Methotrexate is used in cancer chemotherapy as well as for treating inflammatory diseases such as rheumatoid arthritis and psoriasis.
Potassium citrate and other forms of citrate (e.g., calcium citrate, magnesium citrate) may be used to prevent kidney stones. These agents work by making the urine less acidic.
It may be advisable to avoid these citrate compounds during methotrexate therapy except under medical supervision.
St. John's wort (Hypericum perforatum) is primarily used to treat mild to moderate depression.
The herb dong quai (Angelica sinensis) is often recommended for menstrual disorders such as dysmenorrhea, PMS, and irregular menstruation.
Methotrexate has been reported to cause increased sensitivity to the sun, amplifying the risk of sunburn or skin rash. Because St. John's wort and dong quai may also cause this problem, taking these herbal supplements during methotrexate therapy might add to this risk.
It may be a good idea to wear a sunscreen or protective clothing during sun exposure if you take one of these herbs while using methotrexate.
The herb white willow (Salix alba) , also known as willow bark, is used to treat pain and fever. White willow contains a substance that is converted by the body into a salicylate similar to aspirin.
Folate (also known as folic acid) is a B vitamin that plays an important role in many vital aspects of health, including preventing neural tube birth defects and possibly reducing the risk of heart disease. Because inadequate intake of folate is widespread, if you are taking any medication that depletes or impairs folate even slightly, you may need supplementation.
Methotrexate is called a "folate antagonist" because it prevents the body from converting folate to its active form. In fact, this inactivation of folate plays a role in methotrexate's therapeutic effects. This leads to an interesting Catch-22: methotrexate use can lead to folate deficiency, but taking extra folate could theoretically prevent methotrexate from working properly.
Note: Folate supplements have only been found safe as supportive treatment in the specific conditions noted above. It is not known, for example, whether folate supplements are safe for use by individuals taking methotrexate for cancer treatment.
- Reviewer: EBSCO CAM Review Board
- Review Date: 08/2013 -
- Update Date: 08/22/2013 -