When to take methotrexate and folic acid?

A common approach for autoimmune conditions (like rheumatoid arthritis) is:

- Methotrexate (MTX): take it once weekly, on the same day each week. Do not take it daily. You can take it with or after a meal and with a full glass of water.

- Folic acid: given to reduce MTX side effects. The exact timing varies by plan, but two common patterns are:
1) 1 mg folic acid every day except the day you take MTX (i.e., take folic acid on all other days).
2) 5 mg folic acid once per week on a day when you do not take MTX (often the day after MTX).

Important reminders:
- Do not change your schedule or dose without talking to your prescriber.
- If you miss a weekly MTX dose, don’t double up; contact your clinician for guidance.
- MTX can interact with certain foods, alcohol, and other medicines. Report new meds or symptoms (mouth ulcers, persistent nausea, fever, unusual bruising, fatigue) to your doctor.
- MTX is usually teratogenic. If you’re planning pregnancy or could become pregnant, discuss timing and safety with your doctor.

If you can share your exact dose and the plan on your prescription (the weekly MTX dose and whether your folic acid is daily or weekly), I can tailor the explanation more closely to your regimen. If you’re unsure, the best next step is to check with the clinician who prescribed your MTX.