Do you recommend patients hold folic acid on the day they take methotrexate?

The proposed mechanism of action (MOA) of methotrexate in rheumatic disease is not from the antimetabolite angle (given its oncologic MOA as a dihydrofolic acid reductase inhibitor), but rather as a potent anti-inflammatory and immunomodulatory medication through the MOA of extracellular adenosine a...

I think it is worth considering what actions are taken during clinical trials when considering this practice. Without referencing all clinical trials performed, I can comment on my recollection of the clinical trials in which I acted as an investigator. To my recollection, weekly methotrexate dosing...