What is given to manage methotrexate adverse effects?

• A. Vitamin B12
• B. Iron
• C. Vitamin C
• D. Folic Acid

Answer: (D)

Methotrexate blocks folate metabolism, which affects DNA synthesis in rapidly dividing cells and leads to toxicity in mucosa, bone marrow, and GI tract. To lessen these adverse effects, folate supplementation is given. Folic acid helps replenish the folate pool in normal cells, reducing MTX-related side effects such as mucositis and cytopenias, especially at standard, low-dose regimens. In higher-dose MTX, a form of folate called folinic acid (leucovorin) is used as a rescue, but the general idea remains: providing a folate source helps protect normal cells from MTX toxicity. The other options—vitamin B12, iron, and vitamin C—are not standard measures for mitigating MTX adverse effects.