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Discussion Starter #1
I'm really pleased with the effect that methotrexate has had on my skin but not too happy about the headaches which seem to be getting worse/lasting longer. Also a bit shakey/nauseous.

From what I can gather folic acid can help with these side effects. Not sure why though. I'm currently on 5mg a week the day after my methotrexate dose.

Would it be worth dicussing this with my GP, ie. increasing or spreading the dose out during the week? Any advice would be much appreciated.
 

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Hi Aggie,

I am glad the methotrexate is working for you. Sorry to hear about the side effects that you are having.:(

Here what I found about folic acid and methotrexate.

Question: Why is it necessary to take folic acid with methotrexate?
Answer: Methotrexate (MTX) is a chemotherapy drug that prevents cell reproduction by interfering with folic acid activation. MTX is also used in the treatment of psoriatic arthritis and rheumatoid arthritis. Although very effective, its use potentially may produce serious side effects including nausea, mouth ulcers, blood problems, liver cirrhosis, and hair loss. Prolonged treatment with MTX may also lead to folic acid deficiency. To reduce the risk of these side effects, without fear of interfering with its efficacy, a maximum daily dose of 5mg of folic acid is recommended for those patients taking MTX on a regular weekly basis.
http://arthritis.about.com/od/arthqa/f/folicacidmtx.htm

I take 1 mg of folic acid everyday of the week.
You could give your rhuemy a call or contact your pharmacy and ask them your question.

Love,
Lyn
 

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I've been taking mtx for a long time and my doctor has me on folic acid 1 mg twice a day and when I do my IV, I take 3 doses of 5 mgs of leucovorin calcium as a "rescue".
Sally
 

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Hello :)
Prescribing habits for folic acid with methotrexate vary from doctor to doctor. It is usually not taken the day the metho is taken because it's reckoned it will reduce the efficiency of the metho.
5 grams once a week or once a day is very common. The maximum seems to be 10 grms a week
I don't know how effective this is for hair loss occasioned by metho. I thought it was more for general side effects such as mouth ulcers and nausea and in general to avoid folic acid depletion.

All the best
Hugs
Clare
 

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Discussion Starter #5
Clare.T;546176 said:
Hello :)
Prescribing habits for folic acid with methotrexate vary from doctor to doctor. It is usually not taken the day the metho is taken because it's reckoned it will reduce the efficiency of the metho.
5 grams once a week or once a day is very common. The maximum seems to be 10 grms a week
I don't know how effective this is for hair loss occasioned by metho. I thought it was more for general side effects such as mouth ulcers and nausea and in general to avoid folic acid depletion.

All the best
Hugs
Clare
The hair aside, I was just wondering whether it would be helpful as I am experiencing bad headaches a few days after taking the methotrexate and also nausea. I've asked the question of my consultant and am awaiting an answer.
 

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Hello again Aggie :)
I am wondering if you are taking the pills? I have heard that the injections are much better re side effects especially the nausea and other tummy problems. I hope you can get some relief from the side effects - good that it is helping your skin though.
Please let us know what your consultant suggests.
Hugs
Clare
 

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Discussion Starter #7
Clare.T;546263 said:
Hello again Aggie :)
I am wondering if you are taking the pills? I have heard that the injections are much better re side effects especially the nausea and other tummy problems. I hope you can get some relief from the side effects - good that it is helping your skin though.
Please let us know what your consultant suggests.
Hugs
Clare
Yes Clare. I am taking the pills. Unfortunately I've never tolerated medications very well, even at a relatively low dose. I always suffer side effects which is why I've had to intoduce the methotrexate gradually. Saying that, the headaches and nausea are preferable to having open sores all over my face and ears!

I don't want to come off it as I have seen improvements already but will have to discuss alternatives to the tablets if things get worse. I'm still waiting for a response from Dr D'Cruz. x
 

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Discussion Starter #8
Clare.T;546263 said:
Hello again Aggie :)
I am wondering if you are taking the pills? I have heard that the injections are much better re side effects especially the nausea and other tummy problems. I hope you can get some relief from the side effects - good that it is helping your skin though.
Please let us know what your consultant suggests.
Hugs
Clare
Dr D'Cruz has suggested to double my dose of folic acid per week. Fingers crossed this will help.
 

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Hi Aggie,
If you pull the physician desk reference for both mtx and folic acid, and look at their chemical chain composition, you will note that there is only one bond different between the two. The folic acid will render the mtx inactive and so it is used as a "rescue" drug for the mtx. The reason it is used is to protect healthy tissues from the damage done to healthy tissues by the chemo drug. It is for this reason I suggest that people run this by your rheumy/oncologist to see if they really mean for you to allow the mtx to do its full damage to the healthy tissues and not neutralize it with the folic acid or leucovorin calcium, a "pumped up" version of folic acid.
Generally, the higher your mtx dose, the more important it is to protect healthy tissues.
The reason that cancer patients are not told to use folic acid when taking mtx is the risk for healthy cells is considered a justifiable risk in order to kill off cancer cells. To use the folic acid then is not worth allowing cancer cells to go unhindered while inflammatory cells are a more long term control vs immediate need to kill off cancer.

I hope this gives you a better understanding of why the drugs are used in synchronization.
Sally
 

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Discussion Starter #10
Pink Pearl;548039 said:
Hi Aggie,
If you pull the physician desk reference for both mtx and folic acid, and look at their chemical chain composition, you will note that there is only one bond different between the two. The folic acid will render the mtx inactive and so it is used as a "rescue" drug for the mtx. The reason it is used is to protect healthy tissues from the damage done to healthy tissues by the chemo drug. It is for this reason I suggest that people run this by your rheumy/oncologist to see if they really mean for you to allow the mtx to do its full damage to the healthy tissues and not neutralize it with the folic acid or leucovorin calcium, a "pumped up" version of folic acid.
Generally, the higher your mtx dose, the more important it is to protect healthy tissues.
The reason that cancer patients are not told to use folic acid when taking mtx is the risk for healthy cells is considered a justifiable risk in order to kill off cancer cells. To use the folic acid then is not worth allowing cancer cells to go unhindered while inflammatory cells are a more long term control vs immediate need to kill off cancer.

I hope this gives you a better understanding of why the drugs are used in synchronization.
Sally
Thank you Sally. The people on this forum never let me down! :hug:
 
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