How long after your mtx do you take your folic acid?

My pharmacist advised me to leave 4 days so I take my mtx on a friday and folic acid the following Tuesday. The thing is I feel very lethargic and run down by the Monday.

[maxb]

When i was on mtx i was told by my consultant to take it the day after my mtx dose...dont know if its different for others though, id check with your rheumy but they should have told you xx

[Bastidon]

Both my GP and Pharmacist recomended 48 hours. Seems to work OK.

[Hidden]

Hi Paula

I take MTX on Saturday and Folic on Tuesday.

Mary

[Hidden]

Wow, 4 people and each advised to do different things. Not a lot of continuity on this it seems! Thanks for answering this. I think I'll knock it back to 48hrs after the mtx and check this with the rheumy nurse. Thanks all

Paula x

[Beth58]

Hi

The general guidelines are to take Folic 3 days after MTX however, if someone is experiencing severe symptoms some Rheumy nurses advise patients to take it more regularly i.e. every day in some cases.

Beth xx

[Hidden]

Thanks Beth, so based on that I should take the folic acid on Mondays. That is the day I appear to be feeling rough so I'll give it a go. If it makes no difference I'll talk to the nurse. x

[Judi]

Hi, when I started Mtx years ago I was told to take the folic acid Monday and Wednesday nights and then the Mtx on a Friday night. (Another variation). I still stick to this - it is strange though that we are all given different advice from our rheumy teams.

Judi

[megant]

Hi, I was told by my rheumy that I could take the folic acid up to 6 days a week but NOT on the same day at teh MTX !! another variation but as I keep being told "everybdy is different" so go with whatever suits you best.

Alison

x

[elsa123]

Hi, I take 5mg folic acid 6 days a week, not on mtx days.

Strange how different consultants have their favoured way of doing things.

Nic

[Hidden]

I was told to take it 3 days after the MTX. But I now take it for 5 days a week - not on MTX day (Tuesdays for me) or the next day but every day apart from that. My GP, who prescribes it, says he doesn't really see how the extra four would help with side effects but is happy to let me take more if I think it helps (it can't harm!).

I have lethargy for 2 days after MTX but seem to have got over the depression that afflicted me every Thursday and Friday now. I think this is either because my body has acclimatised to the MTX, or because I'm also taking Hydroxy now and things are starting to feel so much better now, six months since diagnosis. Only my ankle and toes are still sore and apart from that I do believe the MTX mixed with Hydroxy is making a very big difference and my ESR was down to 30 this week. So that might be why the depression has lifted - as rheumy said he believes it goes with the disease activity and flare-ups.

So hang in there and don't worry too much about when you take the FA apart from avoiding MTX day Paula - things will get better for you too I'm sure of it. TTx

[Hidden]

My hospital favours either the day before and the day after the methotrexate or every day except the methotrexate day there has been a poll on this conducted by NRAS with a wide variation on the advice given

[wendywoo]

Reading these replies, it definitely varies as to the quantity of folic acid each individual takes. I only take 10mg of MXT each week, on a Monday, and I have only been told to take one folic tablet at least 24hrs, if not more, after the Monday. Many of you are taking folic acid every day, it must be because you are on a higher dose of MTX. Like Tilda, I too take Hyroxy also, one tablet every day. So, no hard or fast rules, so it seems.....

[Hidden]

Hi Paulywoo

This does seem to be something that varies widely, which can be seen in the poll conducted a few months ago: nras.healthunlocked.com/pol...

Different rheumatology units may have different recommendations so it is worth discussing this with your rheumatology team if you are concerned about your folic acid dose.

Kind regards

Sarah Kate

NRAS Helpline

[Hidden]

Thanks all, this thread has really shown that there are no hard and fast rules. Definately something to discuss with the rheumy nurse at my next appointment.

Paula x

[helixhelix]

Nope, no hard rules for this one. Another example of how RA is different in different people. But there is an interaction between folic acid & MTX that goes both ways. So the MTX knocks it out of you - which is why you need to top up. But also the folic acid does inhibit action of MTX which is why you don't take it on MTX day and most people start just with one a week. So I try to only take what I need to stop side effects. But speak to doc about what's best for you. Polly

[Lillibet]

3 days after MTX injection for me!

[LuckysJoy]

I was told both by my GP and Pharmasist to take the following day

[LuckysJoy]

sorry bad spelling

[saxylady2766]

I take my MTX injection on Friday, and told to take Folic on Sat and Sun x

[Jesnaskah]

I'm in the U.S. and will begin my methotrexate today 10mg/week, and was also prescribed folic acid to take every day. But my folic acid is only 1 mg.

So maybe the mg plays a role in how often or when you can take it. I am assuming that because mine is such a low dose (1 mg compared to the 5 mg I've been reading about here), taking it everyday, including the same day as MTX won't have a really big affect on the MTX.

I am super nervous to start this tonight. I hope the side affects will not be too intense for me!! Wishing you all well!! We are in this together <3

[Hidden in reply to Jesnaskah]

I'm in the US too just started on Methotrexate 10 mg and was told to take 1mg of folic acid every day, the same day of methotrexate. It must be the low dosage... tonight is my second round, the first wasn't to bad. I wish all the best.

Fergie

[Jesnaskah in reply to Hidden]

Hi Fergie,

I wish you all the best with MTX... And if you find that Folic acid (synthetic) isn't really helping, you can switch to folate (which is natural). Let me know how you are getting along. I lost tons of hair immediately... So I stopped it all after 2 months. But I hope that your journey will be much different!

[Hidden]

I take Folate everyday, along with all my other vitamins. I take a lot of B vitamins and I find it helps with my hair and skin. I take it in the morning. And the Methotrexate in the evening

I found the tiredness comes on because it lowers your blood pressure. So on the night I take it I skip my blood pressure pill. That really helped that dragging feeling. I do have digestive upset with it, not that day but like the 3rd day in, its bathroom time.