Overwhelmed and would love suggestions: Hi. Was... - NRAS


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Overwhelmed and would love suggestions

Hynesgirl profile image

Hi. Was diagnosed in march of this year with rheumatoid arthritis. Finally got to see rheumatologist in june and began methotrexate 15 mg wkly and folic acid. I was them bumped up to 17.5 mg wkly. I know this seems odd but my hands, fingers, shoulders were improved but my lower back, hips, and toes were not so he added humira and did my first injection last wk. Does anyone have advice on best way to take the methotrexate and humira? And also...the folic acid is confusing too. I was not told to not take my folic acid on the day of methotrexate and now im seeing i shouldnt..any suggestions would be so appreciated. Thanks

7 Replies

Hi. In terms of methotrexate, I was advised to take my folic acid on a Friday, and methotrexate on a Monday, and that's always worked for me! It's good from a mnemonic point of view, at least. I may be adding humira/adalimumab to the mix in the next month or two.

Sorry you've joined our little club, but this forum is a great place for support!

The general rule with folic acid is not to take it on the same day as you take your methotrexate. Apart from that, depending on what dose of folic acid you're taking, the other doses can be taken at intervals over the remaining 6 days ie. some people take it every day except mtx day, others may take it just once a week and some of us (including me) who are on 3 tablets a week take it every other day.

As I understand (and I did question my rheumy on this quite extensively) the *only* reason for not taking folic acid on mtx day is because it may reduce the effect of the mtx so it's not actually dangerous as such, and if you do make a mistake, it's really not the end of the world but obviously best avoided if you can as it rather defeats the object ;-)

Unfortunately I can't comment on the humira as I was only diagnosed in January and biologics certainly haven't even been mentioned yet, although thankfully I'm already doing quite well on mtx and hydroxy.

Hope this is at least some help and if you've only just joined here, hopefully if you stick around you'll find the wonderful support from this forum will soon have you feeling at least a little less overwhelmed. x

Hello and welcome Hynesgirl. I hope you find the group useful. I’m not sure what you mean by the best way to take them? How much folic acid are you prescribed? Are you in the UK? What does it say on the packet of tablets ? You’ve been moved onto humira very quickly, mtx can take at least 3 months to start to work and you’re not on the highest dose either. Sorry about all the questions 😊

Hi Hynesgirl, sorry you have joined the involuntary club!, I have been advised to take the folic acid the day after your methotrexate to be most affective. You may feel your on a heavy dose it takes time to work but as you feel better your Rheumy will probably slowly reduce it to a lower dose, once your inflammation is reduced & under control. It’s all trial & error as like you will see we are all different. I’m with Smelliot methotrexate Monday & folic Friday Works for me. All the very best I haven’t taken humira so cant really comment, I was on cimzia for 5 yrs after the loading dose it was one syringe every 2 weeks...

Wish you all the best for a affective treatment plan that works well for you.

Regarding folic acid, do as your rheumatologist told you. I was told to take it 3 days after MTX. There are many different regimes in operation. If you don't do well with what your consultant has advised, then let her/him know and possibly they will change it, but I don't think it's a good idea to change things yourself without consultation.

If in any doubt about taking medication it's best to ask your Rheumatologist, Specialist Nurse or GP. All the best.

Hi, I have been taking MTX (tablets) for around 17 years & added in Humira injections about 5 years ago. My drug regime is MTX 17.5mg weekly on a Tuesday & I take folic acid every day EXCEPT Tuesday. I started with just 4 days Folic acid but was advised to increase the dose to combat nausea. I also take hydroxychloroquine daily & inject my Humira on a Thursday fortnightly. This works for me, my problem now is that it took so long to get Humira, that damage was already done to the joints & I have problems with osteoarthritis. Hopefully you won't have this problem as you have been started so quickly on medication. If you have any doubts about how to take your meds, contact your rheumy nurse. Good Luck!

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