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Acetylcysteine/L-methylfolate/methylcobalamin (By mouth)

Acetylcysteine (a-seet-il-SIS-teen), L-Methylfolate (L-meth-il-FOE-late), Methylcobalamin (METH-il-koe-BAL-a-min)

Used as a dietary supplement for patients with or at risk for memory loss, dementia, Alzheimer disease, or stroke.

Brand Name(s):

Metafolbic Plus

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use it if you had an allergic reaction to acetylcysteine, L-methylfolate, or methylcobalamin.

How to Use This Medicine:


  • Your doctor will tell you how much medicine to use. Do not use more than directed.
  • Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Some medicines can affect how this medicine works. Tell your doctor if you are taking any of the following:
    • Cholestyramine, colestipol, colchicine, metformin, para-aminosalicylic acid, phenytoin, potassium, pyrimethamine, sulfasalazine
    • Antibiotic
    • Nitrates
    • NSAID pain or arthritis medicine, such as aspirin, diclofenac, ibuprofen, naproxen, celecoxib
    • Seizure medicine

Warnings While Using This Medicine:

  • Tell your doctor if you are pregnant. Do not breastfeed while you are taking this medicine unless your doctor gives you permission. Tell your doctor if you have blood, liver, or heart disease, diabetes, or a history of kidney stones or peptic ulcers.
  • Diabetes ketone tests may be affected by this medicine. If you have diabetes, talk to your doctor about how to test for ketones correctly.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Chest pain, shortness of breath, or coughing up blood
  • Difficulty urinating, pain while urinating, or blood in your urine
  • Numbness or weakness in your arm or leg, or on one side of your body
  • Pain in your lower back, groin, or calf
  • Sudden or severe headache, problems with vision, speech, or walking
  • Swelling anywhere in your body

If you notice these less serious side effects, talk with your doctor:

  • Nausea, vomiting, diarrhea, or upset stomach

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 5/1/2020

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