From the Guidelines
When taking methotrexate 25mg weekly, you should take at least 5mg of folic acid per week to minimize side effects and maximize the therapeutic benefits of methotrexate therapy. This recommendation is based on the strongest evidence available, which suggests that folic acid supplementation reduces gastrointestinal and liver toxicity of methotrexate without reducing its efficacy 1. The exact timing and dosage of folic acid may vary depending on individual patient needs and response to methotrexate, but a minimum of 5mg per week is strongly recommended.
Some key points to consider when taking folic acid with methotrexate include:
- Folic acid supplementation can help reduce side effects such as nausea, mouth sores, liver problems, and blood cell abnormalities
- Methotrexate works by inhibiting folate metabolism, which can deplete the body's folate stores and lead to these unwanted effects
- Folic acid replenishes these stores without interfering with methotrexate's therapeutic benefits for conditions like rheumatoid arthritis, psoriasis, or certain inflammatory conditions
- The recommended dosage of folic acid may be adjusted based on individual patient response to methotrexate and any side effects experienced
It is essential to follow a doctor's specific instructions regarding folic acid dosing, as they may adjust the recommendation based on individual patient needs. However, the minimum recommended dosage of 5mg per week should not be exceeded without consulting a healthcare professional. According to the evidence, prescription of at least 5mg folic acid per week with methotrexate therapy is strongly recommended 1.
From the Research
Folic Acid Dosage with Methotrexate
The recommended dosage of folic acid to take with a methotrexate (MTX) prescription of 25 milligrams per week is:
- 5-10 mg per week, as suggested by 2
- 10 mg per week, as compared to 30 mg per week in 3, which found no additional benefit of the higher dose Some studies suggest that folic acid supplementation can help reduce methotrexate toxicity and side effects, such as:
- Nausea, stomatitis, and hepatotoxicity, as mentioned in 4
- Undesirable symptoms and laboratory abnormalities, as discussed in 3
Key Considerations
When taking folic acid with methotrexate, consider the following:
- Folic acid should be taken daily or weekly, depending on the specific regimen, as discussed in 5 and 4
- The dose of folic acid may vary depending on the individual patient and their specific needs, as suggested by 3 and 2
- Folic acid supplementation can help prevent folate deficiency and hyperhomocysteinemia, which may be associated with cardiovascular disease, as mentioned in 2
Methotrexate Dosage and Administration
Methotrexate dosage and administration may vary depending on the individual patient and their specific condition, as discussed in: