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Use of BOTOX for the treatment of overactive bladder in such patients and in patients with multiple recurrent UTIs during treatment should only be considered when the benefit is likely to outweigh the potential risk

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Dietary folate deficiencies and drugs that interfere with folate metabolism, eg, methotrexate, an anti-carcinogenic agent that inhibits dihydrofolate reductase, and nitrous dioxide (N 2 O), an anesthetic gas that inhibits methionine synthase activity, lead to accumulations and cellular effluxes of homocysteine, causing increases in circulating homocysteine levels (Ueland and Refsum, 1989)

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