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Drug causing folate deficiency: Folate deficiency may result from increased loss of folate, as in renal dialysis or interference with metabolism (eg, Folic acid antagonists such as methotrexate); the administration of anticonvulsants, such as phenytoin, primidone, and barbiturates; alcohol consumption and, especially, alcoholic cirrhosis; and the administration of pyrimethamine and nitrofurantoin. The levels/effects of Folic acid may be decreased by green tea.
There is evidence that the anticonvulsant action of phenytoin is antagonized by Folic acid. A patient whose epilepsy is completely controlled by phenytoin may require increased doses to prevent convulsions if Folic acid is given.
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