During pregnancy and lactation
Prevents neural tube defects in babies
Dietary supplement in adults and elderly
Prevents risk of spontaneous abortions
Postmenopausal women: normalizes homocysteine, supports hot flashes, cardiovascular and bone health
Folate deficiency caused by medicines (phenytoin, phenobarbital, primidone)
Folate deficiency due to long-term red blood cell damage or kidney dialysis
Depression, cognitive impairment, dementia, Alzheimer’s disease

6S-5-methyltetrahydrofolate is a water-soluble vitamin B derivative.
Functions in DNA/RNA synthesis and amino acid metabolism.
Deficiency during pregnancy may cause fetal malformations (neural tube defects, spina bifida, anencephaly).
Supplementation reduces recurrence of NTDs and treats megaloblastic anemia.
Fourth-generation folate derivative with higher bioavailability, safety, and stability.

Anticonvulsants (phenytoin, phenobarbital, primidone) effectiveness may be reduced.
Folate deficiency can result from renal dialysis, methotrexate, alcohol use, pyrimethamine, nitrofurantoin.
May increase risk of sunburn/rashes with amiodarone.
May reduce effectiveness of phenobarbital.

Generally well tolerated.
Rare: GI disturbances (anorexia, diarrhea, nausea, flatulence), hypersensitivity (rash, erythema, urticaria, anaphylaxis).

Safe in pregnancy.
Secreted in breast milk; supplementation may be needed in lactating women with poor nutrition.
Considered compatible with breastfeeding.

Not adequate therapy for pernicious anemia (Vitamin B12 deficiency).
High doses may mask pernicious anemia while neurological symptoms progress.
Medical condition and concurrent drugs/supplements should be considered before prescribing.