Folic acid Side Effects

Some side effects of folic acid may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to folic acid: oral tablet

Get emergency medical help if you have any of these signs of an allergic reaction while taking folic acid: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects are more likely, but may include:

• nausea, loss of appetite;

• bloating, gas;

• bitter or unpleasant taste in your mouth;

• sleep problems;

• depression; or

• feeling excited or irritable.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to folic acid: compounding powder, injectable solution, oral tablet

Gastrointestinal

Gastrointestinal side effects have been reported rarely. They have included anorexia, nausea, abdominal distention, flatulence, and bitter taste.

Gastrointestinal side effects have been reported among patients with doses of 15 mg/day.

Nervous system

Nervous system side effects have included sleep disturbances, concentration problems, irritability, anxiety, depression, confusion, and impaired judgment.

Parenteral administration of high doses of folic acid have been associated with increased seizure activity in patients with epilepsy.

Nervous system side effects have been reported in some patients who were taking 15 mg/day.

Daily doses of folic acid > 100 mcg/day can obscure pernicious anemia in that hematologic remission can occur while neurologic signs and symptoms progress.

Hypersensitivity

Hypersensitivity side effects have been reported rarely. They have included erythema, rash, pruritus, malaise, dyspnea with bronchospasm, and a single case of apparent anaphylaxis.

Metabolic

Metabolic side effects have included impaired gastrointestinal absorption of zinc.

A measurable decline in plasma zinc has been associated with folic acid dosages as low as 400 mcg/day.

Zinc is an intrinsic part of at least 70 metalloenzymes and other cellular components, and is essential for the synthesis of protein, DNA, and RNA. While zinc deficiency is rare, it may become a problem during pregnancy or with patients who have inflammatory bowel disease, malabsorption, liver cirrhosis, and high alcohol intake. Zinc deficiency usually presents as diarrhea; mental irritability; depression; skin lesions of the face, perineum, limbs, and skin folds; alopecia; loss of taste; and defects in the immunologic system.

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