A member asked:

Can too much folic acid inhibit methotrexate?was on 1mg folic acid/day & great long time.due to side effects, increased to 3mg folic acid & now flaring

3 doctors weighed in across 2 answers

Too much folic acid: Imo, doses above 1 mg daily are a waste of money. Higher doses simply get excreted in the urine. Many rheumatologists do not routinely prescribe Folic Acid with Methotrexate unless there is evidence of Methotrexate toxicity.

Answered 6/28/2014

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Dr. Michael Engel answered

Specializes in Pediatric Hematology and Oncology

Methotrexate.....: Is an inhibitor of dihydrofolate (folic acid) reductase, and is essentially a folate (folic acid) antagonist. Do administration of a folate (folic acid) supplement would theoretically interfere with the effects of methotrexate. The degree if that impairment would be proportional to the ratio of folate (folic acid) to mtx. The higher that ratio, the greater the inhibitory effect of folate (folic acid) toward mtx.

Answered 9/8/2013

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