methotrexate and folic acid

Whether you are dealing with cancer or an auto-immune disease, methotrexate is a powerful medicine that can help. It has numerous side effects and storage issues that you need to be aware of. 

The article discusses these issues and what happens if methotrexate is taken with folic acid.

What Is Methotrexate Used For?

Methotrexate can be prescribed to treat a variety of different types of arthritis and associated conditions, including:

  1. Rheumatoid arthritis
  2. Psoriatic arthritis
  3. Reactive arthritis
  4. Vasculitis
  5. Enteropathic arthritis
  6. Myositis
  7. Systemic sclerosis.


Using methotrexate can cause several severe side effects. In fact, some of the most serious symptoms of methotrexate toxicity include nausea, vomiting, mouth ulcers, and bleeding

It is also possible for methotrexate to interfere with the way the body processes folic acid, which is an important vitamin for making new cells and repairing DNA.

Taking methotrexate can also cause liver damage. This may occur after long-term use or when the drug is combined with another hepatotoxic medication. In such cases, further monitoring of liver enzymes is required. If liver enzymes rise, then the dose should be reduced.

The liver can also be damaged if the patient has a family history of liver disease or if she takes other hepatotoxic medications. Long-term methotrexate users should also have liver biopsies performed.

Treatment for Psoriasis

MTX, or methotrexate, is a drug that is used for treating psoriasis. It is a strong medicine and should not be used by pregnant women or women who are breastfeeding.

The drug is used to slow down the rate at which skin cells are produced. It can be taken by mouth, usually as a pill. It is FDA approved to treat severe psoriasis. However, there is a risk that MTX can cause liver problems.

As reported by the National Library of Medicine (NLM), Methotrexate can cause liver damage, portal hypertension, fibrosis, and cirrhosis, especially with long-term use and higher doses.

Some people use methotrexate along with topical corticosteroids or hydroxyurea. The combination is the most effective for long-term control of localized psoriasis.

CDC defines Psoriasis as an inflammatory skin disorder that results in patches of thick, red skin covered with silvery scales. These patches most commonly appear on elbows, knees, scalps, lower backs, faces, palms, and soles of feet, but can also be found elsewhere (fingernails, toenails, and mouths).

Cyclosporine is another medication that can be used in treating psoriasis. It is less effective than methotrexate for treating generalized psoriasis. This drug can be used in combination with UVB phototherapy.

Treatment for Auto-Immune Diseases

Using methotrexate as a treatment for auto-immune diseases is a big deal, as it’s been shown to be the gold standard for the treatment of chronic inflammation in autoimmune diseases. 

The drug was first developed as a chemotherapeutic agent for malignancy, and was later applied to other inflammatory arthritis conditions. 

It’s available as a tablet or liquid, and should be taken on the same day each week. It’s been shown to be the best way to control inflammation in autoimmune diseases, and has been used for more than 30 years.

One of the most important reasons to use methotrexate is that it’s the least expensive way to treat autoimmune diseases. For example, it’s usually used for rheumatoid arthritis, but it can be used to treat other inflammatory arthritis conditions, as well as cancer.

Side Effects of Methotrexate

methotrexate uses

Taking methotrexate can cause some side effects, such as nausea and drowsiness. If you experience any of these side effects, contact your doctor immediately. 

If you are pregnant, you should use an effective birth control method while taking methotrexate.

The dose of methotrexate you will receive is determined by your condition. For example, a person with Crohn’s disease may receive a lower dose of methotrexate than a person with rheumatoid arthritis

The length of time you will be taking methotrexate will depend on your body’s response to the drug.

Some people may experience serious skin reactions. These reactions may include blistering, a sore throat, and skin pain. 

Other people may experience more mild skin reactions such as burning in the eyes, a sore throat, or a sore neck. It is also important to notify your doctor if you develop an infection.

Proper Storage of Methotrexate

Whether you are using methotrexate for psoriasis, RA, or osteosarcoma, it is important to know the proper storage of methotrexate. Methotrexate should be stored in a cool environment, between two and eight degC.

If you are using methotrexate subcutaneously, the container must be labeled with a cytotoxic sticker. This is especially important if you are using a preservative-free formulation of the drug. 

The container should also be marked with an expiration date. The container should be stored in a separate location from other medications. The container must be locked when not in use.

The container should be sealed when disposed of. If you are using methotrexate injection, it should be disposed of in a sealed cytotoxic sharps bin. A preservative-free syringe should be used for low-birth weight infants.

The toxicity of methotrexate is dependent on the dose. Higher doses can result in increased toxicity. If the patient is taking concomitant drugs, such as NSAIDs, the combination may increase the risk of toxicity.

Adverse reactions associated with methotrexate are often reversible. However, it is important to report all adverse reactions to the patient’s responsible person. In addition, methotrexate should be used with extreme caution in patients with active infection.

Methotrexate is metabolized by the liver. In patients with chronic liver disease or alcoholism, methotrexate should be avoided. Alternatively, an alternative dosing regimen may be needed.

When using methotrexate, it is important to monitor blood levels more frequently. In addition, foliate deficiency may increase the risk of methotrexate-related adverse reactions.

When using high-dose methotrexate, the patient should be alkalinized before the first dose. The first dose should be given over four hours. In the case of methotrexate injection, the syringe should be diluted with 0.9% Sodium Chloride Injection. 

Injections are available in 25mg/ml or 50mg/2ml vials, and the usual dose ranges between 7.5mg and 25mg per week, according to Johns Hopkins Arthritis Center

In the case of methotrexate lyophilized powder, it should be withdrawn at one mg/mL before the syringe is discarded.

Methotrexate is available as a single agent or in combination therapy. 

It may be used as a first-line therapy for adults with moderate to severe plaque psoriasis. It can also be used for recalcitrant psoriasis and non-Hodgkin’s lymphoma.

Methotrexate and Folic Acid

Taking Methotrexate and Folic Acid together can be a problem. Methotrexate has the same chemical structure as folic acid and interferes with the metabolism of folic acid. This can result in a folate deficiency. 

Folate is an essential nutrient and a deficiency can lead to many problems, including tiredness, muscle weakness, an upset stomach, liver toxicity, anemia, vomiting, and gastrointestinal problems.

Folic acid is an important part of many biological reactions, including the formation of DNA. Folate plays a key role in the growth and development of the body. It is derived from dark leafy greens, beans, citrus fruits, and whole grains.

In addition, folate is important for the regulation of the immune system. It is therefore important to take enough folic acid while you are taking methotrexate.

It is important to take folic acid when you take methotrexate because it can help to alleviate some of the side effects. However, it is important to consult your doctor before taking any supplements.

For some people, the side effects caused by methotrexate are so bad that they stop taking it. In addition, Methotrexate blocks some of the activities of folic acid, which can cause mouth sores, abdominal pain, liver malfunctions, hair loss, and anemia.

Folic acid can be taken either in tablet form or as a liquid. It is best taken at the same time each week. You can also take folic acid in conjunction with other medications. Your doctor can tell you when you should stop taking supplements.

There are many non-fortified natural food sources of folic acid. These include beans, green leafy vegetables, and whole grains. The British Society for Rheumatology recommends a dose of at least five mg of folic acid a week.

However, the British Society for Rheumatology guidelines do not specify the day of the week that folic acid should be taken. If you take methotrexate on a daily basis, you should take your folic acid at the same time every week.


methotrexate side effects

Methotrexate is an anti-rheumatic drug that is used to treat a variety of conditions. It is available as an oral solution or an injection. Symptoms may include nausea, vomiting, dizziness, and a decreased platelet count. It can also be toxic to the liver

Taking methotrexate can lead to folate deficiency, which can cause nausea and vomiting. If you are experiencing any symptoms, contact your doctor. 

You may also want to speak to a pharmacist about your medications. Your pharmacist can help you identify medications and determine if they are safe for you to take.