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Table 1 Recommendations for folic acid supplementation by different guidelines

From: Managing reproductive problems in women with epilepsy of childbearing age

Guideline Recommendation for dosage Recommendation for adding time
SIGN 2015 [34] 400 μg/day: not on ASMs
5 mg/day: on ASMs or not on ASMs, but high risk (with a family history of neural tube defects or a BMI > 30 kg/m2)
From preconception and throughout the first trimester of pregnancy
RCOG 2016 [35] 5 mg prior to conception and to continue the intake until at least the end of the first trimester
AAN/AES 2009 [36] At least 0.4 mg/day Prior to conception and during pregnancy
ETDP-EFA 2007 [37] 0.4 mg/day for nonpregnant women, 0.6 mg/day for pregnant women and those contemplating pregnancy, and 0.5 mg/day for lactating women. Many epileptologists recommend higher doses (0.8–4 mg/day) for women with epilepsy. However, for women with a family history of a neural tube defect, 4 mg/day is the recommended dosage. Before conception and throughout pregnancy
NICE 2012 (update 2016) [38] 5 mg/day Before any possibility of pregnancy
  1. ASM Antiseizure medication, AAN American Academy of Neurology, AES American Epilepsy Society, ETPD – EFA Epilepsy Therapy Development Project – Epilepsy Foundation of America, NICE National Institute for Health and Care Excellence, RCOG Royal College of Obstetricians and Gynaecologists, SIGN Scottish Intercollegiate Guidelines Network