Folic acid and methotrexate

[lizziebrush]

I have been told to take 5mg of folic acid once a week after I have injected. I was talking to someone this week who takes folic acid everyday and just misses when he takes methotrexate!!!! What's right?

[Titchyj]

Hi, I was told the same at the beginning , but when I got more side effects e.g. Nausea, dizziness and diarrhoea, I was told to take it every day except the day I take MTX. I would speak to you Rheumy nurses for their advice.

Jan

[nomoreheels]

Hiya lizziebrush. When I first started on tablets (in Spain) I was told to take 5mg the day after taking methotrexate. I found the side effects were getting worse the longer I took it so was upped to the day before & the day after. When that didn't help I was put on to the injections, again folic acid the day before & day after. When we moved back to the UK I was told to take them every day except the day I injected & find I'm considerably better with this regime. There doesn't seem to be a hard & fast rule about this & of course it somewhat depends on your tolerance to the drug.

If you're having problems it may be worth mentioning it next time you see your Consultant.

[helixhelix]

Everyone's different! Basically the approach is to give you the lowest dose of folic acid possible as although it helps diminish side effects it can also reduce the effectiveness of the MTX. So a lot of people are started on one a week, and only increased if you need to. I started on 1 a week, but when I started getting mouth ulcers it went up to 6 a week. And now I've swapped to injections I've been able to drop back down to 2 a week. The fewer pills I can take each week the happier I am....

[Hidden]

I find it very interesting that different rheumatologists in different places do something's so different. Not to say either is wrong or right. I take 15 mg of methotrexate by injection a week. I was taking 1 mg of folic acid a day including the day I inject. Then a month or two later she told me to take 2 mg a day. The only side effect I think I have on occasion is a mouth ulcer. I am taking other medications as well. I can't really complain about pain at this point. I know the RA and fibromyalgia can make you very tired and that's probably the worst that I have right at this point.

[bluetit33]

hello lizziebrush, on reading your comments and the replies, on folic acid, it is amazing me how many different aspects there are to taking this. I myself was told to take folic acid (10mg) two days before my mtx. I will take this up with my rheumy in July, see what the comments are. Also happy easter to all. bluetit33

[julie_warwick]

people seem to be given different advice re. folic acid , I used to take 1 the day after mtx but this was increased to one daily except mtx day when I got a sore mouth and nausea to help with side effects , go with whatever your rheumatologist says.

[norfolkjo]

I was told 1 5mg tab three days after metho . Reason start low increase only if needed for sickness as more folic reduces effective ness of metho hence not taking on metho day

Im ok on one but have options to up if sickness gets worse

[chelleD]

Evrybody is different and your dose is calculated by your rheumy for u. I started with 1 a day after mtx but suffered with mouth ulsers so RHeumy increased to every day but mtx day. Trust your rheumy and pay attention to what's happening to you and your right dose will be found. Don't woRry too much about what someone else is taking like I said we are all different

[Hidden]

Like helix said, they usually start you on once a week and will increase it if you have side effects from MTX. You should not take folic acid on the same day at it inhibits the effectiveness of MTX. I'd be raising my eyebrows at a rheum who does not know that!