Acfol (Folic Acid) in Spain: Pregnancy and Anaemia
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 29 October 2026
Acfol is folic acid on prescription in Spain. Why it is used before and in early pregnancy, who needs a higher strength and why B12 is checked first.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Acfol is a Spanish brand of folic acid, one of the B vitamins. Doctors prescribe it before and in early pregnancy, to help prevent problems with how a baby's brain and spine form. It is also used to treat anaemia caused by low folate. In Spain, Acfol tablets need a prescription.
- Acfol is folic acid. It is a higher-strength tablet than most pregnancy supplements.
- Folic acid before and in early pregnancy lowers the risk of spina bifida and similar defects.
- Acfol needs a prescription in Spain. The right amount depends on your situation, and your doctor decides.
- If you have anaemia, your vitamin B12 should be checked before folic acid is started.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
What is Acfol and why do doctors prescribe it?
Acfol contains only folic acid. Your body needs folate to make healthy red blood cells and new cells. A growing baby needs it most in the first weeks, often before you know you are pregnant. The leaflet lists two main uses:
- Pregnancy. To prevent or treat low folate in pregnant women, to help prevent neural tube defects. This matters most for women who have had a baby or pregnancy affected by one.
- Anaemia and low folate. To treat low folate in a type of anaemia with large red cells (megaloblastic anaemia), in heavy drinking and in conditions where the gut does not absorb food well.
Folic acid before and during pregnancy: what does it do?
The neural tube is the early form of a baby's brain and spinal cord. It closes in the first weeks of pregnancy. If it does not close fully, the baby can be born with spina bifida or other serious defects. MedlinePlus says enough folic acid before and during pregnancy can prevent major birth defects of the brain or spine.
The NHS advises starting folic acid when you start trying for a baby, ideally a few months before. Keep taking it until the end of the first 12 weeks. If the pregnancy was not planned, start as soon as you know.
Who might need a higher-strength folic acid?
Most women take a standard folic acid supplement. Acfol is a stronger tablet. The right amount depends on your situation; some women need a higher-strength prescription, and your doctor decides. The NHS lists these reasons a doctor may suggest a higher strength:
- You or the baby's father has a neural tube defect, or a relative with one.
- You have had a pregnancy affected by a neural tube defect.
- You have diabetes.
- You have a blood condition such as sickle cell anaemia or thalassaemia.
- You take medicine for epilepsy or HIV.
If any of these apply, talk to a doctor before you try for a baby. Do not switch strengths on your own. Our pregnancy care page explains how we help in early pregnancy.
Is Acfol sold in the UK or US?
No. Acfol is a Spanish brand. The same medicine is sold in other countries simply as folic acid. These names help you match what you used before:
| Name | What it is | Where |
|---|---|---|
| Acfol | Folic acid tablets, higher strength | Spain (prescription) |
| Ácido fólico (generic) | Folic acid tablets from other makers, same strength range | Spain (prescription) |
| Folic acid (higher strength) | Same medicine, prescribed by a GP | UK |
| Folic acid supplements | Standard strength, often in pregnancy multivitamins | UK, Spain, US (shops and pharmacies) |
A pregnancy multivitamin is not the same as Acfol. Check with a doctor or pharmacist before you take both.
Do you need a prescription for Acfol in Spain?
Yes. Acfol tablets are listed as a prescription medicine (medicamento sujeto a prescripción médica) on the AEMPS CIMA database. So are the other folic acid medicines of that strength. Lower-strength pregnancy supplements are a different product. Your pharmacist can show you those.
Planning a pregnancy, or just found out you are pregnant?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He checks your history and tells you which folic acid suits you.
Folate anaemia: why B12 is checked first
Low folate and low vitamin B12 can both cause anaemia with large red cells. They look alike on a blood test. The NHS says your GP will check your B12 before you start folic acid. Folic acid can ease the symptoms so well that it hides a B12 problem. If low B12 is missed, it can harm the nerves over time.
The Acfol leaflet says the same thing in its own way. Ask your doctor first if you have anaemia without a known cause. Large, long courses can lower B12 in the blood. Our anaemia and vitamin deficiency page and our guide to blood count results explain the tests.
Which medicines affect folic acid?
Tell your doctor or pharmacist about all your medicines. The leaflet lists these, among others:
- Medicines for epilepsy. Folic acid and these medicines can affect each other's levels.
- Methotrexate, trimethoprim and sulfonamide antibiotics, which work against folic acid.
- Zinc supplements, antacids, the contraceptive pill and long courses of steroids.
- Alcohol.
What Acfol does not do
- It does not treat low B12 or pernicious anaemia. Those need their own treatment.
- It does not treat iron deficiency. Iron is a separate test and a separate medicine.
- It does not rule out every birth defect. It lowers the risk of neural tube defects. Routine pregnancy scans still matter.
Side effects and when to get help
Folic acid is usually well tolerated. The leaflet says it can be used in pregnancy and breastfeeding. It does not affect driving. Rare side effects include stomach upset, feeling sick and diarrhoea. Allergic reactions such as a rash or itching are rare. See a doctor if:
- You feel very tired, short of breath or pale, or your tests show anaemia.
- You have pins and needles, numbness or a sore, red tongue. These can point to low B12.
- You are pregnant and have not yet been seen by a midwife or doctor.
Call 112 if your face, lips or throat swell or you struggle to breathe after a dose. In pregnancy, also call 112 for heavy bleeding or severe pain in the tummy.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask about your plans, your health, your family history and your current medicines.
- Check whether a standard supplement or a higher strength suits you.
- Look at any blood results you have, and suggest tests for anaemia or low B12 if needed.
- Explain how to join local pregnancy care in Spain.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.
Frequently asked questions
What is Acfol?
A Spanish brand of folic acid tablets. It is used before and in early pregnancy, and to treat anaemia caused by low folate.
Is Acfol the same as a pregnancy folic acid supplement?
It is the same vitamin, but a higher strength. Most women need only a standard supplement. Your doctor decides if you need more.
Do I need a prescription for Acfol in Spain?
Yes. Acfol is a prescription medicine in Spain. Lower-strength folic acid supplements are a separate product sold in pharmacies.
When should I start taking folic acid?
The NHS advises starting when you begin trying for a baby, ideally a few months before, and carrying on until the end of week 12.
Why check vitamin B12 before folic acid?
Folic acid can hide the signs of low B12. If low B12 is missed, it can harm the nerves. A blood test sorts this out.
Can I take Acfol while breastfeeding?
The leaflet says folic acid can be used in pregnancy and breastfeeding. Ask your doctor whether you still need it.
Sources
- AEMPS CIMA: Acfol package leaflet
- NHS: Vitamins, supplements and nutrition in pregnancy
- NHS: Treating vitamin B12 or folate deficiency anaemia
- MedlinePlus: Folic acid
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
