Role of folic acid supplementation in reducing side effects of oral methotrexate in patients of psoriasis: A study

• Main Authors: Tulika Rai, Satyendra Kumar Singh
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Indian Journal of Drugs in Dermatology
• Subjects: Folic acid; methotrexate; psoriasis; side effects
• Online Access: http://www.ijdd.in/article.asp?issn=2455-3972;year=2016;volume=2;issue=2;spage=83;epage=86;aulast=Rai

Background: Methotrexate (MTX) has been used for the treatment of severe psoriasis for more than 50 years. MTX use can be associated with many side effects, and folic acid is supplemented to reduce these side effects. MTX can be given orally or parenterally. Materials and Methods: In this study, a total of 81 patients of severe psoriasis were given 15 mg/week of MTX orally, and side effects were noted at each visit. Results: A total of 36 patients developed side effects, of which ten patients were discontinued due to the development of serious side effects. Remaining 26 patients developing nonserious side effects were given folic acid 5mg/day on non-MTX days and continued with 15 mg/week of MTX therapy. They were further evaluated for any improvement in side effects. Folic acid supplementation was associated with improvement in gastrointestinal and mucosal side effects in 17 out of 26 patients. Conclusion: Therapeutic effects were not compromised in all these patients after initiation of folic acid therapy. We recommend the supplementation of folic acid 5 mg/day in all patients of psoriasis who are receiving 15 mg/week of MTX therapy.