Interactions médicamenteuses
Folic Acid + Methotrexate
Gravité: Modérée
Folic Acid and Methotrexate: moderate interaction.
Dernière mise à jour Sources: US FDA label
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Résumé
Folic acid is routinely co-prescribed with low-dose weekly methotrexate to reduce nausea, mouth ulcers, and liver enzyme elevations without meaningfully reducing efficacy in rheumatoid arthritis or psoriasis. In oncology, folate supplementation could theoretically reduce the antineoplastic effect of methotrexate, particularly at high doses, so it is not given outside protocols.
Ce que signifie cette interaction, en termes simples
Folic Acid and Methotrexate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Folic Acid belongs to Miscellaneous; Methotrexate belongs to Oncology.
Pourquoi elle survient
Pharmacodynamic antagonism: methotrexate inhibits dihydrofolate reductase, and folate repletion restores folate-dependent pathways in normal cells, reducing toxicity.
Conduite à tenir
For low-dose weekly methotrexate in rheumatologic or dermatologic disease, give folic acid at a typical dose of 5 mg weekly or 1 mg daily, commonly on a day other than the methotrexate dose. Monitor blood counts, liver enzymes, and renal function regularly, and assess disease control.
Questions à poser à votre pharmacien
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Références
- Methotrexate Injection/Tablets Prescribing Information - Drug Interactions — FDA Label
- 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis — ACR Guideline
Autres interactions de Methotrexate
- Acitretin + Methotrexate Contre-indiquée
- Adenovirus types 4 and 7 live + Methotrexate Contre-indiquée
- Influenza virus vaccine quadrivalent intranasal + Methotrexate Contre-indiquée
- Ketorolac + Methotrexate Contre-indiquée
- Measles mumps and rubella vaccine live + Methotrexate Contre-indiquée
- Measles mumps and rubella vaccine + Methotrexate Contre-indiquée
Autres interactions de Folic Acid
- Ethotoin + Folic Acid Modérée
- Folic Acid + Fosphenytoin Modérée
- Folic Acid + Glucarpidase Modérée
- Folic Acid + Pafolacianine Modérée
- Folic Acid + Phenobarbital Modérée
- Folic Acid + Phenytoin Modérée
Questions fréquentes
Can I take Folic Acid with Methotrexate?
MediHelp rates the interaction as moderate. Folic Acid and Methotrexate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Folic acid is routinely co-prescribed with low-dose weekly methotrexate to reduce nausea, mouth ulcers, and liver enzyme elevations without meaningfully reducing efficacy in rheumatoid arthritis or psoriasis. In oncology, folate supplementation could theoretically reduce the antineoplastic effect of methotrexate, particularly at high doses, so it is not given outside protocols.
How serious is the interaction between Folic Acid and Methotrexate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: For low-dose weekly methotrexate in rheumatologic or dermatologic disease, give folic acid at a typical dose of 5 mg weekly or 1 mg daily, commonly on a day other than the methotrexate dose. Monitor blood counts, liver enzymes, and renal function regularly, and assess disease control.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Methotrexate page.
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