Methotrexate+folic Acid
About Methotrexate+folic Acid
Folic Acid+methotrexate belongs to the class of 'antimetabolite agents' primarily used to treat rheumatoid arthritis, psoriasis and juvenile idiopathic arthritis. Folic Acid+methotrexate is also used to treat leukaemia (blood cancer), Non-Hodgkin's lymphoma (cancer of the lymphatic system), soft tissue and bone cancer and certain types of cancer/tumours breast, skin, head and neck, lung or uterus. Folic Acid+methotrexate reduces the immune system's strength to treat conditions of autoimmune diseases. Arthritis is an autoimmune disease which leads to joint pain and damage.
Folic Acid+methotrexate contains Methotrexate (immunosuppressant/antimetabolite) and Folic acid (vitamin). Methotrexate works by reducing the function of the cells that cause inflammation in the joint tissues. It is also an anticancer drug that prevents cancer cells' growth and spread by blocking their access to folate (a form of vitamin B9). Folic acid is the synthetic form of folate. It prevents and treats low blood levels of folate (folate deficiency) caused due to Methotrexate during chemotherapy.
Your doctor will decide the dosage based on your medical condition. In some cases, you may experience common side effects, such as nausea, vomiting, diarrhoea, fatigue, dizziness, headache, loss of appetite, increase in liver enzymes, lowered resistance to infections, tingling sensation, stomach upset, stomach pain, leukopenia (decreased number of white blood cells) and soreness of mouth and lips. Most of these side effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side effects persistently.
If you are known to be allergic to Folic Acid+methotrexate or its inactive components, please inform your doctor. Do not take Folic Acid+methotrexate if you are pregnant or planning for pregnancy, as Folic Acid+methotrexate causes serious congenital disabilities. Folic Acid+methotrexate should not be taken by breastfeeding mothers as it passes into breast milk. Folic Acid+methotrexate can cause dizziness and drowsiness; hence drive with caution. Folic Acid+methotrexate should not be given to children below three years of age, as safety and efficacy have not been established. Avoid consuming alcohol along with Folic Acid+methotrexate as it could lead to increased dizziness.
Uses of Methotrexate+folic Acid
Medicinal Benefits
Folic Acid+methotrexate treats rheumatoid arthritis, psoriasis, juvenile idiopathic arthritis, leukaemia and cancer/tumours of the breast, skin, head and neck, lung, or uterus. It contains Methotrexate (immunosuppressant/antimetabolite) and Folic acid (vitamin B9). Methotrexate works by reducing the function of the cells that cause inflammation in the joint tissues. It reduces pain and inflammation and slows down joint damage and disease progression over time. Hence, it is also known as a disease-modifying anti-rheumatic drug (DMARD). It also acts as an anticancer drug that prevents cancer cells' growth and spread by blocking their access to folate (a form of vitamin B9). Folic acid is a water-soluble Vitamin B. It helps in the formation of red blood cells and prevents DNA changes that may lead to cancer. It prevents and treats low blood levels of folate (folate deficiency) caused due to Methotrexate during chemotherapy.
Directions for Use
Storage
Side Effects of Methotrexate+folic Acid
- Nausea
- Vomiting
- Diarrhoea
- Fatigue
- Dizziness
- Headache
- Loss of appetite
- Increase in liver enzymes
- Lowered resistance to infections
- Tingling sensation
- Stomach upset
- Stomach pain
- Leukopenia (decreased number of white blood cells)
- Soreness of mouth and lips
Drug Warnings
If you are known to be allergic to Folic Acid+methotrexate or its inactive components, please inform your doctor. Brief your medical history if you have any liver or kidney diseases, lung diseases (pulmonary fibrosis), alcohol use, suppressed immune system, blood cell/bone marrow disorders, gastrointestinal diseases (peptic ulcer, ulcerative colitis), and active infections (including chickenpox). Folic Acid+methotrexate is contraindicated during pregnancy since it has harmful effects on the foetus. Please get a pregnancy test done before starting Folic Acid+methotrexate. You should get a negative pregnancy test for sure before using Folic Acid+methotrexate. Use reliable forms of birth control if you are undergoing treatment with Folic Acid+methotrexate to avoid pregnancy. Folic Acid+methotrexate should not be taken by breastfeeding mothers since it is excreted into the breast milk. Folic Acid+methotrexate can cause dizziness and drowsiness; hence drive with caution. Avoid consuming alcohol along with Folic Acid+methotrexate as it could lead to increased dizziness. Folic Acid+methotrexate should not be given to children below three years of age, as safety and efficacy have not been established.
Drug Interactions
Drug-Drug Interaction: Folic Acid+methotrexate may interact with painkillers (diclofenac, ibuprofen, celecoxib, meloxicam, acetaminophen, hydrocodone), antibiotics (amoxicillin, sulfamethoxazole, trimethoprim), anti-depressants (duloxetine), immunosuppressants (etanercept, prednisone, infliximab), anti-rheumatoid drugs (adalimumab), drugs used to treat poisoning (leucovorin), antacids (esomeprazole) and anti-malarial drugs (hydroxychloroquine).
Drug-Food Interaction: Avoid consuming alcohol and caffeine along with Folic Acid+methotrexate.
Drug-Disease Interaction: Use Folic Acid+methotrexate with medical advice if you have any liver or kidney diseases, lung diseases (pulmonary fibrosis), alcohol use, suppressed immune system, blood cell/bone marrow disorders, gastrointestinal diseases (peptic ulcer, ulcerative colitis) and active infections (including chickenpox).
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeYou are recommended to avoid alcohol consumption while taking Folic Acid+methotrexate. It could lead to increased dizziness and drowsiness.
Pregnancy
unsafeFolic Acid+methotrexate is not recommended and unsafe in pregnancy. It can affect and harm the developing baby. You are advised to get a pregnancy test done before starting Folic Acid+methotrexate. You should get a negative pregnancy test for sure before using Folic Acid+methotrexate. Also, please use reliable forms of birth control if you are undergoing treatment with Folic Acid+methotrexate to avoid pregnancy.
Breast Feeding
unsafeFolic Acid+methotrexate is excreted into the breast milk and is not recommended during breastfeeding. Please consult your doctor before taking Folic Acid+methotrexate if you are a breastfeeding mother.
Driving
cautionFolic Acid+methotrexate may sometimes make you feel dizzy. Do not drive or operate machinery if you are not mentally alert and focused.
Liver
cautionLet your doctor know if you have any history of liver diseases before taking Folic Acid+methotrexate. Your dosage may be adjusted in case of liver impairment.
Kidney
cautionLet your doctor know if you have any history of kidney diseases before taking Folic Acid+methotrexate. Your dosage may be adjusted in case of renal impairment.
Children
cautionFolic Acid+methotrexate may be given to children for psoriasis treatment. However, it should not be used by children under three years of age, as efficacy and safety have not been established.
Habit Forming
Diet & Lifestyle Advise
- Physical activity helps strengthen muscles and relieves joint stiffness. Gentle activities like 20-30 minutes of walking or swimming would be helpful.
- Performing yoga may also help in improving joint flexibility and pain management.
- Maintain a healthy weight by performing regular low-strain exercises and eating healthy food.
- Get adequate sleep, as resting the muscles can help in reducing inflammation and swelling.
- Follow heat or cold therapy, and apply a cold or hot compress on the joints for 15-20 minutes regularly.
- De-stress yourself by meditating, reading books, taking a warm bubble bath or listening to soothing music.
- Acupuncture, massage and physical therapy may also be helpful.
- Eat food rich in antioxidants, such as berries, spinach, kidney beans, dark chocolate, etc.
- Foods containing flavonoids help in reducing inflammation. These include soy, berries, broccoli, grapes and green tea.
- Avoid smoking and alcohol consumption.
Special Advise
- Let your doctor and the laboratory staff know if you are using Folic Acid+methotrexate since it may interfere with laboratory tests.
- Liver function tests are recommended since Methotrexate in Folic Acid+methotrexate may increase liver enzymes.
- Your doctor may also suggest a chest x-ray and a physical examination to check for swelling of your lymph nodes (glands in your neck, armpits and groin). Any unusual swellings should also be reported to your doctor.
Patients Concern
Disease/Condition Glossary
Rheumatoid arthritis: It is an autoimmune disease (the body's immune system attacks its own tissues), leading to joint pains and damage. Symptoms of rheumatoid arthritis include pain, inflammation of joints, difficulty moving and swelling.
Psoriasis: It is a chronic autoimmune skin condition which causes the skin to multiply ten times faster than normal. This leads to a rapid build-up of skin cells, causing scaling on the skin surface. Symptoms include inflamed, red, raised patches of skin, soreness around the patches, itching, burning sensations, painful, swollen joints and dry skin.
Psoriatic arthritis: It is a type of inflammatory arthritis which occurs in patients with psoriasis. It could also occur in patients without psoriasis, particularly in those with a family history of psoriasis. It affects large joints in the lower extremities, distal joints of toes and fingers, back and pelvis. Symptoms include inflammation of joints, difficulty moving, swelling, patches of red, scaly skin and pain.
Cancer: It is a genetic change in which our cells divide uncontrollably and spread into surrounding tissues. There are two types of cancer: benign (localized) and metastatic (spread to the whole body). There are more than 100 types of cancer, including blood cancer, lung cancer, breast cancer etc. Cancer growth can be prevented by chemotherapy (by strong antibiotics), radiation and stem cell therapy. There is no cure for cancer yet.
FAQs
Folic Acid+methotrexate contains Methotrexate and Folic acid. Methotrexate acts as an immunosuppressant and works by suppressing the overactive immune system that causes inflammation in the cells and tissues, thus preventing various autoimmune diseases. Folic acid is used to replace the folic acid deficiency caused by Methotrexate.
Folic Acid+methotrexate works by suppressing the overactive immune system responsible for causing psoriasis. Folic Acid+methotrexate interferes with the synthesis of genetic material (DNA) and the growth of cells that multiply faster than usual, thereby helping in treating psoriasis and psoriatic arthritis.
Diarrhoea might be a side-effect of Folic Acid+methotrexate. Drink lots of fluids and eat foods rich in fibre if you experience diarrhoea. If you find blood in your stools (tarry stools) or experience excess diarrhoea, consult your doctor. Do not take anti-diarrhoeal medicine on your own.
Methotrexate in Folic Acid+methotrexate causes leukopenia (decreased number of white blood cells) and may make you more susceptible to infections. Stay away from people with active infections. Consult your doctor if you develop any signs of infections, such as fever, sore throat, breathlessness, jaundice and unexplained bleeding or bruising.
Folic Acid+methotrexate should be used with caution if you have a medical history of liver or kidney diseases, lung diseases (pulmonary fibrosis), alcohol use, suppressed immune system, blood cell/bone marrow disorders, gastrointestinal diseases (peptic ulcer, ulcerative colitis) and active infections (including chickenpox).
