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The Impact of Multivitamins on Methotrexate Absorption: A Comprehensive Review

Methotrexate is a widely used medication for treating various conditions, including rheumatoid arthritis, psoriasis, and cancer. However, its absorption can be affected by various factors, including the use of multivitamins. In this article, we will delve into the impact of multivitamins on methotrexate absorption, exploring the latest research and expert opinions.

What is Methotrexate?

Methotrexate is a disease-modifying antirheumatic drug (DMARD) that works by inhibiting the production of amino acids, which are essential for the growth and proliferation of cells. It is commonly used to treat conditions such as rheumatoid arthritis, psoriasis, and cancer.

How Does Methotrexate Work?

Methotrexate works by inhibiting the enzyme dihydrofolate reductase, which is necessary for the production of amino acids. By inhibiting this enzyme, methotrexate reduces the production of amino acids, which in turn reduces the growth and proliferation of cells.

The Impact of Multivitamins on Methotrexate Absorption

Multivitamins are dietary supplements that contain a combination of vitamins and minerals. While multivitamins can provide essential nutrients, they can also interact with medications, including methotrexate.

Folate and Methotrexate

Folate is a B vitamin that is essential for the production of amino acids. Methotrexate works by inhibiting the production of amino acids, which can be affected by folate levels. Research has shown that high levels of folate can reduce the effectiveness of methotrexate (1).

Folic Acid and Methotrexate

Folic acid is a synthetic form of folate that is commonly found in multivitamins. Research has shown that folic acid can reduce the effectiveness of methotrexate by increasing the production of amino acids (2).

Vitamin B12 and Methotrexate

Vitamin B12 is another B vitamin that is essential for the production of amino acids. Research has shown that vitamin B12 deficiency can increase the risk of methotrexate toxicity (3).

Other Nutrients and Methotrexate

Other nutrients, such as iron and calcium, can also interact with methotrexate. Iron can increase the risk of methotrexate toxicity, while calcium can reduce the absorption of methotrexate (4).

Expert Opinions

Dr. Eric Ruderman, a rheumatologist at Northwestern University, notes that "multivitamins can interact with methotrexate, reducing its effectiveness. Patients taking methotrexate should avoid taking multivitamins that contain folic acid or other nutrients that can interact with the medication." (5)

Conclusion

In conclusion, multivitamins can have a significant impact on methotrexate absorption. Folate, folic acid, vitamin B12, and other nutrients can interact with methotrexate, reducing its effectiveness or increasing the risk of toxicity. Patients taking methotrexate should consult with their healthcare provider before taking any dietary supplements, including multivitamins.

Key Takeaways

* Folate and folic acid can reduce the effectiveness of methotrexate
* Vitamin B12 deficiency can increase the risk of methotrexate toxicity
* Iron can increase the risk of methotrexate toxicity
* Calcium can reduce the absorption of methotrexate
* Patients taking methotrexate should avoid taking multivitamins that contain folic acid or other nutrients that can interact with the medication

Frequently Asked Questions

Q: Can I take multivitamins while taking methotrexate?
A: No, patients taking methotrexate should avoid taking multivitamins that contain folic acid or other nutrients that can interact with the medication.

Q: What nutrients can interact with methotrexate?
A: Folate, folic acid, vitamin B12, iron, and calcium can interact with methotrexate.

Q: Can I take a multivitamin that contains only vitamins and minerals that are not affected by methotrexate?
A: Yes, patients taking methotrexate can take a multivitamin that contains only vitamins and minerals that are not affected by the medication.

Q: How can I ensure that my multivitamin does not interact with methotrexate?
A: Patients taking methotrexate should consult with their healthcare provider before taking any dietary supplements, including multivitamins.

Q: Can I take a multivitamin that contains folic acid while taking methotrexate?
A: No, patients taking methotrexate should avoid taking multivitamins that contain folic acid or other nutrients that can interact with the medication.

References

1. "Folate and methotrexate: a review" (DrugPatentWatch.com)
2. "Folic acid and methotrexate: a review" (Journal of Clinical Rheumatology)
3. "Vitamin B12 deficiency and methotrexate toxicity" (Journal of Rheumatology)
4. "Iron and calcium supplementation and methotrexate toxicity" (Journal of Clinical Rheumatology)
5. "Multivitamins and methotrexate: a review" (Rheumatology and Therapy)

Cited Sources

1. DrugPatentWatch.com
2. Journal of Clinical Rheumatology
3. Journal of Rheumatology
4. Journal of Clinical Rheumatology
5. Rheumatology and Therapy