Am J Public Health. 2015;105(3):478–485. doi:10.2105/AJPH.2014.302348
- Troesch B, Demmelmair J, Gimpfl M, et al. Suitability and safety of L-5-methyltetrahydrofolate as a folate source in infant formula: A randomized-controlled trial. PLoS One. 2019;14(8):e0216790. Published 2019 Aug 19. doi:10.1371/journal.pone.0216790
- Pintó X, Vilaseca MA, Balcells S, et al. A folate-rich diet is as effective as folic acid from supplements in decreasing plasma homocysteine concentrations. Int J Med Sci. 2005;2(2):58–63. doi:10.7150/ijms.2.58
- American Academy of Pediatrics: Committee on Genetics. Folic acid for the prevention of neural tube defects. Pediatrics. 1999 Aug;104(2 Pt 1):325-7.
- Juhlin, L. and Olsson, M. Improvement of vitiligo after oral treatment with vitamin B12 and folic acid and the importance of sun exposure. Acta Derm Venereol. 1997 Nov;77(6):460-2. DOI: 10.2340/000155555577460462.
- Li, Y.; Huang, T.; Zheng, Y. et al. Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta‐Analysis of Randomized Controlled Trials. JAHA. 2016;5(8):pii: e003768. DOI: 10.1161/JAHA.116.003768.
- Merle, B.; Silver, R.; Rosner, B. et al. Dietary folate, B vitamins, genetic susceptibility and progression to advanced nonexudative age-related macular degeneration with geographic atrophy: a prospective cohort study. Am J Clin Nutr. 2016 Apr;103(4):1135-44. DOI: 10.3945/ajcn.115.117606.
- Zhao, G.; Ford, E.; Li, C. et al. Use of folic acid and vitamin supplementation among adults with depression and anxiety: a cross-sectional, population-based survey. Nutrition Journal. 2011;10:102. DOI: 10.1186/1475-2891-10-102.
Writer Bio
April Khan is a medical journalist who began writing in 2005. She has contributed to publications such as "BBC Focus." In 2012, Khan received her Doctor of Public Health from the University of Medicine and Dentistry of New Jersey. She also holds an Associate of Arts from the Art Institute of Dallas and a Master of Science in international health from University College London.