How to combat severe bloating with MTX and Folic Acid

[DenMum]

I am taking 15mg MTX once per week and 15mg Folic acid the next day. Have been on this dosage since just before Christmas. Bloating is getting worse and seems to be worse from Folic acid than from MTX. I mentioned it to my Rheumy last week but he made no comment. Any suggestions about how to ease this.

[Ali_H]

Are you supposed to be taking your folic acid in one go? I am on 15mg of MTX and take 5mg of folic acid twice a week, 3 and 5 days after my MTX.

Ali

[DenMum in reply to Ali_H]

Those are definitely the instructions but reading the chats here it seems there is huge variety in how others take it so i think i will try spreading the folic acid over a few days. its difficult getting quick answer from medical staff in the current crisis

[Ali_H in reply to DenMum]

Do you have original letter from rheumy explaining treatment to Drs because that may differ to prescription being drawn up.... lost in translation somewhere??

Too much folic acid at once can cause bloating so spreading it over 3 days might help, remember to let your rheumy/go know what you are doing and why.

Ali

[DenMum in reply to Ali_H]

Thanks Ali. It was prescribed like that by my rheumy. I will send him and the go an email.

[springcross]

I take 5 mg FA every day (six days) except on MTX day.

Side effects of FA are flushing;

nausea, loss of appetite;

bloating, gas; bitter or unpleasant taste in your mouth;

sleep problems;

depression; or feeling excited or irritable.

How should I take folic acid?

Take folic acid exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Info taken from Drugs.com link below

drugs.com/folic_acid.html

Hope this helps.

[Boxerlady in reply to springcross]

I'm another one who takes 5mg for 6 days a week - sounds like you're taking a big dose on one day.....

[springcross in reply to Boxerlady]

Hi. I'm not taking a big dose on one day. I take 5 mg six days a week on the days I don't have MTX.

[Boxerlady in reply to springcross]

Sorry - no - I was replying to DenMum 😊

[springcross in reply to Boxerlady]

Oh, OK 👍

[AgedCrone]

Drink more water & check your FA dose!

[Kerrychelsea]

Hi, my dosage is exactly the same as you. I am only 4 week in but coming to think about it, yes to bloating. I am going to try ginger/peppermint tea. All the best x

[AgedCrone in reply to Kerrychelsea]

Are you really taking 15 mg of folic acid in one day? The usual dose in the United Kingdom is 5 mg per day , in the US it is often only 1 mg per day I suggest you really do check that you’re not supposed to be only taking 15 mg a week i.e. 5 mg on three days?

[nomoreheels]

Hiya DenMum, welcome. It does sound as though it's the folic acid causing the bloating. I've been on MTX for 11 years & though folic acid doses have changed (days taken) I’ve never been instructed to take more than 5mg in one day. Currently I inject 17.5mg MTX & 5mg folic acid every day except MTX day.

Please check with your Rheumy, or Nurse, explaining the reason you're questioning them, I do wonder if it didn’t occur to him that you may be taking the dose in one day. The thing is it's prescribed off-license for the prevention of MTX side effects so Rheumy's do differ in their prescribing of it though usually not such a high dose on one day only.

I hope you solve the issue & find it helpful being here.