Folic Acid (methotrexate)

I am new to RA.  Just got my first prescription for methotrexate.  The doctor also gave me folic acid to take to help reduce the side effects of the methotrexate.   She said to take the methotrexate on an empty stomach and it would be better to take it at night.  That way if you get an upset stomach from it, hopefully you will sleep right through it.  

She never said how/when to take the folic acid.  Do you take it with the methotrexate?  Does it need to be taken at a different time than my other vitamins.  The folic acid script says to take it daily.  (of course the methotrexate is once a week).

I have looked it up, but haven't found a definative answer.  It also made me confused because under interaction it mentions methotrexate.

Thanks for the help,
K

[txsilver]

Folic acid should be taken daily while taking MTX.  My doc advised me to take 2/day and 6 on the day before, day of and day after taking MTX.  If you find you are suffering a lot of side effects from the MTX, you may want to ask your doctor for a prescription for Leukovoran.  It can only be taken exactly 24 hours after taking MTX and functions like an antidote.  
I was on the pill form at first but had to switch to injections because the side effects from the pills were worse than the injections.  Once I switched to injections and added the leukovoran, I was able to function better the day after taking the shots.  
With side effects in mind, I suggest you pick a day of the week when you will have a less demanding day the next day.  Also, avoid alcohol while taking this medication.  How often is your doctor setting up follow ups to track your liver function?  Did you get a flu and pneumonia shot?  Because MTX surpresses your immune system, it is important that you get those if you have not already.

[kmil1999]

Thanks so much for all the info.  She prescribed oral MTX.  folic acid is 1 mg/day.  She gave me an order to do monthly labs.

Luckily, I got both a flu and pneumonia shot last month.  

I have a couple of sores on my fingers.  (gardening) Should I wait till they are healed before I start the MTX?

Thanks again
Karen

[txsilver]

Glad the info was helpful!  I hope the pill form works out for you.  I was not thrilled with the idea of giving myself shots, but it got easy.  
Regarding the sores, how bad are they?  Being on MTX will mean you heal slower so, if the sores are bad, you may want to give them a head start on healing.  

[M5646]

I am starting MTX and folic acid today. I am terrified about the hair lose thing. Have you had that problem? I have multiple auto immunes going on and we have tried so many things over the years with little help. I take Gabapintin 400mg 3X a day. I also work a few hours a nite and am wondering how MTX is going to affect that. Also, I am to have spine surg soon and am concerned about MTX and that as well as the healing. I just got over bronchitis and have let everyone I know that if they are even a little sick to stay away please. I have already had MRSA 2X in under 1.5 years about 10 years ago and nearly died. My Rheum knows all this and I had plenty of labs before he gave the MTX/folic acid RXs, but I am still shaky about taking the first dose. Stressed. Any suggestions are welcomed and I would like to heard from anyone about how their MTX lives are going. Has it helped at all? Thank you.   Moi`