Folic acid and rheumatic treatment 4/5 (1)

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This page contains a brief description that does not cover the medication. For more information read the review in for the respective drug.

Folic acid in rheumatic disease

  • Folic Acid Tablets 1mg: Supplement by Methotrexate treatment in rheumatology. Prescribed by a doctor on a "blue prescription" in Norway
    • The mechanism of action has not been elucidated, but folic acid appears to reduce the incidence of methotrexate side effects such as nausea and high liver enzymes. Protective effect on mouth ulcers and low blood cells (anemia, leukopenia, thrombocytopenia) are uncertain
  • Folic acid (especially calcium folinate: Leucovorin, Recuvolin) is antidote to methotrexate. Calcium folinate is not given concomitantly with methotrexate except in the treatment of poisoning. Calcium folinate is used little in rheumatology because the drug is more expensive than folic acid
  • Folic acid 1mg / day is not believed to reduce the methotrexate effect. A Cochrane summary this year 2000 showed a tendency for several tender joints among those receiving folic acid supplements for Metotrexate-treated rheumatoid arthritis (reference: Oritz Z, 2000). An updated review in 2013 concludes that Folic acid does not (statistically) appear to reduce the methotrexate effect (reference: Shea B, 2013)
    • Many people recommend Folic acid 1 tablet every day for Metotrexate treatment. Dosage 5-6 days a week (excluding the Metotrexate day and any subsequent day) is also used
  • Before and during pregnancy (first three pregnancy months) Folic acid tablets 0,4mg / day are used preventively against Spina Bifida in fetus (reference: Public Health)
  • Lack of folic acid can be seen at Celiac Disease and other conditions with reduced intestinal uptake or nutritional problems.



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