Folate deficiency impairs DNA synthesis, resulting in ineffective erythropoiesis, macrocytosis and megaloblastic anemia, often accompanied by glossitis, mucosal changes and fatigue. This medication is commonly used for Hypertension.
Hematology and nutrition reviews describe folate deficiency as a classic cause of megaloblastic anemia and mucosal abnormalities, frequently exacerbated by medications that antagonize folate metabolism.
O’Leary F, Samman S. Vitamin B12 in health and disease. Nutrients. 2010;2(3):299-316. (discussion of folate and B12 in megaloblastic anemia); Lešić S et al. The impact of vitamin deficiencies on oral manifestations. Dent J (Basel). 2024;12(4):109.
Some side effects may be linked to nutrient depletion caused by this medication.
Studies indicate that diuretics including potassium-sparing, can act as folate antagonists, potentially leading to a deficiency. This occurs because some diuretics inhibit the enzyme responsible for utilizing folate (folic acid) in the body. Research suggests a link between long-term diuretic use (over six months) and decreased blood folate levels while also showing a significant increase in damaging homocysteine levels. Folate supplementation during potassium-sparing diuretic therapy should therefore be considered.