An Addisonian goose chase

BMJ 2009; 338 doi: (Published 28 January 2009) Cite this as: BMJ 2009;338:b112
  1. Jane L Walker, clinical pharmacist in diabetes and endocrinology,
  2. Stephen E R S Stanaway, consultant physician in diabetes and endocrinology
  1. 1Wrexham Maelor Hospital, Wrexham
  1. jane.walker2{at}

    This started as a chance inquiry from one of our patients who was alarmed to read the following in her patient information leaflet (PIL) for a particular brand of folic acid: “Do not take folic acid tablets if you have Addison’s disease.”

    This puzzled the endocrinologist and further puzzled the clinical pharmacist as we knew of no such contraindication. The first clue came after we contacted the pharmaceutical company in question, which “reassured” us that “the wording is more explanatory” in the data sheet. This stated: “Folic acid should never be given alone in the treatment …

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