I take methotrexate — why do I need folic acid?

What does folic acid reduce?

Methotrexate affects how the body handles folic acid. Some of its side effects come from that.

Adding folic acid helps reduce mouth ulcers, nausea, loss of appetite and changes in liver values.

It does not reduce how well methotrexate works. The treatment goes on doing its job.

Which day is it taken?

Folic acid is usually taken on a different day from methotrexate.

The exact day and dose are given to you individually. Changing that schedule on your own is not wise.

If you have forgotten the dose or the day, do not guess — ask.

What is monitored during treatment?

Methotrexate is taken under regular blood-test monitoring: full blood count, liver and kidney function.

Those tests exist to catch side effects early. They should not be skipped, even when you feel well.

When to contact your doctor immediately

• Many mouth ulcers have appeared
• There is severe nausea or vomiting
• Fever, a sore throat or a persistent cough has started
• Unusual bruising or bleeding appears on the skin

These are uncommon but need attention. Getting in touch early keeps the problem small.

If you are planning a pregnancy

Methotrexate is not used in pregnancy. If you have plans, speak to your doctor in advance.

This needs a separate conversation — for men as well as women.