So I switched Rheumys. Really like this new one. I've been on Enbrel for 7 months now, and it has started to lose effectiveness. New Rhuemy has added MTX. 6 pills every week, I took 3 for the first time today, and going to work up to the 6 over the next few weeks. I also got a Rx for folic acid.
Here's my questions...when do I take the Folic Acid? I see people dont take it on the day of MTX. I wasnt told this, so I took it today with the MTX. Bad?
I hear about fatigue...I didnt realize it could make me tired, and that people are strategic on the days they take it. I should have waited until Saturday evening, as tomorrow I have a lot going on...Can I adjust the day I take it next week to Saturday instead of Th?
Has anyone ever tried getting Vit B injections while on Enbrel and MTX? Was thinking it might be a good boost for the days when I become exhausted.
How many days apart from Enbrel do I take it to avoid any wierd SE?
Anything else I should know? My Dr was pretty casual about this drug, so I didnt ask many ? and he didn't share alot about it. I'm switching to Humira when my insurance approves it, which will take about 8 weeks. Anyone have exp with switching over?
Folic acid is Vitamin B. I have heard not taking the folic acid the day of the MTX, but only on the internet. I take it everyday was told to and told especially to take it MTX day. I can't imagine why I would pick a day or two of low folate as that is what causes any SE. I take my MTX the same day every week at the same time. Occasionally because of my Enbrel schedule (every 5 days) I have them within a day or the same day with no problems.
I inject MTX on Wednedays, the same day I inject Enbrel. I also take folate all 7 days of the week. Once a month I give myself a B12 injection- due to a diagnosed deficiency. If you are not particularly low - I would take a b complex supplement. Talk to your dr about that. Vit d is also very important, so make sure your levels are ok for that.
Good luck! I understand the biologics can work synergistically with MTX. Taking them together has helped me .
My doctor has me on 5mg of folic acid every day except the day after my MTX injection, when I take leucovorin. I asked him about not taking folic acid on the day of the shot and he said that wasn't his standard practice. I think it depends, but I'd listen to a doctor over the internet any day.
The leucovorin was a lifesaver, though. I'm pretty sensitive to MTX, and had a lot of mouth ulcers at first, but not so much with that addition. Good luck to you!
My doc said not to take the folic acid the day you take the MTX because it suppresses some of the effectiveness of the MTX. I take the folic acid six days a week. I also choose to take it on Sunday nights because my Monday's are pretty light. I am lucky and have had no side effects from the MTX. You aren't supposed to drink when you are on MTX because it is hard on your liver. However - it is hardest on the liver the first few days after you take it so, by the time Friday and Saturday comes around, I can have a single glass of wine if I am out.
Best of luck - I hope it helps you. So far, so good for me.
First, let me preface this by saying I have never gone to medical school. :) Just wanted to get that out in the open first! However, I have had multiple conversations about the interaction between MTX/Folic acid with my neurophysiologist father. It is my understanding that MTX prevents the absorption of folic acid in the body, but folic acid has absolutely no negative interaction with the efficacy of MTX. I have taken 1 mg of folic acid every day for years while taking MTX. Except for that period of time when my brain was wonky, and I'd run out of folic acid and forgot to get more. I had some pretty horrific side effects from the MTX during that time period, and when I asked my doc about it, he gave me the equivalent of a smack up aside my head and told me to take the folic acid (duh). :) But that is a different story altogether.
Folic acid is completely water soluble, so it doesn't really matter if you take 1 mg, 5 mg, or even 50 mg. Your body will use exactly the amount of folic acid it needs, and the rest will flush out of your system. Now, I am certainly not advocating the consumption of 50 mg of folic acid on a regular basis - all things in moderation, my friends. The best plan is to talk with your doctor and a qualified pharmacist to figure out the best dosing schedule.
As for MTX/biologics: I've been on Humira, Humira and MTX, Enbrel, Enbrel and MTX, MTX alone, and Remicade and MTX (Obviously not all at the same time). The different combinations have ranged in effectiveness from not at all to "WHOOPIE, I feel better than I have in years." Each person's body is different, and their reaction to medications differ. Over time, medications work or don't according to what my body dictates. I'm just along for the ride most of the time. I haven't taken vitamin B shots because I haven't really seen a need for it, since I take the pills, but that, too, is something you may want to discuss with your doctor. I began taking MTX on Saturdays because I was worried about how I would feel, and have stuck to that schedule pretty much forever. I recently switched to injectable MTX because of cost, and it has turned out to be a terrific option, as the injections seem to be a better option for psoriasis control, which the pills haven't done in a long, long time.
I couldn't agree more, I do the same. Folic acid every day, MTX injection on Saturday, currently on Remicade but have done Cimzia and Humira in the past (varying results). I have done the max dose of MTX for years, after a while and staying on the folic acid, I didn't notice it making me tired. I came to believe that it was really the disease making me tired anyway but I sleep in on Sunday just to be sure that I don't get an MTX hangover.
tmbrwolf329 said:
First, let me preface this by saying I have never gone to medical school. :) Just wanted to get that out in the open first! However, I have had multiple conversations about the interaction between MTX/Folic acid with my neurophysiologist father. It is my understanding that MTX prevents the absorption of folic acid in the body, but folic acid has absolutely no negative interaction with the efficacy of MTX. I have taken 1 mg of folic acid every day for years while taking MTX. Except for that period of time when my brain was wonky, and I'd run out of folic acid and forgot to get more. I had some pretty horrific side effects from the MTX during that time period, and when I asked my doc about it, he gave me the equivalent of a smack up aside my head and told me to take the folic acid (duh). :) But that is a different story altogether.
Folic acid is completely water soluble, so it doesn't really matter if you take 1 mg, 5 mg, or even 50 mg. Your body will use exactly the amount of folic acid it needs, and the rest will flush out of your system. Now, I am certainly not advocating the consumption of 50 mg of folic acid on a regular basis - all things in moderation, my friends. The best plan is to talk with your doctor and a qualified pharmacist to figure out the best dosing schedule.
As for MTX/biologics: I've been on Humira, Humira and MTX, Enbrel, Enbrel and MTX, MTX alone, and Remicade and MTX (Obviously not all at the same time). The different combinations have ranged in effectiveness from not at all to "WHOOPIE, I feel better than I have in years." Each person's body is different, and their reaction to medications differ. Over time, medications work or don't according to what my body dictates. I'm just along for the ride most of the time. I haven't taken vitamin B shots because I haven't really seen a need for it, since I take the pills, but that, too, is something you may want to discuss with your doctor. I began taking MTX on Saturdays because I was worried about how I would feel, and have stuck to that schedule pretty much forever. I recently switched to injectable MTX because of cost, and it has turned out to be a terrific option, as the injections seem to be a better option for psoriasis control, which the pills haven't done in a long, long time.
I have been taking mtx for 9 months now and I take 10mg every week. I just wanted to compare this dosage with everyone else? Is this a high or moderate dose? It seems to have sorted me out however reading some,of your comments has freaked me up because I am only taking acfol, which is folic acid the day after I take mtx, not every day after!! So only once a week, Oooooo noooo! should I be taking this every day???
Don't panic. 10mg is a low dose of mtx (I believe the max is 25mg/weekly) and folic acid once a week is also enough for many people. IF you started to get any side effects from the mtx then the folic acid dose can be increased.
If you are seeing symptomatic improvement and no side-effects on this regime then BE HAPPY. Be VERY happy.
princesa said:
Hi, I have been taking mtx for 9 months now and I take 10mg every week. I just wanted to compare this dosage with everyone else? Is this a high or moderate dose? It seems to have sorted me out however reading some,of your comments has freaked me up because I am only taking acfol, which is folic acid the day after I take mtx, not every day after!! So only once a week, Oooooo noooo! should I be taking this every day???
I was on 25 mg methotrexate once a week 5 pills Saturday morning and 5 pills Saturday evening with folic acid 1mg daily even on Saturdays. Methotrexate can boost the effectiveness of biologics, make sure you get all your lab work done. My rheumy orders labs every three months. I am currently pulled off it due to to many infections though. O do realize what a difference it made.Good luck.