What should be taken with methotrexate to reduce adverse effects?

What should be taken with methotrexate to reduce adverse effects?

• A. Vitamin B12 supplement
• B. Vitamin C
• C. Folic acid supplement
• D. Vitamin D

Answer: (C)

Methotrexate blocks an enzyme in the folate pathway, decreasing availability of folate needed for DNA synthesis in rapidly dividing cells. Giving folic acid replenishes folate stores, helping to reduce common adverse effects like mucositis, myelosuppression, and hepatotoxicity without typically compromising the drug’s effectiveness in many regimens. In higher-dose MTX, a rescue approach with folinic acid can be used, but for standard dosing, folic acid supplementation is the usual means to lessen toxicity. Other vitamins (like B12, C, or D) don’t counteract the MTX-related folate blockade and aren’t used for this purpose.

Methotrexate blocks an enzyme in the folate pathway, decreasing availability of folate needed for DNA synthesis in rapidly dividing cells. Giving folic acid replenishes folate stores, helping to reduce common adverse effects like mucositis, myelosuppression, and hepatotoxicity without typically compromising the drug’s effectiveness in many regimens. In higher-dose MTX, a rescue approach with folinic acid can be used, but for standard dosing, folic acid supplementation is the usual means to lessen toxicity. Other vitamins (like B12, C, or D) don’t counteract the MTX-related folate blockade and aren’t used for this purpose.