Folic acid antagonists can be divided into two groups: (a) DHFR inhibitors (eg, sulfamethoxazole-trimethoprim), which block the conversion of folate to its more active metabolites (Figure 1), and (b) other folic acid antagonists, a group consisting primarily of anticonvulsant medications (phenobarbital, phenytoin, primidone, and carbamazepine) but also including Spasmophen (an antispasmodic drug that contains low doses of phenobarbital) and cholestyramine
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