What is l-methylfolate?

Folate is a form of B vitamin that occurs naturally in many foods. Folic acid is the man-made form of folate that is added to processed foods or vitamin and mineral supplements. Folate is needed in the human body for production of red blood cells.

A lack (deficiency) of folate in the human body can be caused by certain diseases, by taking certain medications, or by not getting enough folate in your diet. Folate deficiency can lead to decreased red blood cells, or anemia.

L-methylfolate is a medical food for use in people who have conditions related to folate deficiency.

The Zervalx brand of l-methylfolate is used in the following situations:

  • in people who have high levels of a certain amino acid in their blood, a condition called hyperhomocysteinemia (HYE-per-HOE-moe-sis-tin-EE-mee-a). This condition can be related to folate deficiency or may be caused by receiving methotrexate (Rheumatrex, Trexall);
  • in women with high-risk pregnancies who need additional folate in their diets to prevent hyperhomocysteinemia; or
  • in people with certain types of anemia (a lack of red blood cells) that may be complicated by a folate deficiency.

The Deplin brand of l-methylfolate is used in the following situations:

  • in people with major depressive disorder who have folate deficiency. Deplin is used together with anti-depressant medications in people with major depressive disorder and low folate levels.
  • in people with schizophrenia who have hyperhomocysteinemia related to folate deficiency.

Deplin is not an antidepressant. However, it may enhance the effects of antidepressant medications.

L-methylfolate may also be used for other purposes not listed in this medication guide.


You should not use this medication if you have ever had an allergic reaction to l-methylfolate.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before using l-methylfolate, tell your doctor if you have:

  • a history of bipolar disorder (manic depression);
  • vitamin B12 deficiency; or
  • pernicious anemia.

Zervalx may be used throughout pregnancy or while you are trying to get pregnant.

Before you take Deplin, tell your doctor if you are pregnant or breast-feeding.

Avoid drinking alcohol while you are taking l-methylfolate.

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Seek emergency medical attention if you think you have used too much of this medicine.

An overdose of l-methylfolate is not likely to cause life-threatening symptoms.

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

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Side effects

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

Less serious side effects may include:

  • nausea;
  • loss of appetite;
  • bloating;
  • gas; or
  • bitter taste in your mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Tell your doctor about all other medications you use, especially seizure medication such as:

  • carbamazepine (Carbatrol, Tegretol);
  • ethosuximide (Zarontin);
  • fosphenytoin (Cerebyx);
  • lamotrigine (Lamictal);
  • phenobarbital (Solfoton);
  • phenytoin (Dilantin);
  • primidone (Mysoline); or
  • valproic acid valproate.

Other drugs that can interact with l-methylfolate include:

  • birth control pills;
  • cholestyramine (Prevalite, Questran), colestipol (Colestid);
  • colchicine;
  • isotretinoin (Accutane);
  • methylprednisolone (Medrol);
  • methotrexate (Rheumatrex, Trexall);
  • pancreatin (Hi-Vegi-Lip), pancrelipase (Cotazym, Pancrease, Ultrase);
  • pentamidine (Nebupent);
  • pyrimethamine (Daraprim);
  • sulfasalazine (Azulfidine);
  • triamterene (Dyrenium);
  • trimethoprim (Proloprim, Bactrim, Septra); or
  • a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin), indomethacin (Indocin), naproxen (Aleve, Naprosyn), or sulindac (Clinoril).

This list is not complete and there may be other drugs that can interact with l-methylfolate. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Other Names

Deplin, l-methylfolate, and Zervalx

Available Strengths & Dosages

Route Form Strength
oral tablet 7.5 mg

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Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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