At high doses (> 1 5 mg/day), minor zinc depletion may develop (Carmel 2006, Kelly 1998) — observe patients for signs and symptoms of zinc deficiency.


Reduced folate absorption — observe patient for signs and symptoms of folate deficiency and separate doses by at least 4 hours.


Reduced folate levels frequently develop with long-term use, but macrocytic anaemia is rare (Lambie et al 1985). Supplementation can reduce toxicity, which is a beneficial interaction, although medical supervision is advised.

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