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09 Feb 2012

What's the best way to give folic acid with methotrexate?

CPD editor Chris Chapman answers reader questions on methotrexate therapy and discusses additional counselling points for diuretic patients
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Allan Melzack, Community pharmacist
Posted on 10 February 2012.
At the recent CPPE workshop on RA in Manchester it was said that increasing folic acid is a good way to reduce side effects from methotrexate which could explain the variety of dosages.
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Fiona Finnie, Superintendent
Posted on 10 February 2012.
Advice to give daily dosing with folic acid (except on the day methotrexate is given) tends to come from Dermatology rather than Rheumatology - which may explain why it isn't following the Rheumatology advice. Possibly some of the dermatology studies into reducing hepatic side effects or on whether folic acid reduced the effectiveness of methotrexate were done with daily dosing. Best wishes. Fiona
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Fiona Finnie, Superintendent
Posted on 10/02/12 11:49 in reply to Fiona Finnie.
I'm not a superintendent !
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Niall Hunt, Other healthcare professional
Posted on 10/02/12 11:56 in reply to Fiona Finnie.
You need to update your preferences using the "Update Profile" link at the top right
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Kelly Tweedie, Other healthcare professional
Posted on 10 February 2012.
The Haywood Rheumatology centre in Staffordshire give methotrexate as a daily dose of 5mg to be taken every day- including the MTX day *if* MTX is taken at the opposite end of the day- so if folic acid is taken in the morning, MTX taken in the evening- if not, then folic acid is omitted on MTX day.
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Umi Mistry, Community pharmacist
Posted on 13/02/12 10:09 in reply to Kelly Tweedie.
do you mean Folic acid as a daily dose of 5mg!!!!
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