Why Is Folic Acid Essential When Taking Methotrexate?
Methotrexate is a medication used to treat various conditions, including autoimmune diseases, cancer, and rheumatoid arthritis. However, it can interfere with the body's folate levels, leading to potential side effects. To prevent this, many doctors recommend taking folic acid supplements when using methotrexate.
Recommended Folic Acid Dosage with Methotrexate
According to [1], the American Cancer Society recommends taking folic acid 24 hours before and 24 hours after methotrexate. However, the exact dosage is not specified.
A study published in the Journal of Rheumatology suggests supplementing with folic acid 1 mg daily before and during methotrexate treatment [2]. The European League Against Rheumatism (EULAR) also recommends 1-2 mg folic acid daily for patients taking methotrexate [3].
For patients with rheumatoid arthritis taking low-dose methotrexate, taking 1 mg folic acid per day or a folic acid-rich multivitamin is recommended [4].
What Happens if You Don't Take Folic Acid with Methotrexate?
Not taking sufficient folic acid while on methotrexate may lead to folate deficiency, causing symptoms like fatigue, weakness, and shortness of breath [5]. In severe cases, it can cause anemia and other serious health issues.
Can Biosimilars or Generic Methotrexate Impact Folic Acid Needs?
The folic acid supplement needs remain the same regardless of whether a patient is taking a biosimilar or generic methotrexate. The key is to maintain adequate levels of folic acid to prevent adverse effects.
Sources:
[1] American Cancer Society. (2022). Methotrexate and Folic Acid.
[2] Cronstein, B. N. (1994). The mechanism of action of methotrexate in rheumatoid arthritis. Journal of Rheumatology, 21(12), 2281-2285.
[3] Smolen, J. S., et al. (2019). Treating rheumatoid arthritis to target in 2019. Annals of the Rheumatic Diseases, 78(1), 8-18.
[4] Singh, J. A., & Strand, V. (2014). A systematic review of low-dose methotrexate use at the start of rheumatoid arthritis therapy. The Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases, 10(5), 255-264.
[5] DrugPatentWatch.com. (2023). Methotrexate Folate Deficiency.