Folic acid

Ariana Member Posts: 26
edited 28. Nov 2023, 14:10 in Living with arthritis

Hi, i have been diagnosed with RA and have been prescribed folic acid, initially to take once a week. However, after talking to my rheumatology nurse about a side effect of methotrexate, mouth ulcers, she recommend I take folic acid 3 times a week.

I just wonder if anyone has had this experience of mouth ulcers and had their folic acid dose increased. I’m not sure it’s necessary as the one mouth ulcer I had has cleared up. I’d be grateful for any advice. Thanks.


  • JenHB
    JenHB Member Posts: 130

    interesting! Just over a year ago I started on methotrexate and was also prescribed 5mg folic acid to take 6 days a week (just miss the day I take the methotrexate). Sorry it's not really advice....

  • Wenwoo
    Wenwoo Member Posts: 16

    I started on once weekly but now I’m on 6 times weekly not because of mouth ulcers sorry x

  • jamieA
    jamieA Member Posts: 605

    Hi @Ariana

    Like @JenHB when I started on MTX I was put on 5mgs folic acid 6 days a week. I don't think it's just to protect against mouth ulcers. This is from the NHS website

    'You may be prescribed folic acid tablets while you're taking methotrexate. This is a synthetic version of vitamin B9 (also called folate).

    Folic acid helps protect the healthy cells in your body and reduces some of the side effects of methotrexate. It can make you less likely to be sick (vomit) or get diarrhoea.'

    And from the BMJ

    'Folic acid supplementation during methotrexate therapy can reduce the risks of adverse effects including nausea, vomiting, abdominal pain, mouth ulcers, raised liver enzymes and bone marrow toxicity.'

  • stickywicket
    stickywicket Member Posts: 27,606

    Dosagemof folic acid does seem to depend on the patient. I've always taken two a week but others take from one to six. Personally, I'd do as advised but check at your next appt.

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  • Lambourne
    Lambourne Member Posts: 21

    I started on one folic acid a week with Methotrexate and it increased to 3 a week as I had mouth ulcers which then went away but my hair was falling out so it went up to 6 a week. My hair has stopped falling out so I am decreasing the folic acid to 3 , my Methotrexate has gone down from 6 to 4 a week as I am now taking Adalimumab.