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Methotrexate and Folic Acid Dose
- Thread starter Crohn2357
- Start date
No, folate supplementation does not reduce efficacy. I'ts highly recommended, in fact.
But I believe you are taking too much. From what I heard, you want to stay around 1mg. Personally, I take a dedicated folic acid supp, 800 mcg, and then there is 400mcg included in my multivitamin - so 1.2 mg total.
But I believe you are taking too much. From what I heard, you want to stay around 1mg. Personally, I take a dedicated folic acid supp, 800 mcg, and then there is 400mcg included in my multivitamin - so 1.2 mg total.
I used to take 10mg folic acid whilst on methotrexate because if I dropped any lower I would suffer with horrible sickness caused by the methotrexate.
nogutsnoglory
Moderator
Is that 10mg weekly or daily? It seems high though, I'm on 1mg daily.
Sorry didn't put it was 10mg weekly
PsychoJane
Moderator
There does not seem to be a concensus on which acid folic dosage someone taking methotrexate should take. Daily dosage will generally be someone between 1-3mg 6 days a week (skipping the day of the injection/pill). 10 mg is a bit higher that what I generally saw being mentionned but for medical condition 10 mg is still an acceptable dosage.
I'm not familiar enough with the pharmacokinetic of that product to suggest if the daily versus weekly dosage is best though.
I'm not familiar enough with the pharmacokinetic of that product to suggest if the daily versus weekly dosage is best though.
nogutsnoglory
Moderator
I don't skip on the day of my injection. I'm taking the Folic acid daily.
PsychoJane
Moderator
Was it your specialist that suggested you to take it even on the day of methotrexate?
As far as I know, taking it on that day will lessen the efficiency of methotrexate because it competes for the reductase of the same enzyme... Now... is 1mg a big deal? That I don't know and I can't find a publication that specifically adresses this. I only found some regarding 5mg where they advise to take it 6days/week. All I know is that my GI and Rheumy had both advised me to skip on the injection day and I was on 1mg as well.
As far as I know, taking it on that day will lessen the efficiency of methotrexate because it competes for the reductase of the same enzyme... Now... is 1mg a big deal? That I don't know and I can't find a publication that specifically adresses this. I only found some regarding 5mg where they advise to take it 6days/week. All I know is that my GI and Rheumy had both advised me to skip on the injection day and I was on 1mg as well.
nogutsnoglory
Moderator
Yes my dr just said take it daily. I can clarify next time.
nogutsnoglory
Moderator
It's possible in my case he doesn't care so much about the efficacy because he sees it as mainly a tool for preventing antibodies to Remicade.
When I was on MTX previously & I was taking 10mg of folic acid per week, 3 days before my shot. I still had side effects but they weren't too crazy.
I was then in remission for a year or so until around Feb last year and tried to deal with it without meds up until October last year when I was put back on it. I was given a new GI and this particular GI didn't believe in prescribing folic acid with MTX due to indications that it may promote polyp growth in the intestines. I tried it without the folic acid for 3 months and had terrible side effects - nausea and fatigue to the point where I couldn't even leave bed on some days. It got so bad that I actually stopped taking my shots for a few weeks because I was sick of feeling so horrible.
Only a few weeks ago, my GP decided that it's better off me taking folic acid and having my MTX shots rather than being on nothing at all so I'm back to taking both. I haven't noticed any major side effects yet so I'm feeling more hopeful.
I'm actually looking to see a new GI and talk to them about changing meds to something less intense - maybe azathioprine - and see how I go.
Best of luck!
I was then in remission for a year or so until around Feb last year and tried to deal with it without meds up until October last year when I was put back on it. I was given a new GI and this particular GI didn't believe in prescribing folic acid with MTX due to indications that it may promote polyp growth in the intestines. I tried it without the folic acid for 3 months and had terrible side effects - nausea and fatigue to the point where I couldn't even leave bed on some days. It got so bad that I actually stopped taking my shots for a few weeks because I was sick of feeling so horrible.
Only a few weeks ago, my GP decided that it's better off me taking folic acid and having my MTX shots rather than being on nothing at all so I'm back to taking both. I haven't noticed any major side effects yet so I'm feeling more hopeful.
I'm actually looking to see a new GI and talk to them about changing meds to something less intense - maybe azathioprine - and see how I go.
Best of luck!
- Location
- Circle Pines Minnesota
I was on 1mg everyday!