Dose of 10 mg Folic Acid for methotrexate for rheumatoid arthritis

A dose of l0mg folic acid daily did not compromise therapeutic efficacy of methotrexate. How folic acid supplementation could take care of non-gastrointestinal side effects as well is difficult to explain. They were able to use methotrexate in even higher dosage without associated gastrointestinal symptoms. Similar results were experienced by Duhra et al. In this study it was possible to abolish or reduce severity of gastrointestinal symptoms induced by methotrexate by supplementation with folic acid. Thus, it should be possible to abolish these adverse effects by reducing intracellular methotrexate to folate ratio by folic acid supplementation. Therefore, the centrally mediated gastrointestinal effects of methotrexate may be produced via intracellular folate depletion. Reduced folate is involved in normal synthesis and metabolism of neurotransmitters in central nervous system. Intracellular accumulation of methotrexate and its metabolites result in depletion of folate store. However dosage lower than 15mg/week may not achieve the desired control of psoriasis.