Folic Acid with Tea Interaction Details
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 13, 2023
Interaction Effect
Decreased folic acid exposure
Interaction Summary
Concomitant use of folic acid and green or black tea resulted in decreased folic acid plasma levels. In healthy volunteers, concomitant administration of folic acid 0.4 mg with either green or black tea reduced the mean AUC of folic acid by 26.6% and 17.9%, respectively, as well as Cmax of serum folate by 39.2% and 38.6%, respectively; and folic acid 5 mg coadministered with green tea reduced the mean AUC of folic acid by 39.9% and the mean Cmax of serum folate by 27.4%. Avoid using folic acid and green or black tea together, especially in pregnant women.
Severity
Moderate
Onset
Rapid
Evidence
Probable
How To Manage Interaction
The concomitant use of folic acid and green or black tea may result in decreased folic acid exposure. Avoid using folic acid and green or black tea together, especially in pregnant women.
Mechanism Of Interaction
Decreased folate absorption
Literature Reports
A) An open-label, randomized crossover study of patients receiving folic acid in combination with either black or green tea showed a reduction in folic acid AUC and Cmax. Seven healthy volunteers received 5 different treatments consisting of folic acid (0.4 mg/day or 5 mg/day) in combination with either green or black tea (0.3 g/250 mL) or water, as a reference drink. A wash-out period of at least 1 week was maintained between treatments. To minimize individual differences in baseline folate plasma serum concentrations, a regimen with folic acid 5 mg/day for 1 week followed by 2 folic acid-free days along with study drinks 3 times daily (tea concentration, 0.3 g/250mL) were administered prior to and in between treatment periods. Plasma samples were collected over 8 hours. Coadministration of folic acid 0.4 mg with either green or black tea reduced the mean AUC of folic acid by 26.6% and 17.9%, respectively, as well as Cmax of serum folate by 39.2% and 38.6%, respectively. Relative bioavailability of folic acid was 77.7% with green tea and 88.4% with black tea. Coadministration of folic acid 5 mg with green tea reduced the mean AUC of folic acid by 39.9% and the mean Cmax of serum folate by 27.4%. Relative bioavailability of folic acid was 60% with green tea .
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
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The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.