How long between increasing methotrexate doses and how much folic acid should I be taking?

[Happy43]

I've started 10mg injections increasing to 15mg and 20mg with two weeks inbetween. I've been prescribed 5mg folic acid for six days inbetween.

I've read elsewhere that methotrexate increases are every four weeks and folic acid is 5mg only on the next day or 1mg daily for six days?

Now I'm confused if I've been given the right information 🤪 anyone else had these increase times and doses?

Thanks

[happytulip]

I am no longer on MTX but I look 5mg folic acid for 6 days a week and ommitted it on the day I took MTX. It was the only way to cope with the nausea.

[Happy43 in reply to happytulip]

Thanks, did you increase the methotrexate every two weeks? I've read about it being every four weeks.

[happytulip in reply to Happy43]

I think it was between 2-4 weeks but was a few years ago so can't be sure. Alot has happened since.

[PMRpro]

Some doctors use more folic acid than others. And some patients need more than others. 5mg on 6 days is the maximum but 5mg just the day after mtx is rarely enough.

[Krazykat26]

Hi Happy 🤗

I'm on methotrexate (tablets though not injection) I started on 12.5 mgs n stayed on that dose for 5 months n it's just been increased to 15mgs (3weeks ago) so I can't really help there BUT I can say that ever since I started mtx I have been told to take 5mgs of folic acid for six days n no folic acid when I take MTX.

🌈😽😽Xx

[Happy43 in reply to Krazykat26]

Hi Krazykat thanks for your reply, sounds like the folic acid is right. You say you were on 12.5mg for 5 months and increased to 15mg, I'm wary of such increases and the time inbetween that I've been given 😮.

Has it worked for you? I'm having some stomach side effect issues, this is my second immunosuppressant. I tried azathioprine but had to stop.

😊

[Krazykat26 in reply to Happy43]

Yes it has..I've had good results..with me it has to be slow..but I will say that I've got SCLE so my stomach seems to be tolerating it ok..as well as liver kidneys etc.

Maybe u could suggest slower increase in order for u to adjust?

I'm on loads of other drugs too n I'm hoping to reduce the steroids in the near future..but hey u know your body right? We live with our symptoms day in day out..I'm no doctor but I'm living in my skin n like u I've tried other meds which didn't work for me!!

Go with your gut feeling..I was on another immunosuppressant called ciclosporin n I found them really hard to swallow..made me gag n then regurgitate..it was like my body was saying this ain't it!! Symptoms got better for a while but I was really struggling keeping them down..dermy was saying increase it..but my BP had gone up (side effect of the ciclo) so I was taking another drug to counteract that 🙆🤦 so eventually with some research after advise on this forum I suggested MTX..dermy agreed..n prescribed it in Nov last year..said it was small dose n let's see how it goes..covid happened n I haven't seen him since but I know I'm tolerating it well from bloods n then had a telephone consultation 3 wks ago with a registrar in dermy dept n they have increased it to 15mgs ( again at my suggestion)

If u feel that the increases r too much I would say discuss with the doc..or just go with what feels right for u..it's fine for docs to give orders n then send us off...see u in 4 months..but it doesn't happen like that...4months stretch out into longer months coz docs r chocablock n aren't living with this stuff 24/7!! When we leave the consultation room..they move onto the next one!!

I've rambled but I'm scrambled!! Forgive me!! 😹🙆🌈😽😽Xx

[Happy43 in reply to Krazykat26]

Haha 😂 easily done! I agree with everything you've said.

Glad you've had a good result.

😊