Folic Acid Again!

Posted , 7 users are following.

When I saw my GP for repeat prescription he was surprised my (London) consultant only prescribed 5mg folic acid once a week and said that in Devon the normal practice is six times a week. I questioned whether that was 5 mg or 1mg but he insisted it was 5 and the pharmacist concurred.

As I had terrible nausea, vomiting and painful indigestion this week on my 4th dose of mtx I rang the specialist nurse at Guys who told me to take the folic acid for three days before the next mtx dose.

So I'm still not clear why we are not all told to take folic acid 6 days a week. I presume you can't overdose on it because the body excretes excess?

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12 Replies

  • Posted

    Hi Dinah, the Folic acid helps with nausea and you should probably discuss it with your Consultant and then do as he says because you will find that everyone else has a view and generally a contradictory one!

    My Consultant told me to take the Folic acid at the same time as the MTX, after I had an adverse reaction to the MTX.  He told me to take it once a week but, when I had an infection, he told me to take it 6 days a week.  But, if I ever mentioned that he had told me to take MTX and folic acid together, nurses and Pharmacists told me he was wrong.

    I trust my Consultant, so do as he says and if I have problems, I discuss them with him.  Continuity of care etc..

     

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  • Posted

    Hi Dinah,

    Everybody seems to be given different information on this. I was on 1 x 5mg per week but suffer bad side effects. When I told my consultant this he upped it to 6 x per week. Every day except MTX. I can definitely say that has helped with mouth ulcers etc. it has to be prescribed folic acid though, not over the counter. For some reason they are different. I would certainly ask if you can up it 😊😊

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    • Posted

      What I don't understand is if high dose folic acid counteracts the mtx side effects why we aren't all just prescribed maximum dose. I guess maybe it is because it also makes the MTX slightly less effective - hence why you can't take them on the same day?
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    • Posted

      I have no idea!! Maybe some people need more than others. Some people sail through MTX whilst others get a delightful dose of every side effect going. I don't think there is one clear answer to this... Trial and error maybe? 😊😊
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  • Posted

    I inject methotrexate on Thurday and take 15mg folic acid on Saturday. I feel sick for a day or so after injecting but fine for the rest of the week. I was told never to take it on injection day. I also take Emeprazole twice a day which helps with indigestion. x

     

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  • Posted

    This just underlines the fact that we are all told different things and I think we should listen to our Consultants and do as they tell us.  They are the only doctors who can prescribe it.

    I assume everyone has read the following  https://patient.info/medicine/methotrexate-maxtrex-metoject

    https://patient.info/health/folic-acid-deficiency-anaemia

     

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  • Posted

    If your daily dose of folic acid is 1 mg then it can be taken daily..just not taken on the same day as the methotrexate. Methotrexate was poison to me, lowered my immune system, and did not help to which my RA specialist agreed. You need to do your own research and do what your body is telling you to do, as a doctor does not know how this drug will effect you personally. Only 30% respond to this medication.
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  • Posted

    It's a really confusing one. When I saw a consultant in Nottingham, I was prescribed 5mg daily and in fact was told to use it together with MTX. In London, I was prescribed 5mg once a week and 5mg of continuous dose of prednisolone. I was later advised by one of d registrars and the rheumatology nurse not to use the continuous prednisolone as a result of it's possibly side effects which I stopped.

    Long and short is I feel I'm bring experimented on with all these different contradicting prescription.

    I stopped taking the folic acid over a year ago because each time I raise it with both consultants and Gp, I get different opinions.

    I'm just generally on MTX injection, get low blood count once in a while but they reduce my dose when this happens and then back up when my blood result comes back satisfactory.

    My mouth ulcers have reduced since switching my toothpaste to Sensodyne (weird but true as I've experimented on Colgate) and even when I break out (just one as to my usual 4-5), it's not as painful.

    I think we all have to be observant and monitor ourselves and maybe report this to the doctors to help them as well. Thanks for sharing Dinah and everyone for your experiences. It's helped me a lot in some things that I have never associated with the drug

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    • Posted

      Exactly!! The specialists do. Of know your individual body chemistry and take an educated shot in the dark, and then adjusts it accordingly based on your feedback or his interpretation of your experience. You basically are an experiment. That is why I pay close attention to the way I am feeling, and research it from there. I then consult with my doctor and tell him whether the drug is working for me and whether or not the side effects are doing much mode harm than good..asking if necessary to go a different route in my trestment .
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  • Posted

    Hi Dina,

    I have been on MTX since May 2002, 20mgs MTX and 5 mgs Folic Acid on th other 6 days.

    I have posted replies to other posts on MTX and i am one of those that have had NO side effects in all that time.

    Had my 3 monthly check up last Friday and all my bloods are good. Have the MTX blood record book whish they complete each check up and can see any variations.

    After reading some these posts i did think that the Folic Acid every day but MTX day was working.

    My consultant said right from the start that it was important to take the Folic Acid.

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  • Posted

    I take my folic acid 7 days a week 1 mg according to my Dr.
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