Folic acid question: I know I’m not meant to take folic... - NRAS


31,561 members38,335 posts

Folic acid question

girli1969 profile image

I know I’m not meant to take folic acid same day as methotrexate, I take one tablet on each of the six following days. My question is, if I inject methotrexate on a Wednesday evening can I take the folic acid on Thursday morning, or should I wait until the evening (ie 24 hours). I know it’s meant to minimise side effects, only thing I get is a bit of a headache sometimes, thanks

7 Replies

As we've discovered here, it's only in the UK that we are told this. Our American and Canadian friends take folic acid daily. So I really don't think it will make a huge difference.

When I first started MTX I used to get a headache later on the next day, and taking a folic acid tablet as soon as the headache started made it vanish......

I'm on folic acid 6 days & inject MTX Wednesday morning. I take my folic acid Thursday morning with my other meds. It would make sense to me if you inject in an evening you'd take your folic acid in the evening on the Thursday. Or, if you take the rest of the week's folic acid in the morning you inject in the morning too or vice versa.

I've just been reading about something else relating to MTX girli & it happens to say that you should leave taking folic acid 24 hours after taking MTX otherwise it has a similar effect of taking it the same day, it reduces the amount of MTX your body ingests. So hope that clears it up.


I inject MTX on a Wed night and take folic acid 6 days a week.

I leave it 12 hours before taking my folic acid the next day. I'd like to leave it longer but can't handle the nausea.

Initially when I started taking MTX my Consultant told me to wait 3 days before I took 1 folic acid tablet (ie 1 for the whole week), he said that way it would maximise the bodies uptake of the MTX. But I am in the group like you that needs it 6 days a week to keep the nausea down to a minimum.

I solved my headache problem 100% by drinking 7 to 8 glasses of water on the day I take MTX. I drink throughout the day not all in the evening!

girli1969 profile image
girli1969 in reply to Joy_1

Thank you, I also do really well when fully hydrated on injection day! I must remember to always do that.

Joy_1 profile image
Joy_1 in reply to girli1969

I'm sure you will get into the habit in time.

It made a huge difference to me - pounding headache all day to no headache at all.

It is very common practice in Canada to take folic acid 7 days a week with mtx. Infact, I would take my 5mg of folic acid just before I injected mtx. (with the approval of my rheumy) . So, I think you need to follow the advice of your Health board. Just know that Health Canada & the FDA do not have such rules as the MTX & folic acid debate is left to the rheumatologists. There are many people in North America who are in clinical remission with folic acid 7 days aweek. Just like there are many people in the UK in clinial remission with folic acid 6 days aweek.

Again please follow the advice of your doctor.

take care


You may also like...