Guest guest Posted July 20, 1999 Report Share Posted July 20, 1999 Hi Kim, I too was never told to " Not " take my folic acid. I have been on MTX over 10 years and have taken 1 g of Folic acid 7 days a week the whole time. So far my blood test have all been normal. I only take blood tests once every 3 or 4 months. Joanne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 1999 Report Share Posted July 20, 1999 --- barnabyq@... wrote: > I have seen in several posts recently that those of > you who take mtx and folic acid skip your folic acid > pill(s) on the day of your mtx dose. Is this > something your RD advised you to do, or is it > something you have taken upon yourself to do? Hi -- When my RD first put me on MTX she also put me on a B-Complex multi-vitamin. Folic acid is a component of the B complex of vitamins. At the time I assumed it was because I was (am) fat and told her I was going on a mostly vegetarian diet. Meat supplies b-complex vitamins, and I supposed she was being sensitive to my diet. At the time she did not say a thing about avoiding the vitamins on the day I took (orally, at the time) methotrexate. My B-Complex prescription ran out long ago and she never thought to renew it. Recently she put me on the injectible form of MTX and prescribed folic acid -- to be avoided on the day of injection. So my anecdotal experience would seem to indicate that folic acid on the day of inGEStion is not a problem, but folic acid on the day of inJECtion is. Still, this may only have been an oversight on the part of my rheumy -- who is good but not infallable -- and the only way you can know your rheumy's opinion is to ask him/her for it -- Good Luck! Feel Better! Keep in Touch! , NJ Highlands raharris@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 1999 Report Share Posted July 21, 1999 Dear Barnaby: My own physician at Columbia Presbyterian in NYC has told me that this is essential since the Folic Acid stops the action of the Methotrexate. If you take it on the day of your dose/shot you risk lessening the impact of your Metho. He adds that there is a window of hours that needs to be on either side of the dose (folic acid free) but rather than complicate life -- for instance six hours before/six hours after (he didn't actually share the exact number of hours with me), he said that most rheumatologist simply say don't take it on the same day -- easy! I must note that I have found that vast numbers of our group were never even told about this essential information. The only explanation I can think of is that their rheumatologist do not use Methotrexate frequently -- perhaps a small town rheumy who only uses it in rare cases. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 1999 Report Share Posted July 21, 1999 Dear Joanne, Skipping the folic acid one day a week is to increase the efficacy of the methotrexate dose you take. The dose of folic acid that people use is from 1 mg to 5 mg per day for six days a week. Some people find that mouth sores are persistent unless they stay at the higher dose. It is individual. What is not individual is that folic acid acts to reduce the efficacy of methotrexate in all of us. This is why the 24 hour window in folic acid use is recommended by most rheumatologists. I am sure glad that your bloodwork has all been normal. When I had abnormal liver function tests a few years ago, a two month hiatus from the Methotrexate was necessary, and I fell into quite a bad flare. With Enbrel available now, I wonder if it would become an option for those who have to stop Metho right away. Enbrel is not known to cause liver trouble, so if I were very concerned about a huge flare while off the Methotrexate I would personally beg to take Enbrel in the interim. Arava being in the same class as Methotrexate would not be a good choice, as it also taxes the liver. Good luck and best wishes to all, Quote Link to comment Share on other sites More sharing options...
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