ie - Vit B12,Iron, Vit D- Ostelin, multivitamin,evening primrose,fish oils,caltrate, cold and flu tablets, Xalatran eye drops, diprosone ointment.
Thanks for checking these drug interaction with Methotrexate dose and are there any other documented drug reaction ??
Cheers Helen Park
Is it safe to have vitamin supplements with Methotrexate tablets?
Question posted by hpark on 30 Sep 2010
Last updated on 13 May 2017 by keith2468
4 Answers
keith2468
13 May 2017
Here, this is an old question. But I see this question a lot in the patient groups for my disease. Also people get mixed up on the timing.
It is the vitamin folic acid (folate) you most need to worry about, because folic acid is an antidote to methotrexate. Folic acid stops methotrexate working. Doctors call it "Folic acid rescue."
A. Typically patients taking methotrexate for *autoimmune disorders* are told to either:
1. Take 5 mg of folic acid 24 (maybe 48) hours after they take their weekly methotrexate.
-OR-
2. Take 1 mg of folic acid every day except the day they take methotrexate.
3. Sometimes mouth sores persist and a dose adjustment is necessary. Consult your specialist in that case.
4. Your doctor knows the specifics of your case and may give you different instructions tailored to you. Follow your doctor's instructions. (But if you think you're supposed to take the folic acid on the same day as the methotrexate, just phone to confirm you've understood correctly.)
Taking this big a dose of folic acid on the same day as the methotrexate would act as an antidote before the methotrexate could reduce your autoimmune condition.
Taking this big dose of folic acid a day or two after the methotrexate acts as an antidote after the methotrexate has reduced the immune condition but before the methotrexate causes mouth sores.
B. Specialist "B vitamin complex vitamins" may contain too much folic acid. The "B50 Complex Tablets" I take, for example, have 1 mg of folic acid. So I never take those on the same day as my methotrexate.
C. My rheumatologist told me the small doses of folic acid in typical ordinary multivitamins don't have enough folic acid to matter. So I can take my multivitamin every day, even though it contains a small dose of folic acid.
D. It is a very good idea to do up a list of which medications, vitamins, and supplements you take. Put the dose you currently take next to the medication name in the list. Print the list out and take it along to every appointment you have with a medical professional.
This will save a lot of time and help prevent mistakes. Your doctors and your dentist will appreciate it.
You can also keep a 50% size copy of this list in your wallet.
Maintaining this list on your computer makes it easy to update when there are changes.
Disclaimers:
1. Your specialist knows your specific case and he or she is the person you should rely on. Also your family doctor and pharmacist can help you.
2. If you're taking methotrexate for cancer, I can't help you. For cancer, the instructions vary a lot, so you'd definitely have to ask your oncologist.
3. I'm a fellow patient, not any kind of medical professional.
When someone with a similar questions googles this question, I hope they find this answer useful.
jenone
13 Oct 2010
I have been taking methotrexate for 10 months now, and take evening primrose, fish oil and megaB complex (as well as 5mg megafol). As far as I know that is okay.
bacterial
30 Sep 2010
hi Helen Park, its always as well to check with your healthcare provider before taking any supplements. If in doubt take medical advice. I've not taken any supplements at all since being on Methotrexate, but as long as you run it past your doctor and the pharmacists to see if any meds are contra-indicated you should be okay. Best wishes for your health. bacterial
lady of howard
30 Sep 2010
Hi, I take all kinds of vitamins and supplements as well as other perscriptive meds, all with my rhuematologist's approval, and so far so good. I would advise talking to your healthcare provider and your pharmacist (and try using the "interactions checker" above--in the darker blue strip just below the Drugs.com logo--as a guide) about all of the RXs and supplements that you are currently taking. Take care and be well! Lady of Howard
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caltrate, diprosone, fish oil, vitamins, influenza, psoriasis, evening primrose, fish oils, methotrexate, multivitamin, eczema, interaction
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