Drug/Small Molecule:

folic acid

Overview

Generic Names:	Folate; PGA; Pteroyl-L-glutamic acid; Pteroyl-L-monoglutamic acid; Pteroylglutamic acid; Pteroylmonoglutamic acid; Vitamin B9; Vitamin Bc; Vitamin Be; Vitamin M
Trade Names:	Acifolic; Apo-Folic; Cytofol; Dosfolat B activ; Folacid; Folacin; Folbal; Folcidin; Foldine; Folettes; Foliamin; Folicet; Folipac; Folsan; Folsaure; Folsav; Folvite; Folvron; Incafolic; Millafol
PharmGKB Accession Id:	PA449692

Description

Indication

ATC Therapeutic Category

• B03BB:Folic acid and derivatives

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Pharmacology

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Protein Binding

Toxicity

Isomeric SMILES Code:

In-Depth Annotations ()

1. rs1801131 at chr1:11777063 in MTHFR
   Well studied, associated with multiple phenotypes.

   Variant Name:

   MTHFR:1298A>C

   Related Drugs:

   folic acid, methotrexate

   Evidence:

   http://www.pharmgkb.org/.../variant.jsp
   

2. rs1801133 at chr1:11778965 in CLCN6, MTHFR
   Well studied, associated with multiple phenotypes.

   Variant Name:

   MTHFR:677C>T

   Related Drugs:

   fluorouracil, folic acid, methotrexate

   Evidence:

   http://www.pharmgkb.org/.../variant.jsp#ImportantVariantInformationforMTHFR-677CT
   

Curated Annotations ()

1. rs1801131 at chr1:11777063 in MTHFR
   At 6 months methotrexate and folic acid therapy, of early rheumatoid arthritis patients with the MTHFR 1298AA genotype showed good improvement relative to combined CA and AA genotypes (OR 2.3), while 1298C allele carriers developed more adverse drug events (OR 2.5) (e.g. pneumonitis, gastrointestinal ADEs, skin and mucosal ADEs, and elevated liver enzyme levels). Patients with MTHFR 1298AA / 677CC diplotype showed greater clinical improvement.

   Variant Name:

   MTHFR:1298A>C

   Related Drugs:

   folic acid, methotrexate

   Related Diseases:

   Arthritis, Rheumatoid

   Evidence:

   PMID:16572443
   

2. rs1801131 at chr1:11777063 in MTHFR
   In 330 patients who completed 3 months methotrexate treatment for psoriasis, no significant genotypic associations were found between clinical outcome (e.g. efficacy, toxicity) and 50 SNPs in pathway genes for methotrexate metabolism (ATIC, FPGS, GGH, MTHFR), including 47 common ( >5% minor allele frequency) haplotype-tagging SNPs (r(2) > 0.8) plus 3 additional SNPs.

   Variant Name:

   MTHFR:298A>C

   Related Drugs:

   folic acid, methotrexate

   Related Diseases:

   Psoriasis

   Evidence:

   PMID:19016697
   

3. rs1801133 at chr1:11778965 in CLCN6, MTHFR
   Given methotrexate and folic acid therapy, patients with the MTHFR 1298AA / 677CC diplotype showed greater clinical improvement for early rheumatoid arthritis.

   Variant Name:

   MTHFR:677C>T

   Related Drugs:

   folic acid, methotrexate

   Related Diseases:

   Arthritis, Rheumatoid

   Evidence:

   PMID:16572443
   

4. rs1801133 at chr1:11778965 in CLCN6, MTHFR
   In 330 patients who completed 3 months methotrexate treatment for psoriasis, no significant genotypic associations were found between clinical outcome (e.g. efficacy, toxicity) and 50 SNPs in pathway genes for methotrexate metabolism (ATIC, FPGS, GGH, MTHFR), including 47 common ( >5% minor allele frequency) haplotype-tagging SNPs (r(2) > 0.8) plus 3 additional SNPs.

   Variant Name:

   MTHFR:667C>T

   Related Drugs:

   folic acid, methotrexate

   Related Diseases:

   Psoriasis

   Evidence:

   PMID:19016697
   

5. rs2372536 at chr2:215898265 in ATIC
   In 330 patients who completed 3 months methotrexate treatment for psoriasis, no significant genotypic associations were found between clinical outcome (e.g. efficacy, toxicity) and 50 SNPs in pathway genes for methotrexate metabolism (ATIC, FPGS, GGH, MTHFR), including 47 common ( >5% minor allele frequency) haplotype-tagging SNPs (r(2) > 0.8) plus 3 additional SNPs.

   Variant Name:

   ATIC:347C>G

   Related Drugs:

   folic acid, methotrexate

   Related Diseases:

   Psoriasis

   Evidence:

   PMID:19016697
   

6. rs70991108 at chr5:79985919 in DHFR, MSH3
   Risk or phenotype-associated allele: del/del Phenotype: Women with the del/del genotype had increased serum and red blood cell folate concentrations. Study size: 197 Study population/ethnicity: Females from the Young Hearts Study; 20-26 years old; Northern Ireland Significance metric(s): p = 0.02 (serum folate); p = 0.16 (red blood cell folate) Type of association: PD

   Variant Name:

   DHFR c.86 + 60_78; DHFR:19bp deletion in intron 1;

   Related Drugs:

   folic acid

   Evidence:

   PMID:18247058
   

The following genes are in curated knowledge about this drug.

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene		Description
FOLR2		(source: Drug Bank)
FOLR3		(source: Drug Bank)
GGH		(source: Drug Bank)
SLC25A32		(source: Drug Bank)
SLC46A1		(source: Drug Bank)

PharmGKB Curated Pathways

• Methotrexate Pathway
• Thiopurine Pathway

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug		Description
amobarbital		Folic acid decreases the effect of anticonvulsant (source: Drug Bank)
butalbital		Folic acid decreases the effect of anticonvulsant (source: Drug Bank)
hexobarbital		Folic acid decreases the effect of anticonvulsant (source: Drug Bank)
mephenytoin		Folic acid decreases the levels of hydantoin (source: Drug Bank)
methylphenobarbital		Folic acid decreases the effect of anticonvulsant (source: Drug Bank)
pentobarbital		Folic acid decreases the effect of anticonvulsant (source: Drug Bank)
phenobarbital		Folic acid decreases the effect of anticonvulsant (source: Drug Bank)
phenytoin		Folic acid decreases the levels of hydantoin (source: Drug Bank)
primidone		Folic acid decreases the effect of anticonvulsant (source: Drug Bank)

Curated Information

The following diseases are in curated knowledge about this drug.

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

1. The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease

LinkOuts

Common Searches

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.