Question
I take 12.5mg of methotrexate per week for rheumatoid arthritis. I also take 1mg of folic acid every day except on the day I take the methotrexate and the day after. In the fall I also take a multi vitiman which contains 0.4mg of folic acid. Is that to much folic acid to take and can it cause the methotrexate not to work as well? Should I also not take it on the day of the methotrexate and the day after?
Answer
Folic acid supplementation should not effect MTX. I do not ask patients to stop Folic acid on the days they take MTX, although some rheumatologists do. I frequently increase folic acid above 1 mg per day to reduce side effects such as mouth ulcers.
