anyone prescribed folic to take with sulfasalazine?

[GranAmie]

some of the lierature i have says to take folic daily when on SSZ but i have not been told this or given a scrip for it. maybe someone can answer b4 i bother 'them' yet again...

[Hidden]

You need folic acid for mtx. I never heard about taking it for sulfa. I've been on sulfa for over a year now with no problems.

[helixhelix]

I've been on sulpha 6 years and no-one has ever mentioned this. Yes I take folic acid for the MTX, but there's never been any reference to it being useful with sulpha too.....often the rheumy nurse has checked that " I'm taking folic to counter the side effects of MTX" not "MTX and Sulpha". You could always ask to have your folate levels tested to see if you need it.

[Hidden]

I've been on sulfadalazine for over a year now, with no side effects, you don't need to take folic acid with sulfadalazine, my reumy team have never said it needs to be taken with this. Hope this helps.

Lady B 😊

[Philip]

Me, I have been taking them together for about 3 years and had no problems, I also take methertroxate and the frolicking is to combat any trouble with the methertroxate.

Philip

[Moomin8 in reply to Philip]

Frolicking? ??😂

[dtech in reply to Moomin8]

Phillip does a lot of frolicking. And sometimes gambolling too. 😂

[Philip]

He he he, always make taking the pills funnier, lol

[Em13]

On the info strip attached to my bottle of SSZ, folic acid is one of the specific things you are told to report to your GP if taking SSZ. I'm not sure why.

My "Herb, Drug and Nutrient Interactions" book (available from Amazon from £106!), pg 187, says:

"Mechanism & Significance - SSZ and other sulphonamides interfere with absorption, bioavailability and activity of folic acid, most likely acting as competitive inhibitor and impairing activity of folate-dependant enzymes. Adverse effects of SSZ on folate are generally recognised. However, no evidence based consensus as to influence of various factors, including drug dosage, polymorphisms, nutritional deficiencies, and comorbid conditions. Tissue depletion and elevated Hcy more likely than frank deficiency with maintenance SSZ.

Management - Encourage diet rich in high-folate foods. Co-administer folic acid or 5-MTH. Monitor red blood cell/tissue folate and Hcy levels."

Then on pg 225 there are two whole pages on SSZ and folic acid - much of which could do with a medical interpreter! But it seems you are right to question the need for it.

Maybe blood tests are the safest way to go, Gran Amie, see if you need to supplement or not. I do take SSZ and also a Vitamin B complex containing folic acid myself. My Hb levels are just below the normal range, which can indicate anaemia, but other levels in the blood (MCV) indicate this isn't caused by a folate deficiency, but more likely by being a peri-menopausal vegetarian. But the higher the dose, or the longer you have been taking the SSZ, the more likely a folate deficiency seems to be. And I only started it last month.

Has anyone ever checked your homocysteine (Hcy) level?

[GranAmie]

thanks Em you're a star!. i only started it weds night and will double up next wedsnesday. so far no probs and they want to see me again in 5 weeks for bloods etc so will check it out. luxuriating in the relief from pain thru the steroid jab ... and new lever taps to help these old wrists. njoy yr weekend... soon be half term xx

[Em13 in reply to GranAmie]

It is already half-term in this part of the country! The consultant said I needed fortnightly blood tests for the first few weeks. I am now on monthly tests. How many tabs are you going up to? I'm on 4 a day now. Still a few weeks away from finding out whether they work or not.