3 doctors weighed in:

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
Dr. Ronald Krauser
Internal Medicine - Rheumatology
1 doctor agrees

In brief: 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.

In brief: 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.
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Dr. Michael Engel
Pediatrics - Hematology & Oncology

In brief: 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.

In brief: 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.
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