Oops folic acid on methotrexate day...: I inject... - NRAS

NRAS
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Oops folic acid on methotrexate day...

I inject methotrexate on a Wednesday evening and don’t want to change my day because of my working days... BUT, I accidentally took my folic acid dose this morning... which of course I don’t normally take on methotrexate day.... should I inject anyway, or miss the dose altogether? Not too sure what the impact is.... no use phoning advise line as 1. It would be in the morning and 2. They are short staffed and not responding to queries and ansaphone refers you back to GP. Thoughts please?

10 Replies
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It should be ok to take MTX as usual, in the the UK we tend not to take folic acid on MTX day , but in the US they do. Of course I am not a Dr, but it isn't a problem.

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I often forgot & took the FA on the same day as Mtx..just thought....Oops ..didn’t dawn on me to skip the Mtx!

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I'm in the U.S., and as the others have said the standard here is to take folic acid every day. So you'll be fine.

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One reason they may take folic acid on MTX day is it's only a 1mg dose so wouldn't affect the efficacy by much at all. I do wonder though how much use such a low dose is in helping side effects & if it's why leucovorin (folinic acid) is prescribed in the US, less so in the UK? Not sure if 5mg doses of FA are available there.

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I have taken folic acid on the day I take MXT (there's usually about 12 hours in between as I inject in the evening). As Mmrr says, they do this in the US anyway and I haven't had any ill effects so I think you'll be ok.

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My consultant told me to take it on the same day, said it made no difference. Been doing it for several years now and I'm fine. xx

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Done it myself, my experts say that it does no harm just maybe lessens the effect of the mtx, but once should be no problem

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You've probably decided what's best for you by now but just to add my experience... I've been on MTX 10 years so in that time not surprisingly have done this myself, no ill effects so I wouldn't worry about not injecting the same day. If you're bothered though you could for once inject tomorrow, not take your folic acid & then inject again as normal on Wednesday next week, done this if I've had to miss injecting on Wednesday (my day too, mornings though). You'll be fine either way.

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Yes thank you, I took it.... from what I read the only effect might be to reduce the effective of the methotrexate... and I figured that must be better than not taking the methotrexate at all.

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Good, that's what I've done before. You're correct, it can reduce the effect of MTX but it's minimal when compared to your dose, still best not to do it if our Rheumy's request we don't! By the way I said you could inject tomorrow, I of course should have said the following day (which would have been Thursday), I was late replying to your post.

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