Methotrexate and Folic Acid

Okay I would like to hear what others know about this. Doing my research I see so many different opinions and am wondering what others are doing or have done. My question is whether those of you who are or have taken Methotrexate, have you taken folic acid the day you have taken your MTX dosage?? And if you could give an explanation when you respond that would help greatly. Thank you

Yes, i see the same question out there..I did ask my rheummy, she said take on the same day. I am up to 4mg a day now..

I'm on it 17 yrs and have always taken on the same day. But each doctor does it differantly, so i guess we would have to follow their instructions. You will prob get some replies, others might no take it the same day

good luck

Dear Livinday2day,

It seems each Dr is different, when I took it, I took folic acid every day, while others did not take the folic acid the same day they took the MX. Different theories, I suppose. Hope this helps!

My Rheumatologist is also a University Professor, so this is what he is teaching, perhaps it is a new train of thought.


Your right, SK..I started out with a similar "grandfather" of all rheummies at a teaching college. And have always taken mtx and folic the same day. I've spent 5 minutes, looking on the net, this may be the new way, but my current rheummy isn't that old

It's suppose to make Mtx less effective having on the same day?...Yes i suppose diff theories, like u say

When I was taking MTX orally, it was folic acid everyday other then the day I took the MTX. Now I’m on MTX injections my Rheumy has me on folic acid the morning and night after the injection. From what I understand and info from my Rheumy is that because MTX is a folic acid inhibitor then no point taking folic acid on the same day as it will be less effective. I’m sure there are many different approaches, as long as the folic acid is getting into your system and stopping ulcers etc then timing is up to each Rheumy.

I take methorexate on Mondays and take the Folic Acid on Tuesdays and Wednesday and have monthly blood tests and so far my blood tests have been ok apart from my ESR and CRP they are always up.

Thank you all for the replies. There definately is a lot of different opinions but I can honestly say that yours helps. And you're right tkrlady, while doing my own research is how I found that there are different thoughts. Taking everything into consideration I think I am going to not take it the day I take MTX until I talk with my rheumy.

I just joined this group and I can say that I am really happy that I found it because there is no one around me that has PsA or taking the meds I am, so it's tough to have people around that can relate. Thanks

Hi Livingday2day,

We are glad to have you with us, and I think most of us are in the same boat, don't know anyone else who has this to talk to about it. Time is so limited at the Rheumatologist, even when they take time, they have to be able to ask some questions too.

It does seem odd that there are so many different ideas about this! The Dr's assistant always comes in after the Doc is finished, gives me a print out if any new diagnosis found with a detailed explanation, prescriptions, blood work, and tells me to call if I have any problems or questions. Other than the guaranteed 2 plus hour wait, he is very thorough and well organized.

Wishing you success with the treatment.


SK, you're right about not really having anyone to talk to that can really relate. It may sound silly but I am really excited about the group. So far so good with the people that I have interacted with. It feels good to know there are others to share with that can understand.

In regards to your Dr's, I am really happy for you to hear that you have someone that is thorough and well organized. I feel very lucky as well. At least so far it seems like my doctor is really listening to how I feel and really listening to me as I explain my symptoms to him. Each day as I adjust to the meds I feel better and better, which is something I am really excited about because it has not been an easy road to get here. If I can only get rid of that ocassional nausea, I would be happy as anything. But I will take the ocassional nausea if I can continue to feel how I do right now :)

I wish everyone a great day

These kind of Doctors are a true gift to us, so glad you got one too! Hope you feel better every day!

I take my mtx on wednesday evening and take 5mg folic acid on thurs morning. My rheumatologist said that was the best way to do it. I have top up folic acid during the week as I was suffering mouth ulcers (not sure what you call these in US - canker something?)

They're horrible no matter what you call them, hope you have enough folic acid to never get them again, Gweneth!

My dr said just take folic acid everyday. No mention at all about not taking it day of MTX. It’s been 5 wks. Just increased from 4 tablets to 5…that seems to be ok for me so far.

I have been taking folic acid daily per my Dr.'s instructions since starting MTX in January. No mouth sores, ulcers or other stuff..... Take care

Hey Alan!

So good to hear that there is someone out there that can tolerate it and not have side efffects! Rock on!

I started MTX in November 2010 and at the same time, my rheumy prescribed folic acid, which I take every day, even on the day I take the MTX. I have had minimal side effects from the MTX - some tummy unpleasantness when first starting out and when my dose was increased. The stuff I found on the web is that the folic acid helps alleviate/prevent some of the side effects - for me, at least, it has been working!



I take folic acid everyday even the day that I take MTX. I take 10 pills at 25mg and 1 mg folic acid. I have been on MTX for alittle over 1 yr. My remy Dr teaches at harvard.

I take folic acid everyday-started with 1mg and am now up to 3mg daily - do not stop on MTX days!

Hey Liv, I do not take folic acid on MTX day, my rhu said the folic acid is to clean out the liver after mtx, but that if you take the folic acid at the same time, it will just flush the mtx right out of your body before it has a chance to work. Basically, as I understand it, if you take both at the same time, it completely defeats the purpose of taking the mtx at all. I'm no doctor though, so use your own intuition.

p.s. I've been taking mtx, folic acid, and prednisone, along with simponi (and 2000mg fish oil/day) and exercising 4-5 times a week and am almost completely pain and swell-up free (with the exception of a freak green pepper incident the other day that subsided by the time I woke up)