Oops took my Folic Acid on same day as Methotrexate οΏ½... - NRAS

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Oops took my Folic Acid on same day as Methotrexate 😬 Is it a big deal?

Hessie5 profile image
Hessie5
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I foolishly tool my folic acid tab and just realised it's the day I take my mtx... Does anyone know if it's okay to still take mtx ? I am going to all my Rheumo but I know he won't call back until later on in the week - hence I am reaching out to the team here ... Any advice greatly appreciated :-)

Hessie x

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Hessie5
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oldtimer profile image
oldtimer

Generally, it's OK to take your methotrexate, but it will make it less effective. The other alternative is to postpone your methotrexate to tomorrow if that's convenient to do and not take your folic acid tomorrow.

Hessie5 profile image
Hessie5 in reply to oldtimer

I think that is a good call! Thank you so much for swift reply too.

Hessie5 profile image
Hessie5 in reply to oldtimer

Thanks for the advice. I am going to delay taking, just waiting for a call from the Rheumo - fingers crossed they get back today!

Beverley-NRAS profile image
Beverley-NRAS

Hi Hessie5,

No need to panic. The safest thing to do is to wait until your rheumatology team get back to you. People are not allowed to give direct medical advice on this forum but they can share their own experiences with you and hopefully what they tell you will put your mind at rest.

Regards

Beverley (NRAS Helpline)

Hessie5 profile image
Hessie5 in reply to Beverley-NRAS

Thank you Beverley - I have contacted the Rheumo team and hopefully they will get back to me. Just thought I would reach out in case anyone else did the same !

Gigi71 profile image
Gigi71

I have done this a couple of times, so now move my folic acid away from my meds the day before, I 'm sure we aren't the only ones. All the best X

Hessie5 profile image
Hessie5 in reply to Gigi71

Definitively going to do this Gigi. I was just too hasty - only grateful I didn't take the mtx. Appreciate your feedback!

Gigi71 profile image
Gigi71 in reply to Hessie5

Yes same here go on automatic pilot and down all my meds without thinking. X

woodsedgesue profile image
woodsedgesue in reply to Gigi71

Were you ok though?

Gigi71 profile image
Gigi71 in reply to woodsedgesue

No problem whatsoever x

Matilda_1922 profile image
Matilda_1922

From what was said to me last week by a Rhuematology doctor there is no research for taking Folic acid on MXT day and suggested that I start taking it to help with side effects. Apparently in USA they advise every day.

Hessie5 profile image
Hessie5 in reply to Matilda_1922

Interesting how it's different stateside - even the amount of mtx prescribred here is less than the there my Rheumo told me. Thanks for your advice.

Hessie5 profile image
Hessie5 in reply to Hessie5

Excuse my spelling - typing too fast ! PRESCRIBED - lol

in reply to Hessie5

Oh wow. How much mtx does the UK prescribe? In Canada/US they don't prescribe more than 25 mg of mtx

nomoreheels profile image
nomoreheels in reply to

According to the Royal National Hospital for Rheumatic Diseases the maximum licensed dose is 25mg Sue. Rarely, the maximum dose can be 30mg.

Hessie5 profile image
Hessie5 in reply to

My Rheumy said it's up to 30 I recall in the States - higher dosage and we are lower in the UK.

in reply to

Yeah - 25 is the max here (in the US) too (at least to my knowledge), and my rheumy wouldn't go over 20 because she said she "didn't like what it did" to patients. No more explanation than that though..

in reply to

Yes, all three of my rheumies said they only prescribe 25mg of mtx on extreme cases.

in reply to Matilda_1922

Hi Matilda - That is true - My rheumy had me taking it every day, and when I saw the advice on here to go one off to the shot day I remember asking her about it. She said it was not an issue and to take it every day (the Folic)..

Don't worry. I take folic acid 7 days a week. Yes even on mtx day. In Canada, the medical profession is still debating whether to take it 6 days a week or 7. Also they debate 1mg folic acid or 5 mg folic acid a day.

Everyone should follow the advice of their doctor

Hessie5 profile image
Hessie5

I was told never to take on same day - it's interesting how our cases all vary. Indeed the sensible route is to speak with the Rheumo team. Still waiting there call! Thank you for your feedback - much appreciated.

helixhelix profile image
helixhelix

Well taking folic acid is pretty much the same as munching through a large basket full of parsley and spinach, and nobody tells you not to do that on MTX day!

Hessie5 profile image
Hessie5 in reply to helixhelix

Hi Helix - hmmm that's a great point. Another question to raise with my Rheumy as I eat so much Spinach :-)

glenb profile image
glenb

Well I take MTX on Monday evening before bed but take my folic acid in the mornings. So I won't take on a Monday because MTX day and not Tuesday morning because I just had MTX 8 hours before. My Rheumy said it's for sickness and can take it once a week if I don't feel sick. I eat a bag of spinach and kale every morning in a smoothie as well.

Hessie5 profile image
Hessie5 in reply to glenb

Thanks GlenB - I have to take folic everyday except my mtx days. Love Spinach not so fond of the Kale - a smoothie sounds like a good call though, may be more palatable ...

in reply to Hessie5

Oh Hessie5 , you are missing an awesome healthy treat. You have to try kale this way

Remove the kale stem, place on baking sheet and sprinkle a little cheddar & mozza cheese, bake and remove when cheese melted....Oh my God....heaven yum

Hessie5 profile image
Hessie5 in reply to

Ohhh that sounds delicious - I shall give that a try over the weekend thanks Suzanne!

glenb profile image
glenb in reply to

Sounds amazing, so miss cheese! 😒

in reply to glenb

Oh it is amazing. The kale turns into a delicate crispy chip and oh the cheese,,,what can I say? Yummy :)

glenb profile image
glenb in reply to

Shhh!!!! You're being mean

glenb profile image
glenb in reply to Hessie5

300ml orange juice plus 100g of spinach and 100g of kale. The kale I freeze and add a little ginger. Really good for you and your stomach. Enjoy

Hessie5 profile image
Hessie5 in reply to glenb

That's my breakfast sorted. Thanks for sharing Glen.

Hessie5 profile image
Hessie5

Update - My Rheumy's secretary came back to me today and I was told not to take my mtx - take it tomorrow instead. Huge thanks to you all for your invaluable replies. Have a super week, looks like we're in for some glorious weather 🌀 😊x

Eiram50 profile image
Eiram50

It can be a bit confusing - or at least I can get confused by it!

I am meant to take it every day except for the day I take methotrexate. However, I'm taking my methotrexate on a Tuesday night which means I don't take it on the Tuesday - but then I don't take it on the Wednesday as it's the same 24 hour period ( after Mtx), if you see what I mean? So essentially , it works out that I'm only taking the folic acid 5 days a week, instead of 6 as prescribed.

Confused!

glenb profile image
glenb in reply to Eiram50

Exactly what I do. Sleep off any ill effects of MTX. 5 days a week seems ok for me with folic acid. My Rheumy said there is no ill effects of having folic once a week and I. Ever took it for first couple of years which was wrong but on track now

Bookworm55 profile image
Bookworm55

I did read somewhere that 12 hours was a big enough gap between mtx and folic acid doses - but don't follow that. If I take mtx in the evening on Tuesdays I take the folic acid on Monday morning and Wednesday evening so as far away as possible from mtx while still taking every day. I do have one of those weekly pill containers to help!

Hessie5 profile image
Hessie5 in reply to Bookworm55

Thanks Bookworm. The container is a good idea.

Gigi71 profile image
Gigi71

I take my mtx on Thursday eve, so miss folic acid Thursday morning, but take it Friday morning, checked with my Reumy yesterday and she agreed was correct. X

ThePainPrincess profile image
ThePainPrincess

My doctor did not tell me not to take Folic Acid on MTX day. I asked my pharmacist and she said it was fine to take it together. I will ask my doctor. I have to say that I have been taking 10mg once a week for 6 weeks and have not seen any improvement. I hope all is well for you. Thanks, Penny

Artsymom69 profile image
Artsymom69

My rheum told me to take it every day twice a day. So that is what I have always done.. so each place and dr may be different. Maybe each body too?..

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