Methotrexate and Folic Acid??

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Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 3/2/2010 3:46 PM (GMT -6)   
Just read a reply saying that they take double the dose of folic acid on the day of their injection. Others have said they don't take folic acid on the day of the injection and my GI just told me last visit that I didn't need to take it on that day. Never asked the reasoning behind that or why some think they shoud take twice as much??
57 yr. old F dx. CD 07/07
Was on prednisone for three months but no medication for next 11 months.
Started weekly methotrexate injections 09/22/08.
Lap assisted sigmoidoscopy done May 11/2009


MMMNAVY
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Date Joined Jul 2006
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   Posted 3/2/2010 3:53 PM (GMT -6)   
Bammer my folic acid intake increased as the years went by on MTX. I orginally started out on 1 mg, but switched to injections of folic acid and it went up over time.
I have no idea why your GI would say not to take it that day.
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

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sr5599
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Date Joined Aug 2007
Total Posts : 1202
   Posted 3/2/2010 4:01 PM (GMT -6)   
I take 1mg daily...
1 fistula, crohn's colitis, limited to large intestine
Compounded budesonide 3mg/daily, Cimzia, MTX . Dx Osteoporosis 10/08 started Forteo 1/27/09


lilcrohnieUK
Regular Member


Date Joined Dec 2007
Total Posts : 414
   Posted 3/2/2010 4:25 PM (GMT -6)   
I was always told not to take folic acid the same day as the methotrexate and it says the same on the methotrexate info sheet I got given. That was years ago though and no idea what the reason is though!
 
 


debilitated
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Date Joined Jan 2010
Total Posts : 448
   Posted 3/2/2010 5:33 PM (GMT -6)   
Methotrexate works better if u dont take the folic acid the same day. It gives it the Humph! it needs to work if u dont. My doctor said take it 6 days a week. :D

sr5599
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Date Joined Aug 2007
Total Posts : 1202
   Posted 3/2/2010 6:41 PM (GMT -6)   
Interesting! Thanks for the info...
1 fistula, crohn's colitis, limited to large intestine
Compounded budesonide 3mg/daily, Cimzia, MTX . Dx Osteoporosis 10/08 started Forteo 1/27/09


Rider Fan
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Date Joined May 2008
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   Posted 3/2/2010 7:15 PM (GMT -6)   
During the 6 months that I was on MTX I did a fair bit of research on this. The concern is that taking too much folic acid can - in theory - deplete the effectiveness of MTX because of the way the MTX works in your body. So we need the folic acid to counter some of the MTX side-effects, but too much can reduce the efficacy of the treatment (again in theory).

So the reason your GI told you to not take it on the day of the injection is to safeguard against the folic acid disrupting the action of the MTX. I've also heard of some people taking 5mg of folic acid once a week. Some people take 3mg a day (I believe I read one study saying 3mg does not effect the efficacy and another study saying that it does.)

When I took MTX I followed my GI's instructions, which were 1mg a day including injection day.

How confusing!

If you have a chance ask your GI on his/her opinion.
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Tried SCD, didn't work, now avoiding gluten and dairy.


Go Saskatchewan Roughriders!


MMMNAVY
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Date Joined Jul 2006
Total Posts : 6923
   Posted 3/2/2010 8:58 PM (GMT -6)   
Folic acid is something that needs to be tirated by your doc. I have weekly bloodwork done in part because of this.
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 3/2/2010 9:56 PM (GMT -6)   

Thanks and interesting info. Supposed to see my GI next month so will definately ask. In theory if this is correct, taking double the dose would be counterproductive so that is one reason I asked so others can check it out as well.

MMMNAVY what are the markers in bloodwork as far as folic acid is concerned?

I started out with 5mg a day and went down to 2 mg but my metho also went down from 25gm to 15mg.


57 yr. old F dx. CD 07/07
Was on prednisone for three months but no medication for next 11 months.
Started weekly methotrexate injections 09/22/08.
Lap assisted sigmoidoscopy done May 11/2009


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6923
   Posted 3/2/2010 10:11 PM (GMT -6)   
I have my folate (and other things checked) and get a new dosage according to that.


Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…

Post Edited (MMMNAVY) : 3/2/2010 9:14:11 PM (GMT-7)


lilcrohnieUK
Regular Member


Date Joined Dec 2007
Total Posts : 414
   Posted 3/3/2010 7:00 AM (GMT -6)   
I was actually first prescribed 20mg of folic acid to take once a week (was told it had to be similar to the methotrexate dose) I ended up not taking it for years as I'd feel horrible after taking it, but looking at the amounts you lot are all taking I'm guessing 20mg is too much in one go?? No wonder I felt ill lol I now just take a supplement every day which has added folic acid (except on the days I do my methotrexate) was anyone else prescribed that much?
 
 


karasmommy
Veteran Member


Date Joined Mar 2005
Total Posts : 589
   Posted 3/3/2010 10:56 AM (GMT -6)   
That is me who takes the higher dosage of Folic Acid on the day I inject - the double dosage is prescribed by my Rheumatologist to prevent the side effects that I was getting - my GI was the one that prescribed the MTX, but the Rheumy prescribed the Folic Acid as she deals with more people that take MTX for RA, Lupus, on a daily basis.

My Rheumy told me that the Folic Acid dosage that I am taking doesn't deplete or counteract the MTX if taken the same day. For me it was either the double dosage of Folic Acid that day (taken in the AM - shot in the PM) or else I had to take the form of "Rescue Folinic Acid" (Levoleucovorin) within 12-24 hours of taking my MTX - my insurance won't pay for the Folic Acid or even the "Rescue Folinic Acid", so the compramise was to take my 1.5 mg daily and 3mg day of injection.

I really think that it is different for each person in what their Dr. believes in prescribing for that patient and the conditions in which they are taking the medicine for (in my case both Lupus and Crohn's). I am also borderline anemic most of the time, which can come into being folic deficient so that may equal the higher dosage for me. My levels of folic acid are also checked bi-monthly with my liver and everything is just where it should be according to both my Rheumy & GI Dr.

I have been on MTX almost a year and it is definitely working for both my Lupus and Crohn's - for the first time in years I will be considered in "Remission" - so I don't think that the higher dosage of Folic Acid is making my MTX not work at all.

Just my thoughts smilewinkgrin
Ellen
Diagnosed with Lupus - April 2002
Diagnosed with Crohn's Disease (and all the lovely things that come with it) - January 2003 (problems since early 1990)
Fibromyalgia 2005 
Normal Meds:  Ambian 10mg, Flexeril 10mg as needed, Plaquenil 400mg, MTX 25mg Injection weekly, 1000mg Canasa Supp. as needed, Probiotics

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