Kathi - folic acid and folinic acid in MTX therapy

[Guest guest]

Kathi, I hope you are no longer confused about this. The dosage units can put

you 1000 times or more off!

So, to recap: 1 gram = 1000 mg and 1 mg = 1000 mcg

Folinic acid isn't really used very often because it is very expensive and,

apparently, no more effective than folic acid.

The MTX/folic acid topic is very confusing because researchers and physicians

can't agree completely about the folic acid supplementation - how much and when.

Nobody knows exactly how MTX works in RA either, so that doesn't help (and let's

not forget that how RA itself works is unknown). But the American College of

Rheumatology directs 1 mg of folic acid per day in MTX treatment of RA. Studies

have shown that up to 5 mg should be OK.

Some in the rheumatology field have called for a review and criteria which would

be better guidelines for more individualized MTX therapy. As you could probably

guess, how much folic acid you are taking and when should have some relationship

to how much MTX you take, whether you are taking it orally or by injection, and

what kind of side-effects you are experiencing (and how much MTX you take should

depend on your disease, its severity, your age, your weight, and so on!).

Another source of confusion is that MTX was first used in the treatment of

cancer and folate depletion and folic acid are quite different issues in that

realm.

Hope I didn't make matters worse,

From: Kathi in OK <iamladybird@...>

Date: Thu Aug 1, 2002 2:07 am

Subject: 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