The relationship between methotrexate and folate

Methotrexate is a drug for the treatment of rheumatoid arthritis Rheumatoid arthritis (RA) is a disease in which the immune system attacks joint tissue, causing inflammation and damage to the whole body's joints Methotrexate reduces immune system activity, but has toxic effects on bone marrow, heart and liver functions It is said that taking vitamin B9 or folic acid can reduce the toxicity of methotrexate, but the interaction between methotrexate and folic acid is still a controversial topic At present, there is no specific conclusion about how much folic acid can reduce the toxicity of methotrexate without affecting the efficacy In the treatment of rheumatoid arthritis, methotrexate is usually used in the form of tablets or injection once a week Potential side effects include oral ulcers, rashes, diarrhea, nausea and hair loss The drug can also cause liver problems and affect bone marrow, causing too little production of blood cells Methotrexate can occasionally cause lung inflammation and shortness of breath Some doctors recommend a combination of methotrexate and folic acid to reduce the risk of these side effects It is recommended to take folic acid health products together with methotrexate because methotrexate can cause folic acid deficiency Although some studies have shown that folic acid can reduce the side effects of methotrexate, there are also concerns that folic acid will reduce the efficacy of the drug On the other hand, about one in three patients stopped taking methotrexate within one year due to side effects Therefore, if the combination of methotrexate and folic acid can let patients continue to use drugs, it is obviously beneficial Although the effect of combination of methotrexate and folic acid is still being evaluated, some doctors recommend taking folic acid (one day after taking methotrexate) weekly for maximum benefit Other doctors suggest taking folic acid only when patients need it more, such as when the level of folic acid drops due to infection At present, more research is needed on the combination of methotrexate and folic acid Patients should discuss the advantages and disadvantages of this treatment with doctors.