Re: Folic acid supplementation during MTX therapy

[Guest guest]

Ok ...now I am really confused....although I have

spent the last two weeks that way.....reading the

posts I am seeing large doses of folic

acid...ie..400mg....my prescription was 7...2.5 mg MTX

weekly,,,,and I mg folic acid daily except MTX

days...the explanation was MTX depletes the folic acid

so if you take it on MTX days it is a waste because

the MTX will just eat it...also take the folic acid

always on an empty stomache was what I was told...so

these large doses are actually folinic acid? Confused

in Oklahoma....Kathi

--- <Matsumura_Clan@...> wrote:

> It is up to your doctor, but many physicians do not

> prohibit their RA patients

> from taking folic acid on the same day on which they

> take their methotrexate

> (MTX).

>

> It's true that pharmacologically MTX is categorized

> as an antifolate and that

> folate depletion is responsible for many of the

> annoying side-effects (mouth

> sores, hair loss, GI upset, for example) MTX

> produces in rheumatoid arthritis

> patients on low-dose therapy; however, although we

> don't really understand

> exactly why MTX is effective in treating RA, it is

> believed that its antifolate

> mechanisms are NOT those that are most important in

> altering the RA disease

> process.

>

> " ... Most researchers have found that folic acid

> levels were not related to

> parameters of disease activity and concluded that

> methotrexate does not exert

> its action in RA primarily by inhibiting

> dihydrofolatereductase.

>

> (Alarcon GS, SL. Arthritis Rheum 1997

> Feb;40(2):391; van Ede AE, et al.

> Semin Arthritis Rheum 1998 Apr;27(5):277-292; Hunt

> PG, et al. J Rheumatol 1997

> Nov;24(11):2230-2232; Leeb BF, et al. Clin Exp

> Rheumatol 1995

> Jul-Aug;13(4):459-463; SL, et al. J Rheumatol

> 1998 Mar;25(3):441-446;

> Shiroky JB. Rheum Dis Clin North Am 1997

> Nov;23(4):969-680.)

>

> Nutritional support with rheumatoid conditions:

> Though its use is not

> universally accepted, the ability of folic acid (or

> folinic acid) to reduce

> methotrexate toxicity in individuals being treated

> for rheumatoid arthritis has

> made its use an important adjunct in enabling

> patients to tolerate methotrexate.

> At this time, research supports several rationales

> for substantial folate

> supplementation by individuals taking methotrexate

> for rheumatoid arthritis.

> Beyond the prevention of methotrexate toxicity, the

> prevention or treatment of

> folate deficiency and the prevention of

> hyperhomocysteinemia further contribute

> to the therapeutic value of supplementation with

> high doses of folic acid.

> According to the several studies cited, a daily dose

> of 1000-5000 mcg of folic

> acid or 2.5-5 mg of folinic acid (an activated form

> of folic acid) can

> substantially reduce the adverse effects of

> methotrexate without compromising

> its therapeutic effect in rheumatoid patients.

>

> ( SL, et al. J Rheumatol 1998

> Mar;25(3):441-446; Shiroky JB. Rheum Dis

> Clin North Am 1997 Nov;23(4):969-980; Kamen B. Semin

> Oncol 1997 Oct;24(5 Suppl

> 18):S18-30-S18-39; , SL, et al. Ann Intern Med

> 1994;121:833-841; Ortiz Z,

> et al. J Rheumatol 1998 Jan;25(1):36-43; Shiroky JB,

> et al. Arthrit Rheum

> 1993;36:795.) "

>

> Source:

>

http://home.caregroup.org/clinical/altmed/interactions/Drugs/Methotrexate.htm

>

>

>

> The American College of Rheumatology advises that

> 1mg per day or 7mg per week

> should not lessen the effectiveness of MTX:

>

> " Common but less serious toxicities of MTX include

> mucositis, mild alopecia, and

> GI disturbances, which may be caused by folate

> depletion. These toxicities are

> often treated or prevented with the use of folate

> supplementation, which should

> be considered in all patients taking MTX. Folic acid

> at a dosage of 1 mg per day

> or 7 mg once a week is less expensive and less

> complicated than the use of

> folinic acid. Neither low-dose folate (1 mg per day)

> nor folinic acid (<=5 mg

> per week) interferes with the beneficial effect of

> MTX . "

>

> Source:

>

http://www.rheumatology.org/research/guidelines/ra-drug/ra-drug.html

>

>

> The following is the abstract of a research article

> entitled, " Methotrexate in

> rheumatoid arthritis. Folate supplementation should

> always be given " :

>

>

http://www.lef.org/protocols/abstracts/abstr-013.html#23

>

>

>

>

>

>

>

>

>

>

>

>

__________________________________________________

[Guest guest]

Kathy, I think it was 400 mcg, not mg. Mcg are way smaller than mg. I think

1000 mcg is equivalent to 1 mg. So taking 400 mcg 3 times a day is abit more

than we are taking, but not allot more.

How are you doing on the MTX? My blood test from Monday showed my liver enzymes

were up to 38 from 35 two weeks ago. My doctor said it was still ok, not

anything to be overly concerned about. How is yours doing? Sounds like your

taking almost twice the MTX I am.

Hugs,

Debbie Mc

Re: [ ] Folic acid supplementation during MTX therapy

Ok ...now I am really confused....although I have

spent the last two weeks that way.....reading the

posts I am seeing large doses of folic

acid...ie..400mg....my prescription was 7...2.5 mg MTX

weekly,,,,and I mg folic acid daily except MTX

days...the explanation was MTX depletes the folic acid

so if you take it on MTX days it is a waste because

the MTX will just eat it...also take the folic acid

always on an empty stomache was what I was told...so

these large doses are actually folinic acid? Confused

in Oklahoma....Kathi

--- <Matsumura_Clan@...> wrote:

> It is up to your doctor, but many physicians do not

> prohibit their RA patients

> from taking folic acid on the same day on which they

> take their methotrexate

> (MTX).

>

> It's true that pharmacologically MTX is categorized

> as an antifolate and that

> folate depletion is responsible for many of the

> annoying side-effects (mouth

> sores, hair loss, GI upset, for example) MTX

> produces in rheumatoid arthritis

> patients on low-dose therapy; however, although we

> don't really understand

> exactly why MTX is effective in treating RA, it is

> believed that its antifolate

> mechanisms are NOT those that are most important in

> altering the RA disease

> process.

>

> " ... Most researchers have found that folic acid

> levels were not related to

> parameters of disease activity and concluded that

> methotrexate does not exert

> its action in RA primarily by inhibiting

> dihydrofolatereductase.

>

> (Alarcon GS, SL. Arthritis Rheum 1997

> Feb;40(2):391; van Ede AE, et al.

> Semin Arthritis Rheum 1998 Apr;27(5):277-292; Hunt

> PG, et al. J Rheumatol 1997

> Nov;24(11):2230-2232; Leeb BF, et al. Clin Exp

> Rheumatol 1995

> Jul-Aug;13(4):459-463; SL, et al. J Rheumatol

> 1998 Mar;25(3):441-446;

> Shiroky JB. Rheum Dis Clin North Am 1997

> Nov;23(4):969-680.)

>

> Nutritional support with rheumatoid conditions:

> Though its use is not

> universally accepted, the ability of folic acid (or

> folinic acid) to reduce

> methotrexate toxicity in individuals being treated

> for rheumatoid arthritis has

> made its use an important adjunct in enabling

> patients to tolerate methotrexate.

> At this time, research supports several rationales

> for substantial folate

> supplementation by individuals taking methotrexate

> for rheumatoid arthritis.

> Beyond the prevention of methotrexate toxicity, the

> prevention or treatment of

> folate deficiency and the prevention of

> hyperhomocysteinemia further contribute

> to the therapeutic value of supplementation with

> high doses of folic acid.

> According to the several studies cited, a daily dose

> of 1000-5000 mcg of folic

> acid or 2.5-5 mg of folinic acid (an activated form

> of folic acid) can

> substantially reduce the adverse effects of

> methotrexate without compromising

> its therapeutic effect in rheumatoid patients.

>

> ( SL, et al. J Rheumatol 1998

> Mar;25(3):441-446; Shiroky JB. Rheum Dis

> Clin North Am 1997 Nov;23(4):969-980; Kamen B. Semin

> Oncol 1997 Oct;24(5 Suppl

> 18):S18-30-S18-39; , SL, et al. Ann Intern Med

> 1994;121:833-841; Ortiz Z,

> et al. J Rheumatol 1998 Jan;25(1):36-43; Shiroky JB,

> et al. Arthrit Rheum

> 1993;36:795.) "

>

> Source:

>

http://home.caregroup.org/clinical/altmed/interactions/Drugs/Methotrexate.htm

>

>

>

> The American College of Rheumatology advises that

> 1mg per day or 7mg per week

> should not lessen the effectiveness of MTX:

>

> " Common but less serious toxicities of MTX include

> mucositis, mild alopecia, and

> GI disturbances, which may be caused by folate

> depletion. These toxicities are

> often treated or prevented with the use of folate

> supplementation, which should

> be considered in all patients taking MTX. Folic acid

> at a dosage of 1 mg per day

> or 7 mg once a week is less expensive and less

> complicated than the use of

> folinic acid. Neither low-dose folate (1 mg per day)

> nor folinic acid (<=5 mg

> per week) interferes with the beneficial effect of

> MTX . "

>

> Source:

>

http://www.rheumatology.org/research/guidelines/ra-drug/ra-drug.html

>

>

> The following is the abstract of a research article

> entitled, " Methotrexate in

> rheumatoid arthritis. Folate supplementation should

> always be given " :

>

>

http://www.lef.org/protocols/abstracts/abstr-013.html#23

>

>

>

>

>

>

>

>

>

>

>

>

__________________________________________________

[Guest guest]

Debbie thanks for that explanation ...i dont think

there was a mcg or mg after the 400....I havent had my

blood tested except for when the MTX was started and

my next appointment isnt until September...after

reading some of the posts maybe it is a should be

done....once again Thanks...Kathi in OK

--- Debbie Mc <debmc58@...> wrote:

> Kathy, I think it was 400 mcg, not mg. Mcg are way

> smaller than mg. I think 1000 mcg is equivalent to

> 1 mg. So taking 400 mcg 3 times a day is abit more

> than we are taking, but not allot more.

>

> How are you doing on the MTX? My blood test from

> Monday showed my liver enzymes were up to 38 from 35

> two weeks ago. My doctor said it was still ok, not

> anything to be overly concerned about. How is yours

> doing? Sounds like your taking almost twice the MTX

> I am.

>

> Hugs,

> Debbie Mc

> Re: [ ] Folic acid supplementation

> during MTX therapy

>

>

> Ok ...now I am really confused....although I

> have

> spent the last two weeks that way.....reading the

> posts I am seeing large doses of folic

> acid...ie..400mg....my prescription was 7...2.5 mg

> MTX

> weekly,,,,and I mg folic acid daily except MTX

> days...the explanation was MTX depletes the folic

> acid

> so if you take it on MTX days it is a waste because

> the MTX will just eat it...also take the folic acid

> always on an empty stomache was what I was told...so

> these large doses are actually folinic acid?

> Confused

> in Oklahoma....Kathi

> --- <Matsumura_Clan@...> wrote:

> > It is up to your doctor, but many physicians do

> not

> > prohibit their RA patients

> > from taking folic acid on the same day on which

> they

> > take their methotrexate

> > (MTX).

> >

> > It's true that pharmacologically MTX is

> categorized

> > as an antifolate and that

> > folate depletion is responsible for many of the

> > annoying side-effects (mouth

> > sores, hair loss, GI upset, for example) MTX

> > produces in rheumatoid arthritis

> > patients on low-dose therapy; however, although we

> > don't really understand

> > exactly why MTX is effective in treating RA, it is

> > believed that its antifolate

> > mechanisms are NOT those that are most important

> in

> > altering the RA disease

> > process.

> >

> > " ... Most researchers have found that folic acid

> > levels were not related to

> > parameters of disease activity and concluded that

> > methotrexate does not exert

> > its action in RA primarily by inhibiting

> > dihydrofolatereductase.

> >

> > (Alarcon GS, SL. Arthritis Rheum 1997

> > Feb;40(2):391; van Ede AE, et al.

> > Semin Arthritis Rheum 1998 Apr;27(5):277-292; Hunt

> > PG, et al. J Rheumatol 1997

> > Nov;24(11):2230-2232; Leeb BF, et al. Clin Exp

> > Rheumatol 1995

> > Jul-Aug;13(4):459-463; SL, et al. J

> Rheumatol

> > 1998 Mar;25(3):441-446;

> > Shiroky JB. Rheum Dis Clin North Am 1997

> > Nov;23(4):969-680.)

> >

> > Nutritional support with rheumatoid conditions:

> > Though its use is not

> > universally accepted, the ability of folic acid

> (or

> > folinic acid) to reduce

> > methotrexate toxicity in individuals being treated

> > for rheumatoid arthritis has

> > made its use an important adjunct in enabling

> > patients to tolerate methotrexate.

> > At this time, research supports several rationales

> > for substantial folate

> > supplementation by individuals taking methotrexate

> > for rheumatoid arthritis.

> > Beyond the prevention of methotrexate toxicity,

> the

> > prevention or treatment of

> > folate deficiency and the prevention of

> > hyperhomocysteinemia further contribute

> > to the therapeutic value of supplementation with

> > high doses of folic acid.

> > According to the several studies cited, a daily

> dose

> > of 1000-5000 mcg of folic

> > acid or 2.5-5 mg of folinic acid (an activated

> form

> > of folic acid) can

> > substantially reduce the adverse effects of

> > methotrexate without compromising

> > its therapeutic effect in rheumatoid patients.

> >

> > ( SL, et al. J Rheumatol 1998

> > Mar;25(3):441-446; Shiroky JB. Rheum Dis

> > Clin North Am 1997 Nov;23(4):969-980; Kamen B.

> Semin

> > Oncol 1997 Oct;24(5 Suppl

> > 18):S18-30-S18-39; , SL, et al. Ann Intern

> Med

> > 1994;121:833-841; Ortiz Z,

> > et al. J Rheumatol 1998 Jan;25(1):36-43; Shiroky

> JB,

> > et al. Arthrit Rheum

> > 1993;36:795.) "

> >

> > Source:

> >

>

http://home.caregroup.org/clinical/altmed/interactions/Drugs/Methotrexate.htm

> >

> >

> >

> > The American College of Rheumatology advises that

> > 1mg per day or 7mg per week

> > should not lessen the effectiveness of MTX:

> >

> > " Common but less serious toxicities of MTX include

> > mucositis, mild alopecia, and

> > GI disturbances, which may be caused by folate

> > depletion. These toxicities are

> > often treated or prevented with the use of folate

> > supplementation, which should

> > be considered in all patients taking MTX. Folic

> acid

> > at a dosage of 1 mg per day

> > or 7 mg once a week is less expensive and less

> > complicated than the use of

> > folinic acid. Neither low-dose folate (1 mg per

> day)

> > nor folinic acid (<=5 mg

> > per week) interferes with the beneficial effect of

> > MTX . "

> >

> > Source:

> >

>

http://www.rheumatology.org/research/guidelines/ra-drug/ra-drug.html

> >

> >

> > The following is the abstract of a research

> article

> > entitled, " Methotrexate in

> > rheumatoid arthritis. Folate supplementation

> should

> > always be given " :

> >

> >

>

http://www.lef.org/protocols/abstracts/abstr-013.html#23

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

>

>

> __________________________________________________

>

[Guest guest]

Debbie thanks for that explanation ...i dont think

there was a mcg or mg after the 400....I havent had my

blood tested except for when the MTX was started and

my next appointment isnt until September...after

reading some of the posts maybe it is a should be

done....once again Thanks...Kathi in OK

--- Debbie Mc <debmc58@...> wrote:

> Kathy, I think it was 400 mcg, not mg. Mcg are way

> smaller than mg. I think 1000 mcg is equivalent to

> 1 mg. So taking 400 mcg 3 times a day is abit more

> than we are taking, but not allot more.

>

> How are you doing on the MTX? My blood test from

> Monday showed my liver enzymes were up to 38 from 35

> two weeks ago. My doctor said it was still ok, not

> anything to be overly concerned about. How is yours

> doing? Sounds like your taking almost twice the MTX

> I am.

>

> Hugs,

> Debbie Mc

> Re: [ ] Folic acid supplementation

> during MTX therapy

>

>

> Ok ...now I am really confused....although I

> have

> spent the last two weeks that way.....reading the

> posts I am seeing large doses of folic

> acid...ie..400mg....my prescription was 7...2.5 mg

> MTX

> weekly,,,,and I mg folic acid daily except MTX

> days...the explanation was MTX depletes the folic

> acid

> so if you take it on MTX days it is a waste because

> the MTX will just eat it...also take the folic acid

> always on an empty stomache was what I was told...so

> these large doses are actually folinic acid?

> Confused

> in Oklahoma....Kathi

> --- <Matsumura_Clan@...> wrote:

> > It is up to your doctor, but many physicians do

> not

> > prohibit their RA patients

> > from taking folic acid on the same day on which

> they

> > take their methotrexate

> > (MTX).

> >

> > It's true that pharmacologically MTX is

> categorized

> > as an antifolate and that

> > folate depletion is responsible for many of the

> > annoying side-effects (mouth

> > sores, hair loss, GI upset, for example) MTX

> > produces in rheumatoid arthritis

> > patients on low-dose therapy; however, although we

> > don't really understand

> > exactly why MTX is effective in treating RA, it is

> > believed that its antifolate

> > mechanisms are NOT those that are most important

> in

> > altering the RA disease

> > process.

> >

> > " ... Most researchers have found that folic acid

> > levels were not related to

> > parameters of disease activity and concluded that

> > methotrexate does not exert

> > its action in RA primarily by inhibiting

> > dihydrofolatereductase.

> >

> > (Alarcon GS, SL. Arthritis Rheum 1997

> > Feb;40(2):391; van Ede AE, et al.

> > Semin Arthritis Rheum 1998 Apr;27(5):277-292; Hunt

> > PG, et al. J Rheumatol 1997

> > Nov;24(11):2230-2232; Leeb BF, et al. Clin Exp

> > Rheumatol 1995

> > Jul-Aug;13(4):459-463; SL, et al. J

> Rheumatol

> > 1998 Mar;25(3):441-446;

> > Shiroky JB. Rheum Dis Clin North Am 1997

> > Nov;23(4):969-680.)

> >

> > Nutritional support with rheumatoid conditions:

> > Though its use is not

> > universally accepted, the ability of folic acid

> (or

> > folinic acid) to reduce

> > methotrexate toxicity in individuals being treated

> > for rheumatoid arthritis has

> > made its use an important adjunct in enabling

> > patients to tolerate methotrexate.

> > At this time, research supports several rationales

> > for substantial folate

> > supplementation by individuals taking methotrexate

> > for rheumatoid arthritis.

> > Beyond the prevention of methotrexate toxicity,

> the

> > prevention or treatment of

> > folate deficiency and the prevention of

> > hyperhomocysteinemia further contribute

> > to the therapeutic value of supplementation with

> > high doses of folic acid.

> > According to the several studies cited, a daily

> dose

> > of 1000-5000 mcg of folic

> > acid or 2.5-5 mg of folinic acid (an activated

> form

> > of folic acid) can

> > substantially reduce the adverse effects of

> > methotrexate without compromising

> > its therapeutic effect in rheumatoid patients.

> >

> > ( SL, et al. J Rheumatol 1998

> > Mar;25(3):441-446; Shiroky JB. Rheum Dis

> > Clin North Am 1997 Nov;23(4):969-980; Kamen B.

> Semin

> > Oncol 1997 Oct;24(5 Suppl

> > 18):S18-30-S18-39; , SL, et al. Ann Intern

> Med

> > 1994;121:833-841; Ortiz Z,

> > et al. J Rheumatol 1998 Jan;25(1):36-43; Shiroky

> JB,

> > et al. Arthrit Rheum

> > 1993;36:795.) "

> >

> > Source:

> >

>

http://home.caregroup.org/clinical/altmed/interactions/Drugs/Methotrexate.htm

> >

> >

> >

> > The American College of Rheumatology advises that

> > 1mg per day or 7mg per week

> > should not lessen the effectiveness of MTX:

> >

> > " Common but less serious toxicities of MTX include

> > mucositis, mild alopecia, and

> > GI disturbances, which may be caused by folate

> > depletion. These toxicities are

> > often treated or prevented with the use of folate

> > supplementation, which should

> > be considered in all patients taking MTX. Folic

> acid

> > at a dosage of 1 mg per day

> > or 7 mg once a week is less expensive and less

> > complicated than the use of

> > folinic acid. Neither low-dose folate (1 mg per

> day)

> > nor folinic acid (<=5 mg

> > per week) interferes with the beneficial effect of

> > MTX . "

> >

> > Source:

> >

>

http://www.rheumatology.org/research/guidelines/ra-drug/ra-drug.html

> >

> >

> > The following is the abstract of a research

> article

> > entitled, " Methotrexate in

> > rheumatoid arthritis. Folate supplementation

> should

> > always be given " :

> >

> >

>

http://www.lef.org/protocols/abstracts/abstr-013.html#23

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

>

>

> __________________________________________________

>

[Guest guest]

Kathi:

Don't know when you started the MTX but you should

have blood work done every 8 weeks when you are on it

to keep track of the liver enzymes especially. I have

a standing order with the lab and go in like clockwork

every 8 weeks for blood work.

Kathe in CA

__________________________________________________

[Guest guest]

Excellent info . Thanks.

a

> It is up to your doctor, but many physicians do not prohibit their RA patients

> from taking folic acid on the same day on which they take their methotrexate

> (MTX).

>

> It's true that pharmacologically MTX is categorized as an antifolate and that

> folate depletion is responsible for many of the annoying side-effects (mouth

> sores, hair loss, GI upset, for example) MTX produces in rheumatoid arthritis

> patients on low-dose therapy; however, although we don't really understand

> exactly why MTX is effective in treating RA, it is believed that its

> antifolate

> mechanisms are NOT those that are most important in altering the RA disease

> process.

>

> " ... Most researchers have found that folic acid levels were not related to

> parameters of disease activity and concluded that methotrexate does not exert

> its action in RA primarily by inhibiting dihydrofolatereductase.

>

> (Alarcon GS, SL. Arthritis Rheum 1997 Feb;40(2):391; van Ede AE, et al.

> Semin Arthritis Rheum 1998 Apr;27(5):277-292; Hunt PG, et al. J Rheumatol 1997

> Nov;24(11):2230-2232; Leeb BF, et al. Clin Exp Rheumatol 1995

> Jul-Aug;13(4):459-463; SL, et al. J Rheumatol 1998 Mar;25(3):441-446;

> Shiroky JB. Rheum Dis Clin North Am 1997 Nov;23(4):969-680.)

>

> Nutritional support with rheumatoid conditions: Though its use is not

> universally accepted, the ability of folic acid (or folinic acid) to reduce

> methotrexate toxicity in individuals being treated for rheumatoid arthritis

> has

> made its use an important adjunct in enabling patients to tolerate

> methotrexate.

> At this time, research supports several rationales for substantial folate

> supplementation by individuals taking methotrexate for rheumatoid arthritis.

> Beyond the prevention of methotrexate toxicity, the prevention or treatment of

> folate deficiency and the prevention of hyperhomocysteinemia further

> contribute

> to the therapeutic value of supplementation with high doses of folic acid.

> According to the several studies cited, a daily dose of 1000-5000 mcg of folic

> acid or 2.5-5 mg of folinic acid (an activated form of folic acid) can

> substantially reduce the adverse effects of methotrexate without compromising

> its therapeutic effect in rheumatoid patients.

>

> ( SL, et al. J Rheumatol 1998 Mar;25(3):441-446; Shiroky JB. Rheum Dis

> Clin North Am 1997 Nov;23(4):969-980; Kamen B. Semin Oncol 1997 Oct;24(5 Suppl

> 18):S18-30-S18-39; , SL, et al. Ann Intern Med 1994;121:833-841; Ortiz

> Z,

> et al. J Rheumatol 1998 Jan;25(1):36-43; Shiroky JB, et al. Arthrit Rheum

> 1993;36:795.) "

>

> Source:

> http://home.caregroup.org/clinical/altmed/interactions/Drugs/Methotrexate.htm

>

>

>

> The American College of Rheumatology advises that 1mg per day or 7mg per week

> should not lessen the effectiveness of MTX:

>

> " Common but less serious toxicities of MTX include mucositis, mild alopecia,

> and

> GI disturbances, which may be caused by folate depletion. These toxicities are

> often treated or prevented with the use of folate supplementation, which

> should

> be considered in all patients taking MTX. Folic acid at a dosage of 1 mg per

> day

> or 7 mg once a week is less expensive and less complicated than the use of

> folinic acid. Neither low-dose folate (1 mg per day) nor folinic acid (<=5 mg

> per week) interferes with the beneficial effect of MTX . "

>

> Source: http://www.rheumatology.org/research/guidelines/ra-drug/ra-drug.html

>

>

> The following is the abstract of a research article entitled, " Methotrexate in

> rheumatoid arthritis. Folate supplementation should always be given " :

>

> http://www.lef.org/protocols/abstracts/abstr-013.html#23

>

>

>

>

>

>

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[Guest guest]

on 8/1/02 1:07 PM, Kathe Sabetzadeh at lv2ryd@... wrote:

> Don't know when you started the MTX but you should

> have blood work done every 8 weeks when you are on it

> to keep track of the liver enzymes especially. I have

> a standing order with the lab and go in like clockwork

> every 8 weeks for blood work.

I'm supposed to have blood work done every month since I started MTX last

August. I added Arava last week, and am supposed to have blood work done

after two weeks, then resume the once a month schedule.

I guess different doctors have different expectations. But it does get to be

expensive, doesn't it, even with insurance?

Sue

[Guest guest]

Kathe:

I have been taking it for 2 plus months......my rheumy

never said anything about blood tests except for the

baseline he did.....after reading all the posts I said

something to my daughter that is a resp tech and she

went through the roof....mom dont you know....your

liver.....on and on so thanks to all for the

discussion on this subject...have an appointment with

PCP next week and will run this by him.....I did call

and ask and was told as I have a standing every 90 day

appointment that the rheumy usually checks the blood

every 12 weeks......thanks to all again...Kathi in

OK..PS Iris I got excited when I read Debbie Mcs

message about Dallas also, as I think there is just 3

of us in the great southwest.....I believe Alice is in

Texas also...but I think Debbies Dallas is up

north......oh well youll have to settle being close to

me in Oklahoma and I know the standard saying in Texas

is the only thing good to come out of Oklahoma is

I35..LOL....My son lives in Carrolton not that far

from Irving

Kathe Sabetzadeh <lv2ryd@...> wrote:> Don't

know when you started the MTX but you should

> have blood work done every 8 weeks when you are on

> it

> to keep track of the liver enzymes especially. I

> have

> a standing order with the lab and go in like

> clockwork

> every 8 weeks for blood work.

>

> Kathe in CA

>

> __________________________________________________

>

[Guest guest]

Howdy Neighbor Kathi - I had never heard the I35 joke

but have heard - What do you call a good looking woman

in Oklahoma? A tourist from Texas. Yuk, Yuk. I've

only been in Oklahoma coming from Missouri. I never

knew it was so green and beautiful; I always thought

it looked like the Grapes of Wrath movie. If you ever

get to Carollton, give me a call, I'm in the book.

--- Kathi in OK <iamladybird@...> wrote:

> Kathe:

>

> I have been taking it for 2 plus months......my

> rheumy

> never said anything about blood tests except for the

> baseline he did.....after reading all the posts I

> said

> something to my daughter that is a resp tech and she

> went through the roof....mom dont you know....your

> liver.....on and on so thanks to all for the

> discussion on this subject...have an appointment

> with

> PCP next week and will run this by him.....I did

> call

> and ask and was told as I have a standing every 90

> day

> appointment that the rheumy usually checks the blood

> every 12 weeks......thanks to all again...Kathi in

> OK..PS Iris I got excited when I read Debbie Mcs

> message about Dallas also, as I think there is just

> 3

> of us in the great southwest.....I believe Alice is

> in

> Texas also...but I think Debbies Dallas is up

> north......oh well youll have to settle being close

> to

> me in Oklahoma and I know the standard saying in

> Texas

> is the only thing good to come out of Oklahoma is

> I35..LOL....My son lives in Carrolton not that far

> from Irving

>

> Kathe Sabetzadeh <lv2ryd@...> wrote:> Don't

> know when you started the MTX but you should

> > have blood work done every 8 weeks when you are on

> > it

> > to keep track of the liver enzymes especially. I

> > have

> > a standing order with the lab and go in like

> > clockwork

> > every 8 weeks for blood work.

> >

> > Kathe in CA

> >

> > __________________________________________________

> >

[Guest guest]

Kathi,

Here are the guidelines set up by the American College of Rheumatology to

monitor toxicity in patients prescribed meds for rheumatic diseases:

Guidelines for Monitoring Drug Therapy in Rheumatoid Arthritis

http://www.hopkins-arthritis.som.jhmi.edu/edu/acr/guide_drug_treat.html

As you will see, your doctor is not following these guidelines. Every 12

weeks is not sufficient for monitoring MTX. Your daughter is right for

going through the roof.

a

> Kathe:

>

> I have been taking it for 2 plus months......my rheumy

> never said anything about blood tests except for the

> baseline he did.....after reading all the posts I said

> something to my daughter that is a resp tech and she

> went through the roof....mom dont you know....your

> liver.....on and on so thanks to all for the

> discussion on this subject...have an appointment with

> PCP next week and will run this by him.....I did call

> and ask and was told as I have a standing every 90 day

> appointment that the rheumy usually checks the blood

> every 12 weeks......thanks to all again...Kathi in

> OK..

[Guest guest]

Thanks a I appreciate the link, it is printed and

will be going with me to my next appointment...Katghi

in OK

--- a <paula54@...> wrote:

> Kathi,

>

> Here are the guidelines set up by the American

> College of Rheumatology to

> monitor toxicity in patients prescribed meds for

> rheumatic diseases:

>

> Guidelines for Monitoring Drug Therapy in Rheumatoid

> Arthritis

>

http://www.hopkins-arthritis.som.jhmi.edu/edu/acr/guide_drug_treat.html

>

> As you will see, your doctor is not following these

> guidelines. Every 12

> weeks is not sufficient for monitoring MTX. Your

> daughter is right for

> going through the roof.

> a

>

>

> > Kathe:

> >

> > I have been taking it for 2 plus months......my

> rheumy

> > never said anything about blood tests except for

> the

> > baseline he did.....after reading all the posts I

> said

> > something to my daughter that is a resp tech and

> she

> > went through the roof....mom dont you know....your

> > liver.....on and on so thanks to all for the

> > discussion on this subject...have an appointment

> with

> > PCP next week and will run this by him.....I did

> call

> > and ask and was told as I have a standing every 90

> day

> > appointment that the rheumy usually checks the

> blood

> > every 12 weeks......thanks to all again...Kathi in

> > OK..

>

>

__________________________________________________