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Take this medication by mouth with or without food, usually once daily or as directed by your doctor. If stomach upset occurs, it may help to take this product with food.

Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day. The dosage is based on your medical condition and response to therapy.

Nausea, stomach upset, diarrhea, drowsiness, flushing, and numbness/tingling may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

If your doctor has prescribed this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes, unusual weakness.

A very serious allergic reaction to this product is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before taking this medication, tell your doctor or pharmacist your medical history, especially of: certain blood disorders (e.g., pernicious anemia, other anemias).

This drug may make you drowsy. Alcohol or marijuana can make you more drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.

This product should not be used with the following medications because very serious interactions may occur: altretamine, cisplatin, levodopa (when used without carbidopa).

If you are currently using any of these medications, tell your doctor or pharmacist before starting this medication.

Before using this product, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: folic acid antagonist (e.g., methotrexate), hydantoins (e.g., phenytoin, diphenylhydantoin), pyrimethamine, other vitamin/nutritional supplements.

This product can affect the results of certain lab tests (e.g., intrinsic factor antibodies, certain urobilinogen tests). Make sure laboratory personnel and your doctors know you use this drug.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Missed Doses:

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Notes:

Do not share this medication with others.

Laboratory and/or medical tests (e.g., complete blood count, homocysteine levels) may be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.

Remember that it is best to get your vitamins and minerals from healthy foods. Maintain a well-balanced diet and follow any dietary guidelines as directed by your doctor. B vitamins, including folic acid, are naturally found in leafy greens, other vegetables, and citrus fruits. Folic acid is also found in enriched grains such as bread, pasta and cereal.

Some brands of this medication may also contain ingredients such as vitamin E, para-aminobenzoic acid, or alpha-lipoic acid. Consult your doctor or pharmacist if you have questions about the ingredients in your brand.