Accidently taken folic acid on Methotrexate day? - NRAS

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Accidently taken folic acid on Methotrexate day?

Hi guys,

I've accidently taken folic acid this morning - can I still take my Methotrexate this evening? Thanks x

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Yes you can still take your mtx. The amount of folic and how often you take it is different from rheumy to rheumy, and in the USA patients usually take their folic EVERY day. However, try to stick to the advice of your rheumy, but the odd slip now and then won't do you any harm. XX

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Thank you, I never knew the reason behind it as I've not been in this situation before, but the fact you take it everyday of the week on the US makes me feel better xx

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It's easily done, in 10 years of taking MTX I've done it a few times. You've two options... if you're in the UK & taking 5mg you can either just take your MTX or take it tomorrow but return to your normal Sunday next week. The reason most UK Rheumys ask us not to take it the same day is because it's thought it can reduce the effectiveness of the MTX dose slightly if taken regularly on the same day. In the US folic acid is only prescribed in 1mg/day doses not 5mg so unlikely to have a relatively small reduced dose effect of the MTX taking them both together... though I do wonder how effective it is anyhow only taking 1mg a day (7mg/week) & if this if why leucovorin (folinic acid) is prescribed there sometimes (it's usually only prescribed to reduce MTX toxicity in higher doses in the UK).

So the choice is yours but you were correct to ask. Hope this helps.

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Brilliant, thanks for your informative advice, taking the 5mg into consideration I took it this morning instead and will go back to normal at the end of the week zx

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You're welcome. All will be fine I'm sure. Another similar situation... I've forgotten to inject my MTX before now & done it the next day then back to the normal day the following week.

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I use a week medical dispenser and calendar marked Metho love crossing it off !!

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My doctor (in the US) said I should take it everyday.

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Are you not on 1mg though Bonnie? If so take a peep at my reply to SarahJane.

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I just read your reply, nomoreheels. Yes. I am on 1MG. Why is your dose in the UK so much higher? Is your MTX dose higher as well?

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I really don't know why we in the UK are prescribed 5mg & in the US only 1mg, it can make a difference of 23mg a week if we take our country's recommended max dose. I was prescribed 5mg in Spain too, only twice weekly though but they follow ACR guidelines, or did at the time. If you notice Vmitch who is also in the US replied the same, although didn't confirm dose.Maybe it's something you could ask at your next appointment & I'll do the same, see if we get any joy from the professionals! I do know there are no actual guidelines as folic acid with MTX is prescribed off-license.

MTX doses don't differ... I currently inject 20mg but doses can go up to 25mg, even 30mg though comparatively rarely.

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Ok, nomoreheels, I will ask. She won’t be back til September. I had to start back on prednisone over the weekend which I didn’t want to do but the relief was so worth it. I’m so reluctant to go back on the MTX as I was do sick while on it. I honestly felt like I was poisoned and dying. I don’t want to go back to that. I have to decide on something. I was thinking of another doctor’s opinion but haven’t decided that yet. Be well.

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It won’t hurt you to take it the same day but they advise it is taken over the previous days so that it is in your system before taking the methotrexate.

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My consultant told me to take it mtx day, said t makes no difference, I've been doing it for several years now, I'm remission too.

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I do. Just take it several hours earlier or later in the day, just not together.

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I take both methotrexate weekly and folic acid daily per my Rheumatologist

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