藥物交互作用
Folic Acid + Methotrexate
嚴重程度: 中度
Folic Acid and Methotrexate: moderate interaction.
最後更新 來源: US FDA label
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Pharmacodynamic antagonism: methotrexate inhibits dihydrofolate reductase, and folate repletion restores folate-dependent pathways in normal cells, reducing toxicity.
處置方式
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.
可向藥師詢問的問題
- 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?
參考資料
- Methotrexate Injection/Tablets Prescribing Information - Drug Interactions — FDA Label
- 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis — ACR Guideline
Methotrexate 的其他交互作用
Folic Acid 的其他交互作用
常見問題
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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