Drug General Information (ID: DDI4F01WYN)
Drug Name			Folic acid		Drug Info		Methsuximide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vitamins				Anticonvulsants
Structure

Mechanism of Folic acid-Methsuximide Interaction (Severity Level: Moderate)
Increased metabolism (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Folic acid				Methsuximide
Mechanism 1		Folic acid				Increase the metabolism of circulating folate
Key Mechanism Factor 1
		Factor Name		Pharmacokinetics
		Factor Description		Alters the metabolism of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Increased metabolism of Folic acid caused by Methsuximide
Antagonize the effect of antiepileptic agents Click to Show/Hide Mechanism Graph
Drug Name		Folic acid				Methsuximide
Mechanism 2		Reduce the anticonvulsant effect of antiepileptic agent				Antiepileptic agent
Key Mechanism Factor 2
		Factor Name		Antiepileptic agents
		Factor Description		The beneficial effects of antiepileptic drugs may be reduced, leading to an increase in seizure frequency or duration.
Mechanism Description		Antagonize the effect of Methsuximide when combined with Folic acid

Recommended Action
Management		Caution is advised when folate therapy is coadministered with anticonvulsants. Close monitoring for clinical and laboratory evidence of diminished therapeutic response to both treatments is recommended. Patients should be advised to notify their physician if they experience loss of seizure control.

References
1	Berg MJ, Fischer LJ, Rivey MP, Vern BA, Lantz RK, Schottelius DD "Phenytoin and folic acid interaction: a preliminary report." Ther Drug Monit 5 (1983): 389-94. [PMID: 6659012]
2	Katz M "Potential danger of self-medication with folic acid." N Engl J Med 289 (1973): 1095. [PMID: 4742232]
3	Furlanut M, Benetello P, Avogaro A, Dainese R "Effects of folic acid on phenytoin kinetics in healthy subjects." Clin Pharmacol Ther 24 (1978): 294-7. [PMID: 688723]