Kickas.org Forums Treatments, Drugs and Alternatives Anti TNF and other biological medications Remicade/Methatrexate

When taking Remicade and Methatrexate, what is the recommended doseage of folic acid should you take? Thanks

Hi Mary! I had to search to see if there is an agreed-upon answer for folic acid regime during methotrexate treatment, and apparently there is no one right answer.
However, most studies that I've found, suggest 1mg/day.
Did the prescribing doctor suggest any particular dosage?

Hi Megan,, I,m getting conflicting answers .His GI spec said 1mg ,the rheum said 2mg and his GP said 5 mg . I have read 5mg when taking MTX. So I thought I,d put it out there and see what response I get back. Chad,s rheu said LDN was ineffective for AS and that his spine will still fuse if taking LDN, he was,nt impressed. So chad will continue taking remicade with MTX. and off LDN.Did you try taking MTX,with your TNF,S? Megan take care of yourself and Thanks for responding. Mary

I took MTX many moons ago, concurrently with sulfasalazine. Neither of those medications seemed to help me at all, unfortunately. However some people report really good results.
I don't think there have been any studies that show remicade is any more effective when taken with MTX, versus remicade alone. That's always being studied and debated though.
That's unfortunate that Chad's rheumy wrote off LDN. I can't remember now - did he get a chance to try it for very long? I know it was a challenge finding a doctor willing to prescribe it, but it really is a very safe drug (when we're talking side effects) when compared to many other AS treatments. I think many people here would disagree with Chad's doc on his opinion that LDN would not help - if you can induce gut healing, reduce inflammation and pain, and continue to stay active, you can greatly reduce fusing. Might not be perfect, but hey, any bit helps.
So 1mg or 2mg or 5mg? That's a big help. lol Seems like the information I've found says basically the same thing. Ah well. Maybe have Chad play with each dose to see what works best for him then.
Good luck to you guys!

Hi Megan, Chad found that LDN did help him , it was good for his crohn,s disease , but was,nt sure it helped his AS. He was still having alot of back pain,with 4.5mg so I told him to up the dose to 6mg he said it worked but was only on it for a couple days before he saw his Rheu.The rheu shot that down,and was not convinced at all. I have also read that MTX does,nt increase the effects of remicade, so we will just have to see.Chad has been complaining about being very fatigued and the doc then told him its the LDN and its not working for him.So then chad decides to try the MTX and see what happens.I then thought I wonder how much money he,s getting to keep him on TNF,s if he,s getting a percentage prescribing this drug..verses LDN.. I,m bad... LOL .But Chad will be seeing Dr.Edworthy and will get a 2nd opinion from him on the LDN.How are you doing Megan? are you getting any results from your doc?? Hope things will turn around for you very soon.Take care Mary

I'm on mtx (15mg) with 1 mg folic acid on the other days. From what I read, if you have more side effects from the mtx, they could bump up the folate to 2mg. But that's all I recall.

My doctor was having me take 1mg a day on all days that I didn't take the mtx. I was to up my folic acid if I was getting the mouth sores.

Thanks Misty, for the reply.So the folic acid helps with mouth sores. Is it very common to get mouth sores with mtx? How are you doing with the mtx, do you really get sick, and how long have you been on mtx? Do you find it helps with TNF,s ? Sorry for all the questions. Have a great evening.Thanks again.

I also take 1 mg of folic acid each day except the day I take methotrexate. So far, I've had no side effects from the mtx at all, but I did start with a really low dose and build very slowly because I was nervous about side effects.

The folic acid is supposed to help with the mouth sores. I have had to go off of the mtx, I'm one of the unlucky ones that end up with stupid side effects to the point where I can't function so well. The last time, I was on MTX for about 6 weeks..and before that, I had been on it for a year or more. When I was taking it with the anti-tnf's..I felt that it did help me quite a bit, but I was so fatigued, and nauseous and just a general feeling of being hung over for about 3-4 days after taking them - I had to stop, it just wasn't worth it.

I hope that helps!