Interações medicamentosas
Folic Acid + Methotrexate
Gravidade: Moderada
Folic Acid and Methotrexate: moderate interaction.
Última atualização Fontes: US FDA label
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Resumo
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.
O que esta interação significa em palavras 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.
Por que acontece
Pharmacodynamic antagonism: methotrexate inhibits dihydrofolate reductase, and folate repletion restores folate-dependent pathways in normal cells, reducing toxicity.
O que fazer
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.
O que perguntar ao farmacêutico
- 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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Referências
- Methotrexate Injection/Tablets Prescribing Information - Drug Interactions — FDA Label
- 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis — ACR Guideline
Outras interações de Methotrexate
- Acitretin + Methotrexate Contraindicada
- Adenovirus types 4 and 7 live + Methotrexate Contraindicada
- Influenza virus vaccine quadrivalent intranasal + Methotrexate Contraindicada
- Ketorolac + Methotrexate Contraindicada
- Measles mumps and rubella vaccine live + Methotrexate Contraindicada
- Measles mumps and rubella vaccine + Methotrexate Contraindicada
Outras interações de Folic Acid
- Ethotoin + Folic Acid Moderada
- Folic Acid + Fosphenytoin Moderada
- Folic Acid + Glucarpidase Moderada
- Folic Acid + Pafolacianine Moderada
- Folic Acid + Phenobarbital Moderada
- Folic Acid + Phenytoin Moderada
Perguntas frequentes
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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