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Yes, there are potential risks when combining folic acid and methotrexate. Methotrexate is a medication used to treat various conditions such as rheumatoid arthritis, psoriasis, and certain types of cancer [1]. Folic acid, on the other hand, is a type of B vitamin that is often used as a supplement to prevent or treat folate deficiency [2].

When methotrexate is taken alone, it can decrease the body's levels of folate, which can lead to side effects such as mouth sores, stomach upset, and anemia [1]. To prevent these side effects, healthcare providers may recommend that patients take folic acid supplements [1].

However, taking folic acid supplements while taking methotrexate can reduce the effectiveness of methotrexate [1]. This is because folic acid can help the body to break down and remove methotrexate from the body more quickly, which can reduce the amount of time that methotrexate is active in the body [1].

Therefore, it is generally recommended that patients take folic acid supplements on days when they are not taking methotrexate [1]. Patients should always follow the dosing instructions provided by their healthcare provider and should not change their dosage or stop taking their medication without first consulting with their healthcare provider [1].

In summary, while folic acid supplements can help to prevent side effects associated with methotrexate, taking them at the same time as methotrexate can reduce the effectiveness of the medication. Patients should always follow the dosing instructions provided by their healthcare provider.

Sources:

1. Mayo Clinic. (2021). Methotrexate (Oral Route). Retrieved from <https://www.mayoclinic.org/drugs-supplements/methotrexate-oral-route/side-effects/drg-20063830?p=1>
2. National Institutes of Health. (2021). Folic Acid. Retrieved from <https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/>
3. DrugPatentWatch. (2021). Methotrexate. Retrieved from <https://www.drugpatentwatch.com/drugs/methotrexate>