Well as to the how, I take folic acid as a pill, but the why is that your body needs the folic acid when you take MTX. I don't remember if its because your body doesn't abosrb it properly, or store it properly, or why, I just remember that if you take one, you have to take the other!

I take one folic acid tablet with breakfast and the other with supper. I understand that some of the people here do not take the folic acid on the day they take the MTX. However, I take it every day. I take my MTX one tablet per day for five days (taking it all at once upset my stomach). On those days, Mon-Fri, I pop both pills in my mouth at the same time! I have not had any problem taking them on the same day or even at the same time. I have very few mouth sores since my folic acid was increased to two tabs a day. I am interested in knowing what you have read.

Hi,
I take 2x 5mg Folic Acid tabs the day after I take Methotrexate 25mg (orally).
The reason I was given both by my GP and Rheumy was that the Folic Acid will lessen the effect of the MTX if taken on the same day. Folic Acid is taken to lessen or avoid the side effects of MTX.
As far as I iknow, Rheumatologists here - Australia - all prescribe Folic Acid with MTX and usually at a higher dose than in USA.
Again, Lois is taking both in a different regime to most people and is doing well.
Hugs

My Rheumatologist had me taking folic acid daily in the am and MTX was weekly Po or injection whichever way I was doing it at the time.

I wanted to reply to LoiR. I think that you need to let your Rheumy know how you are taking the meds.MTX works by reducing the cell regeneration of your body. An autoimmune disorder, such as RA causes the body to over produce certain cells, those in the joints/synovial areas. The cells are reproduced on a weekly basis and that is why MTX is taken weekly..to target the regrowth of the cells. If you spread out the MTX, you are not getting an effective dose, but may at the same time be doing damage to your body. Please talk to your Rheumy. And if he is fine with taking the pills every day, speak to your pharmacist, to double check.

I also took MTX for years. I asked my Rheumy at the time why I had to take MTX one day a week all at once and not everyday. Her reply was that is how they hoped to avoid liver/kidney damage. Your organs have a chance to recover for a week instead of bombarding them with MTX every day. She had me take folic acid every day.

I take MTX pills once a week and noticed my hair thinning and falling out and also losing its color...(when I color it) So I asked my rheumy if I could decrease my MTX from 25mg to 15 mg...to my surprise he agreed..I also asked if I should increase my folic acid as I was only taking 1 pill daily of 1 mg...so he increased me to 3 pills daily of 1 mg ea. Lets hope this works out ok as I have noticed I do not have the brain for with the reduced mtx....Thank God....

I meant to say Brain fog is gone with reduced mtx

when I was on MTX i took it daily - then my dr changed to the 5mg dosage of folinic acid that I was to only take one time a week, 12 hours after my MTX.
I have a friend who was told to take 5, 1mg pills 48 hours before her MTX. (and now her rheumy has told her she can take all of her folic acid and the MTX at the same time)

confusing, I know

I take 20mg of MTX every week, 4 in the morning and 4 at night, as well as 1mg folic acid daily (even on MTX days). According to a recent study, folic acid supplements may increase cancer risk:

http://www.reuters.com/article/2009/11/17/us-cancer-folicacid-idUSTRE5AG5NU20091117

I believe when you can, natural is always better. When my nausea started getting really bad, I read up on it. I'm not very good at watching my diet and counting micrograms and all that. But I started keeping more salad stuff ready in the fridge for when I wanted a quick snack or healthy meal. I keep vegetables cut up in the fridge and ready. I try to mix it up so I don't get sick of anything. Since I started eating better, the nausea is rarely even noticeable. I try to stick with what I like more, as opposed to what has the 'most' folic acid. It makes it less of a chore, and the food doesn't rot because I don't feel like eating it. ;)

Folic acid foods charts:

http://www.folicacidnow.net/foodChart.html

http://www.whfoods.com/genpage.php?tname=nutrient&dbid=63

Here's a great article on Folic Acid rich foods:

http://www.globalhealingcenter.com/natural-health/folic-acid-foods/

I take it everyday. Keeps all side effects away for me. I had mouth sores an a big tongue an FA took them away. Had not had since.

@inkjoy, My rheumy suggested that I try taking the MTX daily instead of all 5 at once to ease the tummy problems. He didn't give me any guidance on when/how to take the folic acid. I asked him about increasing it to two after reading that folks on this site were taking more and having fewer mouth sores. I inject 50 mg of Enbrel weekly in addition to the MTX.

@peppyest, thank you for asking this question. I'm learning from the other posters that I should question how I'm taking my drugs.

@everybody, thank you for sharing what you've been told about MTX & folic acid. I'll add a question about the MTX to the list I've got going for my appointment in two weeks. I hate to change anything, though. I feel pretty good most of the time--except for occasional fatigue problems--and haven't had a flare since I began Enbrel two years ago. But I really do want to protect my liver.

Wishing everybody lots of good days!

My Rhuemy has me take folic acid everyday and emphasized everyday to avoid the side effects of MTX. We went up to 2 mg this week because last week I was really sick after MTX. This week (Yesteday) I took MTX and I did great today. :)

I am on MTX 25mg weekly, 5 pills in the am and 5 pills in the pm. I take folic acid 2mg every am, (folic acid ordered is 1mg pills so I take 2 pills every am).

He increased the folic acid to counteract the side effects I had from MTX, and it greatly decreased my nausea. I had nausea so bad, I had dry heaves. He also ordered an aniemetic for the nausea as needed and have not used it since folic acid was increased.

Still have extreme fatigue on MTX day and 1 to 2 days later.

I was prescribed 1 mg of folic acid when I was first put on methotrexate. It's prescription dose. I guess methotrexate depletes your body of folic acid, which can cause other problems, so I take it the same day that I take my treatment. Now I use over the counter and have to take 3 pills to reach the 1 mg, but it's cheap. I guess I'll have to research WHY folic acid is so important. It's not like me not to know!