6th February 2024

A 43-year-old female presented to the GP for routine blood tests and was found to have megaloblastic anaemia.

A 43-year-old female presented to the GP for routine blood tests and was found to have megaloblastic anaemia. She is not a heavy alcohol drinker. She is known to have Crohn’s disease and is waiting to see a dietitian for weight loss. She states that she was commenced on a new medication 8-9 months ago. Blood tests confirm the presence of megaloblastic anaemia with low folate levels.

Which of the following medications could have contributed to her condition?